The increasing prevalence of Chronic Obstructive Pulmonary Disease (COPD), which is quite common in our country and all over the world, increases its importance. Chest Diseases Specialist Dr. Lecturer. Ü. Seha Akduman said that statistics show that two out of every ten people in adults and one out of every four smokers have COPD, but the real figure is much higher than this. Pointing out that there are quite striking changes in the 2024 GOLD Guidelines regarding both the diagnosis and treatment of the disease, which has been so common in all societies in recent years, Dr. Lecturer. Ü. Akduman made important statements.

What is COPD (Chronic Obstructive Pulmonary Disease)? 

COPD is defined as the combination of chronic bronchitis and emphysema. Chronic bronchitis is defined as obstruction in our airways, while emphysema is defined as the destruction of the air sacs that provide oxygenation. COPD patients have a combination of these two conditions.  Stating that the most important risk factor for the disease is the use of all tobacco products, especially cigarettes, our expert said, “The increase in the prevalence of cigarettes and unfortunately all tobacco products, including electronic cigarettes, is very important due to the risk it poses to public health.” He said.

What Causes COPD (Chronic Obstructive Pulmonary Disease)?

Pointing out that many risk factors other than smoking have been identified to accelerate the development and acceleration of COPD, Yeditepe University Kosuyolu Hospital Chest Diseases Specialist said, “Many factors ranging from low birth weight to viral infections in childhood, from occupations to dietary habits cause the effect of smoking on the risk factor of COPD to accelerate.”.

What are the Symptoms of COPD (Chronic Obstructive Pulmonary Disease)?

Underlining that if COPD is diagnosed early, its progression can be slowed down with treatment and the quality of life of patients can be preserved, our specialist explained the following about the symptoms that will be a warning for patients: “A persistent cough that is more intense especially in the morning and persists for more than 3 months may be a sign of COPD. In addition, shortness of breath and sputum production are among the most common complaints of patients. Patients complain that they have difficulty breathing during physical activity or even while doing simple daily tasks. Again, feeling the need to expectorate frequently, especially in the morning hours, and wheezing or chest tightness are typical symptoms of COPD.”
Reminding that despite being in the risk group, the patient may not be symptomatic or may not care enough about their symptoms to consult a doctor, Yeditepe University Kosuyolu Hospital Chest Diseases Specialist “Especially smokers, those over the age of 40 or those with chronic dust and chemical exposure should consult a doctor for COPD when they notice these symptoms. The disease progresses differently in each individual and the main goal of treatment is to reduce complaints and reduce attacks. Lung function deteriorates with each attack. The most important points to prevent attacks are appropriate treatment specific to the individual, vaccination, avoiding smoking and polluted air, providing additional oxygen support in necessary patients, and using devices that give positive pressure with CPAP and BIPAP.” He said. 

Is COPD a Common Disease?

Reminding that COPD is currently ranked fourth among the diseases that cause loss of life worldwide, our specialist said that it is estimated that approximately three million people worldwide lose their lives due to COPD every year. Pointing out that the prevalence of the disease is increasing in our country and in the world, Chest Diseases Specialist “It is thought that two out of every ten people in adults and one out of every four smokers have COPD.  It is known that the actual numbers are much higher than this. The most important factors in the expectation of an increase are the aging world population and increased exposure to all other risk factors, especially tobacco smoke.” He said.

How a COPD Attack Happens?

Reminding that COPD is a chronic disease that is progressive and progresses with attacks and for this reason, the whole process is affected by the patient and his family and relatives, Dr. Lecturer. Prof. Dr. Akduman continued his words as follows: “Exacerbations are defined as routine shortness of breath, wheezing and an increase in the amount of sputum. However, exacerbations can be mild and severe enough to require intensive care. Severe exacerbations may require long hospital and intensive care hospitalization. Therefore, this process creates a serious problem for the patient's relatives and the healthcare system.”

What are COPD Risk Factors?

“Lung development starts in the womb and the baby's exposure to cigarette smoke in particular disrupts lung development. Babies with low birth weight at birth are more likely to have COPD than other individuals.” Our expert continued his words as follows: 
“Although the main risk factors for COPD are exposure to tobacco smoke and other inhaled toxic particles and gases, recent research shows that COPD is caused by a combination of genetic and environmental risk factors that start in utero, continue during infancy and adolescence, and last a lifetime.”

How to Treat COPD?

Underlining that COPD is a preventable and treatable disease that manifests itself with symptoms such as shortness of breath, chronic sputum production and cough, Dr. Lecturer. Prof. Dr. Akduman said, “The GOLD 2024 (Global Initiative for Chronic Obstructive Lung Disease) Guideline of the disease, which has been so common in all societies in recent years, has quite striking changes regarding both diagnosis and treatment. Each patient has different levels of bronchitis and emphysema and each patient responds differently to treatment. Because of these differences, it is now considered a heterogeneous disease and each person should be treated according to these differences. One of the most important elements of success in treatment is that the treatment of each patient is preferred for the dominant pathology. COPD is now defined as a heterogeneous disease and it is underlined that each treatment should be individualized.”.

How COPD Disease Goes Away?

In the COPD guideline, which is updated every year, striking changes have been made in diagnosis, staging and treatment recommendations unlike the previous years. Our expert gave the following information about these changes, which have been accepted and implemented worldwide: “COPD, which had four stages until 2024, is now accepted in three stages, and treatment modalities are based on these three stages. We know that treatments such as smoking cessation, regular use of bronchodilator drugs that open the obstruction in the airways, vaccination, breathing exercises, pressurized devices called CPAP/BIPAP, and the addition of oxygen therapy reduce the loss of life.  In addition, it has become clear that the influenza vaccine, which we call influenza vaccine, improves the patient's quality of life and reduces the loss of life by preventing exacerbations. We were already recommending influenza and pneumonia vaccine in COPD patients, but this guideline shows that influenza vaccine has been proven to prolong life, especially in older COPD patients.”

Vaccination in COPD  

Our expert, who informed that the vaccination program has also been changed with this current guideline, gave the following information on the subject: “One of the changes is the introduction of Tdap (Tetanus - Diphtheria - Pertussis) and Shingles vaccine, which has also been introduced in our country. If patients have not had these vaccines before or are not sure if they have had them before, it is recommended because we know that pertussis in particular accelerates the progression to COPD exacerbations and pneumonia. Although resistance has developed in communities regarding the COVID vaccine, it remains among the recommended vaccines for patients with COPD. In order to slow down or stop the progression of COPD and prevent prolonged hospitalizations, vaccination and individualized drug therapy are especially emphasized. It is also recommended to change the treatment of patients with COPD in case of detection of cells that are allergy markers detected in the complete blood count, which we call eosinophils, which we normally do not consider in our diagnosis and treatment until today.”

Reminding that vaccination is much more important especially in the period we are in, Dr. Lecturer. Ü. Seha Akduman said, “It is very important for patients of all ages diagnosed with COPD to get these vaccines. In addition, people with asthma, chronic bronchitis, cardiovascular diseases and people with diabetes should also have these vaccines.”