Chronic Obstructive Pulmonary Disease (COPD) is a very serious and common respiratory disease that restricts the flow of air to the lungs, causing inflammation and damage to the lung tissue and narrowing of the airways, resulting in difficulty breathing. Millions of people worldwide suffer from COPD. For Bulgaria, it is assumed that the sufferers are over half a million people. The disease is usually detected at a late stage, and most sufferers begin treatment only when irreversible changes have occurred in their lungs. In Europe alone, 300,000 people die from COPD every year. The disease kills more people annually than breast and lung cancer combined. The forecast is that by 2030, the disease will be the second cause of death in the world
COPD is among the most common chronic diseases in people over 45 and one of the leading causes of death. The frequency of COPD in our country is significantly above the average for Europe and covers 10% of people over 40 years of age, commented specially for the "Doctor" Prof. Dr. Daniela Petrova, head of the Department of Pulmonary Diseases at the Clinic for Propaedeutics of Internal Medicine at Aleksandrovsk Hospital, member of the Management Board of the "Science and He alth" Foundation.
Prof. Petrova, is there a genetic predisposition to lung diseases?
- Genetic studies have been carried out, which lead to a certain predisposition in a certain contingent of patients. As an example, I can mention the development of atopy in patients with COPD, but these are only predispositions to a certain reaction of the mucosa, not to the specific disease. Depending on social and living conditions, both asthma and COPD can develop.
COPD seriously impairs the quality of life of those affected. Fatigue, insomnia and shortness of breath often limit their physical activity and lead to a limitation of the role of these patients in the social and economic sphere of life. The inability to perform basic physical activities in daily life condemns COPD sufferers to loneliness and social isolation, and they often suffer from anxiety and depression. This dictates the need for a clinical psychologist and ensuring that people with COPD have access to qualified professionals to help them overcome despair and cognitive changes during the course of the disease. I believe that a joint effort of all institutions at the national level is needed to create an effective response practice and follow-up care by a psychologist for these patients.
Who are the risk groups?
- This is mostly the group of smokers as well as working different professions. For example, in catering establishments, painters, artists working with acetone paints and chemicals, as well as those living in large metropolises, such as Sofia. Using one pack of cigarettes a day for 10 years gives a 90% risk of developing COPD. In the final stages of this disease, patients are in a very serious condition, with shortness of breath, weakness, severely disabled. Their prognosis is not good at all.
What is the trend for the development of the disease?
- In 2020, worldwide, it is expected to become one of the first diseases in terms of mortality. The increase in mortality in the disease is due to the inability to cope with smoking. Bulgaria is one of these countries - we still prohibit smoking, at least in public places, and we still cannot enforce it. Environmental pollution is one of the next risk factors.
Are passive smokers at risk?
- Statistics show that they suffer from COPD more often. Smoking near children leads to more frequent illnesses from bronchitis, including asthma. There are observations that sick children, with a genetic predisposition, if they have smoking parents and live among the smoke, the tendency for morbidity in them is significantly higher. Children subsequently have lower lung volumes and suffer more often from obstructive diseases.
What are the symptoms of the disease?
- COPD does not appear suddenly. It is found mostly in people aged 40-50 who have smoked 10-20 cigarettes a day for at least 20 years. The disease is characterized by a chronic cough. It is more common in the morning and is accompanied by the release of a scanty, colorless, stringy secretion. Shortness of breath, or shortness of breath, is the main symptom, but it appears in the later stages of the disease. Dry wheezes are heard when breathing, especially during physical exertion.
The disease can also appear with heart failure, anorexia, weight loss. These are usually signs of decompensation and require urgent hospital treatment.
Symptoms of the disease are the presence of a chronic cough with or without sputum discharge, difficulty breathing during exertion or at rest, reduced physical capacity and easy fatigue, impaired quality of life. The diagnosis is confirmed by a functional breathing test called spirometry.
Can the disease be prevented?
- COPD cannot be cured, but it can be prevented. The prevention of this disease mainly includes quitting smoking, avoiding passive smoking, staying in polluted air, regular prevention and early treatment of respiratory infections, and in no case self-medication.
What is the treatment?
- The goal of treatment is to improve lung function and prevent exacerbations and complications of the condition. Stopping smoking and cutting off contact with air pollutants are the first and main steps in the treatment of obstructive bronchitis. Medicines and antibiotics are also used, because the development of COPD is almost always associated with the risk of infection of already damaged lungs.
Can we talk about prevention of COPD?
- It is basic and depends mostly on ourselves. Smoking, consuming more alcohol, not exercising, living unreasonably and sedentary means that the Bulgarian is neglecting his future. The Bulgarian is a pessimist, and this pessimism is deeply embedded in our immune system, making us susceptible to many diseases. A Bulgarian should be told a few simple things - to eat more fruits and vegetables, to do sports, not to eat sugar and confectionery, not to smoke and to look more happily at his work and the people around him.