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Chronic Obstructive Pulmonary Disease (COPD): Review

Chronic Obstructive Pulmonary Disease (COPD) is nowadays, spreading widely across the globe. COPD is increasingly becoming a natural burden and anticipated to as the rank third cause of mortality by 2020. There is a need to establish an early diagnosis for the disease. Similarly, clinical context and risk factors that accompany COPD are essential for positive diagnosis, but pulmonary function tests are imperative for confirmation purposes. COPD is commonly associated with smocking. Cigarette smoking ranks as the main cause of COPD. However, water-pipe smocking is becoming prevalent behavior in most Middle Eastern countries and thus, becoming a significant causal factor for COPD. A systematic study conducted by medical practitioner in April 2011 in Easter countries to determine the link of water-pipe-smoking and COPD indicated that water-pipe smocking is a significant casual factor of COPD. The study revealed that water-pipe smoking negatively affects lung function and is equally dangerous as cigarette smoking.

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Water-pipe smoking is featuring as the emerging second major cause of COPD. There exist a long-term casual association between cigarette smoking and COPD, with cigarette smoking ranking as the leading single most important risk factor for COPD. A current study about the trend of water-pipe smoking, which is a tobacco consumption method, indicates that it is increasing globally at an alarming rate. A recent study of the same has linked water-pipe smoking with lung and esophageal cancer, periodontal diseases as well as low birth weight. Various studies about the relationship between water-pipe smoking and COPD indicate that symptoms of chronic bronchitis are high (11.7% of water-pipe smokers) as compared to 9.5% for cigarette smokers and 0% for non-smokers respectively. Smoking ranks as the main cause of emphysema and therefore, the increase global adoption of water-pipe smoking is likely to aggravate the situation (Strauss, 1999).

COPD are those diseases that affect the lungs. They include diseases such as emphysema, chronic bronchitis that make patients to have trouble while breathing. The disease mainly affects people aged above 35 years. In the UK, over 2 million people suffer from COPD. The disease is not easily diagnosable and thus, majority of people live with it untreated, mistaking it for smoke cough. The main cause of COPD is smoking, with men ranking as the leading victims. The likelihood of suffering the disease increases with how often one smokes, and the longer one smokes. When, individuals suffer from COPD, they experience trouble while breathing in and out because of obstruction of the airways. In addition, COPD causes the destruction of the lungs through inflammation. When persons persist using water-pipe smoking, smoking damages the lungs further. The continuous inflammation of the lungs results to permanent changes in the lungs. Therefore, the lungs produce more mucus and the airways become thicker in response to the inflammation. The overproduction of mucus obstructs airflow, which makes breathing difficult. Similarly, over smoking leads to the destruction of the air sac, this makes the lungs lose their standard elasticity. The loss of elasticity then makes the breathing process difficult, phlegm and cough that accompany COPD (Davidson, 2000).

The diagnosis of COPD entails a thorough exercise. The process involves the doctor gathering a patient’s medical and family history, as well as carrying appropriate tests. The patients history will entail requesting the patient whether he/she smokes, had contact with lung irritants such as secondary smoking, air pollutants, dust and chemical fumes. The doctor also tries to learn whether the patient experiences any cough and if so, how often and the amount of mucus that comes out when coughing. When examining the patient, the doctor uses a stethoscope to listen for any whistling or abnormal chest sounds. Other tests that doctors use to determine COPD are spirometry or lung diffusion capacity test. Doing diagnosis using a Spirometry entails requesting a patient taking a deep breath and puffing the air into a tube that that links to a spirometer. Spirometer calculates the air a patient breathes out, as well as how fast the patient breathes out. The doctor may then give the patient some medicine to open the airways and then request the patient to repeat the process in order to compare the two results.

The spirometer is important because it can test COPD before symptoms develop. In addition, doctors can use it to determine the extent of COPD of a patient. This is important in assisting the doctor to set the treatment goals depending on the seriousness of COPD detected. The Forced Vital Capacity (FVC) is the maximum air that one can exhale forcibly. It shows flexibility and capacity of the lung, as well as how easily the airways allow air to pass through. The Forced Expiratory Volume is the maximum quantity of air one can exhale per second. For moderate COPD patients the FEV should range between 50-80%, for severe COPD the FEV should be 30-50%, while the ratio for FVC (FEV)/FVC ought to be less 70% of normal despite the COPD patient has FEV less than 50% or greater than 80%. Chest X-ray is another important test that doctors can use to test COPD. A Chest CT scan as often referred is important as it shows a picture of all the structures inside the chest, which can indicate signs of COPD. The scan is important because it may determine whether the patient’s condition is because of impending heart failure or COPD (Bowler, 2009). Finally, doctors may opt to use an arterial blood gas test that measures the amount of oxygen in the blood. This test is imperative in determining the seriousness of the COPD and whether, the patient requires oxygen therapy. Doctors prescribe oxygen therapy for COPD Patients who have PaO2 ≤ 55mmHg or SaO2 ≤ 88% (Murphy, 2001).

In determining the causal relationship between water-pipe smoking and COPD, the researcher will get a sample of people identified with symptoms of COPD who consume water-pipe smoking and non-smokers. The researcher will measure the level of oxygen in the patients’ blood sample when starting and ending the investigation using the arterial diffusion process. The researcher will also determine the amount of air the patients can breathe out, as well as how fast they can breathe out during the initiation and termination of the investigation. The researcher will make sure that the non-smokers get expose to other COPD causing agents such as dust, smoke and chemical fumes. The researcher will then determine the appropriate changes after a time span of three months in the sampled individuals, which will be imperative in determining how water-pipe smoking contributes to COPD as compared to other agents such as dust, chemical fumes and other air pollutants associated with COPD.

Reference List

Bowler. (2009). COPD Diagnosis. Web.

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Davidson, P. (2000).Chronic Obstructive Pulmonary Disease. New York: Prentice Hall.

Murphy, R. (2001).Emergency oxygen therapy for the COPD patient. Emergency Medicine Journal, 8, 5, 333-339.

Strauss, N. (1999). COPD, Cigarette and Water-Pipe Smoking. Emergency Medical Journal. 3, 2, 123-135.

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