Many COPD patients suffer from acute exacerbations where their symptoms suddenly get a lot worse and can result in hospitalisation. 75% of the time it is due to a lung infection whether bacterial or viral. The most common culprits are the influenza virus and Streptociccus pneumoniae, which cause the flu and pneumonia.
Bacteria and viruses cause infections in different parts of the lung and cause bronchitis if it occurs in the larger bronchial tubes or cause bronchiolitis if in the smaller bronchial tubes. An infection in the alveoli or air sacs of the lungs can cause pneumonia. Antibiotics are only effective against bacterial infections and viruses are more difficult to treat. Often a patient will acquire a secondary bacterial infection from having a viral one. This is due to the build up of mucus and inflammation in the lungs which create the perfect breeding ground for bacteria. This is why antibiotics are normally prescribed whether the infection is viral or bacterial as to protect from a secondary bacterial infection from occurring.
The other common causes of exacerbations are sinus infections, air pollution, heat failure and blood clots. It is so important that COPD patients try to avoid any of these triggers and try to prevent picking up any viruses or bacteria in order to prevent exacerbations.
The disease compromises the lung’s ability to defend against bacteria and a new study has shown that even when a patient isn’t experiencing an exacerbation, the bacteria that are colonized in their lungs are causing respiratory symptoms for them. Having bacteria in the lungs increases the inflammation and significantly increases the shortness of breath, cough and sputum in COPD patients. Doctors are aware that most stable patients experience daily fluctuations in respiratory symptoms but the reason why has never been understood until now. These fluctuations can sometimes be fairly intense and often qualify as exacerbations but go unreported to their doctor.
The study shows that medicine needs to alter its approach to treating stable COPD patients and not to focus on just the flare-ups but to understand that COPD is based around a chronic infection and treat accordingly.
“The lungs are constantly being exposed to microbes ‘with every breath you take’ as well as from aspiration of small amounts of secretions from the throat, especially during sleep,” Dr Sethi says. “If the persistence of these bacteria contributes to increased symptoms and inflammation in the lungs in stable COPD, we should regard this as a chronic infection, not innocuous colonization. For that reason, more must be done to reduce chronic infections in COPD.”
However due to resistance, long-term antibiotic treatment is not the way forward and “we need to put more emphasis on developing therapies that can decrease bacterial colonization in COPD.”
At the end of last year a company announced that the drug AB569 had been successful in trials and appears to be able to treat lung infections caused by Pseudomonas aeruginosa, a common culprit of lung infections in COPD and CF patients. This bacteria is common however it is also difficult to treat as it survives without oxygen and it has the ability to develop resistance against antibiotics as it holds a lot of resistant genes. It causes 40% of infections in children with CF and up to 75% of cases in adults with CF as well as a high percentage of COPD infections. If this drug can treat this bacteria and passes human trials then perhaps it can be used to help dramatically cut the number of infections and the resulting exacerbations suffered by COPD and CF patients and also ease their daily fluctuations of respiratory distress.
Here are eight tips that can help you reduce your risk of developing an infection:
- Wash your hands. Regular hand-washing is one of the most important things you can do to reduce your risk of infection.
- Avoid infections. Ask people who are sick not to visit until they are well again, and wear a face mask if you do have to come in contact with someone who has an infection.
- Clear your airways. It is important to keep airways free from mucus. Your doctor can give you devices and teach you manoeuvres to ensure your coughing is productive at shifting the mucus.
- Stay hydrated.
- Clean your equipment. All equipment that you use, including humidifiers, oxygen masks, and flutter valves, should be properly cleaned and maintained to ensure that they don’t harbour infectious organisms.
- Get vaccinated. Talk with your doctor about which vaccines you should get. In general, people with COPD should get a pneumococcal vaccine once, as well as a flu vaccine every year.
- Stay away from crowds. When possible, avoid large crowds, especially during cold and flu season.
- Treat infections as early as possible. Call your doctor at the first sign of infection, so it can be treated before it progresses to a more serious infection of your lungs.
- Breathe clean air if possible. Breathing in air from your supplemental oxygen unit and air that has been filtered in your home will be a lot cleaner and free from irritants such as pollen, dust and germs and will help to reduce the risk of an exacerbation.
References: www.webmd.com and www.buffalo.edu and http://lungdiseasnews.com and www.everydayhealth.com
The characteristic symptoms of COPD include a chronic and progressive cough and sputum production that can be variable from day to day; it may start off intermittently but towards the end will be frequent throughout the day.
The cough itself is an important defence mechanism that helps to clear foreign bodies and excess mucus from the lungs to allow better breathing. However a chronic cough has been found to be associated with detrimental psychological and physical effects on the patient’s life.
Depression, muscle strain and fatigue, sleep deprivation, incontinence and vomiting are all directly associated with coughing. Other related symptoms are rib fractures, fatigue, embarrassment, unconsciousness, difficult conversations on the phone, hoarse sound, unable to stand close to the their relatives due to their cough, and an inability to work in school or elsewhere.
In this new study it has been shown that a lower cough-specific quality of life is associated with a lessened ability to carry out daily activities due to its negative effect on fatigue and lower abdominal muscle endurance, and higher depression levels are also usually observed in patients with COPD.
When coughing the contraction of abdominal muscles is required. However with a chronic cough this can lead to a decline in the endurance of these muscles due to repeated overuse and resulting in them working ineffectively and not being able to help aid the cough or mucus clearance.
In a study of COPD patients with chronic coughs 33% were identified as anxious while 16% experienced depression and approximately 48% of all coughers had moderate or high trait anxiety. Also in general patients were at a higher risk of suffering from phobic anxiety, obsessional tendencies and depression showing that this group of individuals suffered from an emotional and psychological impact on their lives from their chronic cough.
53% of the group attended a speciality centre to help treat their chronic cough and depressive symptoms and there was a statistical improvement in both cough severity and depression scores after three months. This reinforces the fact that quality of life and chronic cough are linked but also that there is treatment to help improve both.
If cough is an important part of COPD and contributes to deterioration in quality of life, the symptom should be controlled and see your doctor who can help to ease your cough which in turn will hopefully improve your quality of life whether physically, psychologically or both.
Ensuring that you follow your doctor’s advice regarding medications and oxygen therapy regime, exercising and eating correctly will help to ensure that you are easing the COPD symptoms as much as possible and therefore also the cough. If you find you are coughing more and gasping for breath maybe your medical oxygen requirements need altering; whether it be an increased flow rate or different machinery to fit your lifestyle. Ask your doctor straight away as anything that you can do to ease the coughing and breathlessness will not only instantly improve your medical condition but will indirectly improve your general quality of life.
Pineapple juice has been shown to be 5 times more effective than cough syrup. It fights infection, kills bacteria, loosens mucus and suppresses coughs.
Pineapple juice contains an enzyme called bromelain, which has anti-inflammatory properties and is effective to combat lung inflammation. It is used to treat arthritis and is also used in the treatment of inflammation and swelling in the nose and sinuses. 1 cup also contains half of your daily requirement of Vitamin C intake. Vitamin C is essential because as well as many other uses, it also enables your body to metabolize certain vital enzymes that regulate your metabolism and manage energy. Pineapple juice also contains manganese, which is a mineral that helps form healthy connective tissue and bones. It also works to absorb more calcium, metabolize carbohydrates and fats and increases regular nerve function. Pineapple juice helps to soothe sore throats and helps to loosen and expel mucus from your lungs more easily.
The study also indicates that the bromelain naturally present in pineapple may provide similar effects if the cough you suffer from is due to asthma. Pineapple juice has also been used to treat other respiratory ailments such as bronchitis, hay fever, asthma and pneumonia. It’s even being tested as a possible treatment for cancer and HIV.
Drinking pineapple juice instead of cough syrup is less expensive and has no toxic chemicals. Also a study also showed that when using pineapple juice patients recovered nearly 5 times faster from their ailments and exhibited a decrease in other symptoms related to coughing such as hacking.
If you suffer from persistent coughing from respiratory conditions such as COPD and asthma then by drinking pineapple juice not only does it soothe related ailments from persistent coughing but it suppresses the cough and helps to loosen mucus build-up and also aids in combating lung inflammation. This in itself can hugely improve your quality of life, help you to breathe better and help to reduce your symptoms and improve your condition. The naturally-occuring components also have other health benefits to aid in your overall health.
References: http://preventdisease.com and http://www.survivalmagazine.org