Chronic Obstructive Pulmonary Disease (COPD)

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Latest Edit: General 2013-6-20 (EDT)

Chronic Obstructive Pulmonary Disease (COPD) is a conditions that includes both chronic bronchitis and emphysema. COPD is the fourth leading cause of death in the US, and individuals with COPD are more likely to have other health conditions, hospitalized more often, and require more healthcare dollars than other individuals their age. The major risk factor for COPD remains cigarette smoking, with genetic succeptibility and occupational exposures also contributing to disease development.[1]

Chronic Obstructive Pulmonary Disease
Copd.jpg

COPD
Causes Environmental Toxins, Smoking, Breathing
See Also Respiratory Conditions, Congestive Heart Failure, Ischemic Heart Disease, Pulmonary Hypertension, Pneumonia
Books Books on Respiratory Conditions
Articles Articles on Respiratory Conditions

Contents

Naturopathic Assessment

Check out this book Natural Therapies for Emphysema and COPD: Relief and Healing for Chronic Pulmonary Disorders


Causal Factors

In order to stimulate the innate ability of the body to heal the causes of disease must be identified and addressed. With COPD, the causes are variable and include external factors such as smoking and environmental factors. A detailed assessment is required to determine which factors are contributing to the development and progression of COPD.

External

  • It is well known that smokers have dose-dependent reduction in lung function. Smoking cigarettes is the most important risk factor in the development of COPD, with an estimated 80% of COPD related deaths attributed to cigarette smoking.[1]
  • Maternal smoking increases the risk of low birth weight and respiratory illness (including COPD later in life).[1]

Environmental

  • Occupational Exposure
  • Nearly 20% of COPD cases can be attributed to occupational exposures. Those at highest risk include those working in dusty areas, exposed to particulate air pollution, and possibly those exposed to cadmium. Combining occupational exposure with cigarette smoking can increase risk of COPD sixfold.[1]

Lifestyle

Social

  • Socioeconomic Status
  • Both mortality and morbidity are inversely related to socioeconomic status. It is hypothesized this may be due to poorer COPD therapy and diagnostic effort in lower socioeconomic classes.[1]

Medical Interventions

  • Prescription Medications
  • Some prescription medications can increase a person's susceptibility and risk of COPD.

Physiology

  • Poor breathing can result in a worsening of symptoms and an aggravation of an existing condition.

Genetics

  • Genetic Mutation
  • Mutations in the serine proteinase inhibitor gene increases risk of COPD.[2]

Diagnostic Testing

A thorough physical exam and history taking is required to evaluate COPD. Diagnostic testing to confirm a diagnosis, and assess severity of COPD may include:[3]

  • Pulmonary Function Testing
  • Pulmonary function tests including spirometry can assist in tracking the progression of COPD, but cannot be used in cases of acute exacerbation.
  • Imaging Studies
  • Chest radiography can help to identify co-morbid conditions that can be treated to alleviate symptoms of COPD including pneumothorax, atelectasis, or neoplasm.
  • Laboratory Studies
  • Sputum evaluation during acute exacerbations of bronchitis may be used to identify concurrent infection, but has been shown to be of limited usefulness in treatment.
  • Other Diagnostics
  • Pulse oximetry is often used to monitor individuals in acute exacerbation.
  • Arterial blood gases have traditionally been used to monitor individuals with COPD, but are now considered of limited usefulness.
  • Waveform capnography may be helpful in distinguishing COPD from other conditions with similar symptomology.
  • Electrocardiogram and cardiac monitoring is important in individuals with comorbid cardiac conditions.

Related Symptoms and Conditions

Conditions related to COPD include:[3]

Characteristics

Chronic Obstructive Pulmonary Disease (COPD) includes two conditions, chronic bronchitis and emphysema. In most patients with COPD, there is a combination of both sub-conditions. Chronic bronchitis and emphysema can be defined as follows.[4]

Chronic Bronchitis

  • Chronic bronchitis is defined as a productive cough for longer than three months in two consecutive years.

Emphysema

  • Emphysema is an permanent abnormal enlargement of airspaces in the lungs.

Common Symptoms

Common symptoms associated with COPD include:[3]

Naturopathic Treatment

The goal of naturopathic treatment is to support and work in tandem with the healing power of the body and to address the causal factors of disease with individual treatment strategies. COPD is a chronic disease and requires medical management, ongoing monitoring, and individualized treatment.

It is always advisable to work with a naturopathic doctor before engaging in any treatment plan.

Home Care

Home Care strategies include:

The home should also be free of environmental irritants.[5]
  • Smoking cessation in the early stages of COPD has been shown to preserve lung function and slow deterioration. Smoking cessation at any stage of the disease has shown to decrease mortality.[6]

Lifestyle

Lifestyle recommendations include:

  • Ensure you drink adequate water.
  • Exercise conditioning has been shown to increase endurance in individuals with COPD. Oxygen supplementation may be needed during exercise.[1]
  • Postural drainage of mucous has been shown to be effective in individuals who produce large amounts of mucous.[1]
  • Avoiding exposure to dust and other air pollutants may slow disease progression.[1]
  • Controlled coughing techniques can help to dispel mucous and prevent uncontrolled coughing attacks.[7]
  • Controlled breathing techniques such as pursed lip breathing may help to alleviate dyspnea associated with COPD.[1]
  • Sound sleep can improve health outcomes.
  • Proper precautions should be taken to minimize the risk of contracting an upper respiratory infection.[5]
  • Environmental Allergies and sensitivities should be evaluated and treated appropriately.[5]

Naturopathic Therapies

The prescribing of naturopathic therapies requires the guidance of a naturopathic doctor as it depends on a number of factors including the causal factors, a person's age, prescription medications, other conditions and symptoms and overall health. It is always advisable to work with a naturopathic doctor prior to taking any natural therapies.

Naturopathic Therapies for COPD include:[8][9]

  • Homeopathy may prove to be helpful in the treatment of COPD.
Article Acupuncture Improves COPD Symptoms, NMJ, [1], 2012 August
  • Therapeutic acupuncture may help to improve respiratory function and decrease heart rate in individuals with COPD.[10]
  • Tai Chi and Qigong programs are beneficial in symptom improvement, and aids in ability to perform physical activities in individuals with COPD.[11]
  • Hydrotherapy treatments such as steam inhalation may be helpful in the treatment of COPD.[1], [9]
  • Controlled coughing, a technique where individuals inspire deeply, hold their breath, and produce an effective mucous dispelling cough, is helpful in individuals with COPD and bronchitis.[1]
  • The use of electromechanical percussor, or the cup-hand technique may be used by caregivers to help individuals with bronchitis and COPD to expel mucous.[1]
  • Chest diathermy may be helpful.[9]

Specialized Naturopathic Therapies

Specialized therapies that are used to treat COPD include:

  • Myers cocktail may relieve bronchial spasms and shortness of breath.

References

Reviewed by Iva Lloyd, BScH, RPE, ND [2]

  1. 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 Shapiro SD, Reilly JJ, Rennard SI (2010) Mason: Murray and Nadel's Textbook of Respiratory Medicine 5th ed Chap 39 Chronic Bronchitis and Emphysema Saunders
  2. Ericksson S (1964) Pulmonary emphysema and alpha-1 antitrypsin deficiency Acta Med Scand 175:197-205
  3. 3.0 3.1 3.2 Swadron SP, Mandavia DP (2009) Marx: Rosen's Emergency Medicine, 7th ed Chap 72 Chronic Obstructive Pulmonary Disease Mosby
  4. Cosgrove D, Mouded M, Wise R (2006) Piccini and Nilsson: The Osler Medical Handbook 2nd ed Chap 82 Chronic Obstructive Pulmonary Disease Johns Hopkins University
  5. 5.0 5.1 5.2 5.3 Punturieri A, Weinmann GG, Reynolds HY (2009) Mandell: Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases 7th ed Chap 62 Chronic Obstructive Pulmonary Disease and Acute Exacerbations Churchill Livingstone
  6. Department of Health and Human Services (1990) Health benefits of smoking cessation. A report of the Surgeon General. Publication No. (CDC) 90-8416 Washington, DC, Department of Health and Human Services (US)
  7. Sutton PP, Parker RA, Webber BA, et al (1983) Assessment of the forced expiration technique, postural drainage and directed coughing in chest physiotherapy Eur J Respir Dis: 64:62-68.
  8. Prousky Jonathan (2008) Principles and Practices of Naturopathic Clinical Nutrition CCNM Press
  9. 9.0 9.1 9.2 9.3 Hoffman D (2003) Medical Herbalism: The Science and Practice of Herbal Medicine Healing Arts Press
  10. Marino DM, Marrara KT, Lorenzo D, Silva ML, Silva JR (2010) Short-term effects of acupuncture on pulmonary function and heart rate in patients with chronic obstructive pulmonary disease J of Chinese Med Oct: 18-19
  11. Chan AW, Lee A, Suen LK, Tam WW (2010) Effectiveness of a Tai chi Qigong program in promoting health-related quality of life and perceived social support in chronic obstructive pulmonary disease clients Quality of Life Research 19(5):653-64
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