Chronic obstructive pulmonary disease is a condition which results from a combination of bronchitis and emphysema, usually caused by smoking. People with COPD may experience shortness of breath and sputum production.
Tailoring of inhaled therapy
The mainstay of therapy for those with COPD is inhaled treatment, with a combination of bronchodilators ± inhaled steroids.
Bronchodilators are medicines which relax the muscles within the walls of the airways, aiding airflow and easing the sensation of breathlessness. Tailoring of inhaled steroids help to treat inflammation and the underlying disease process of COPD.
However, more recent evidence suggests that the use of inhaled steroids should be targeted to a selected minority of patients whose airways are actually responsive to this treatment. Whereas inhaled steroids may be of great benefit to a few patients, they carry the potential for unnecessary side-effects in others. Careful assessment is required to target this treatment to those most likely to benefit.
The assessments which we perform include measurement of exhaled nitric oxide (FENO), bronchodilator responsiveness and blood tests, as well as a full clinical assessment including your previous respiratory history, examination and review of existing and further xrays and scans.
Lung volume reduction procedures
Some patients with more advanced COPD may benefit from more radical treatments, such as lung volume reduction. Because COPD causes the lungs to lose their natural springiness, they tend to become over-inflated. Breathing with over-inflated lungs requires more work and is less efficient, which increases the sensation of breathlessness.
Some patients may benefit from a procedure to remove a portion of lung, either surgically or endoscopically by causing certain segments of the lung to collapse or fold up into less space. Two different endoscopic treatments are possible.