What Are Obstructive Diseases
Say you swallow a hotdog. But, it doesnt travel down your esophagus to your stomach. Instead, it goes down your airway. At some point it will get stuck. So, its the most basic form of obstruction. This hotdog may completely block your airway making you unable to breathe.
But, if it gets lodged just right, you may still be able to breathe. Air can get in past this hotdog obstruction, but it will have a hard time getting out. So, when you have an obstruction, air can get in but has a hard time getting back out.
When you exhale, the obstruction resists the flow of air. So, it causes increased resistance to the flow of air. So, it may seem you can exhale forever and never get all your air out. Air is therefore slowed when you exhale. A medical term for this is airflow limitation. It is this that makes you feel short of breath.
There are diseases that may obstruct airways. Chronic bronchitis fits into this category. Asthma also fits into it. They both cause inflammation and increased sputum that make airways narrow. So, they both obstruct airways. They are obstructive diseases.1-5
Obstructive Sleep Apnea causes your upper airway to collapse while your sleeping. So, it obstructs the flow of air. Croup causes inflammation of your upper airways. So, its certainly an obstructive disease. Rhinitis causes inflammation in your nasal passages. So, it also qualifies. 5
Cystic fibrosis, emphysema, and bronchiectasis also qualify.5
Global Alliance Against Chronic Respiratory Diseases
The Global Alliance against Chronic Respiratory Diseases contributes to WHOs work to prevent and control chronic respiratory diseases. GARD is a voluntary alliance of national and international organizations and agencies from many countries committed to the vision of a world where all people breathe freely.
Chronic Lung Diseases Including Copd Asthma Interstitial Lung Disease Cystic Fibrosis And Pulmonary Hypertension
Chronic lung diseases can make you more likely to get severely ill from COVID-19. These diseases may include:
- Asthma, if its moderate to severe
- Chronic obstructive pulmonary disease , including emphysema and chronic bronchitis
- Having damaged or scarred lung tissue such as interstitial lung disease
- Cystic fibrosis, with or without lung or other solid organ transplant
- Pulmonary hypertension
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Having HIV can make you more likely to get severely ill from COVID-19.
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Understanding The Difference Between Copd And Asthma
When you develop a lung disease or infection such as asthma or chronic obstructive pulmonary disease , you are often required to make significant lifestyle modifications to make breathing easier. After diagnosis, its normal to have questions. For many people, the big question is: How can I breathe easier?
The first step is getting the diagnosis straight. A sufferers prognosis and treatment options are very dependent on the actual condition. When it comes to chronic lung conditions, it can be difficult to tell symptoms apart, and on occasion, it can result in an incorrect diagnosis. For example, asthma and COPD differences are subtle, and theres even a third possibility: asthma-COPD overlap syndrome. Knowing the difference can be difficult but essential to a good treatment plan.
Here are a few major differences between COPD and asthma:
Is Chronic Asthma The Same As Copd
Chronic asthma and COPD can have similar symptoms, but they are considered distinct conditions. COPD refers specifically to chronic bronchitis, emphysema or both.
Other differences include the fact that asthma tends to start during childhood, while COPD is more likely to appear among adults who smoke.
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Ask The Allergist: Does Chronic Asthma Lead To Copd
Q: Ive had severe asthma all my life. Am I at risk for developing chronic obstructive pulmonary disease, or COPD?
Bradley Chipps, MD: Not every person with asthma develops ; they are two different conditions. However, we are seeing a significant number of patients who have features of both asthma and COPD and distinguishing between the two is not always easy.
Asthma is an inflammatory lung disease often associated with allergies, and symptoms vary over time and in intensity.
COPD is a progressive disease that usually develops after the age of 40. It is characterized by persistent airflow limitation and inflammation, commonly associated with exposure to noxious particles or gases primarily cigarette smoke, either from personal use or secondhand exposure, or environmental pollutants, including biomass fuels from poorly vented gas stoves.
While asthma does not automatically lead to COPD, a person whose lungs have been damaged by frequent flares of poorly controlled asthma is at increased risk of developing COPD or if they are living or working in environments where they are exposed to airborne pollutants.
Some develop Asthma/COPD Overlap , which is now being recognized more widely in the medical community.
Q: Can you stop the progression of COPD if you catch it early enough?;
Q: Whats the treatment for ACO?
I also recommend pneumonia and annual flu vaccinations, smoking cessation assistance and pulmonary rehabilitation, or exercise programs.
Canadian Chronic Disease Surveillance System
The CCDSS is a collaborative network of provincial and territorial chronic disease surveillance systems, led by the Public Health Agency of Canada . The CCDSS identifies chronic disease cases from provincial and territorial administrative health databases, including physician billing claims and hospital discharge abstract records, linked to provincial and territorial health insurance registry records using a unique personal identifier. Data on all residents eligible for provincial or territorial health insurance are captured in the health insurance registries; thus, the CCDSS coverage is near-universal with the exception of some small populations. Case definitions are applied to these linked databases and data are then aggregated at the provincial and territorial level before being submitted to PHAC for reporting at the provincial, territorial and national levels.
The CCDSS has expanded from its initial mandate of diabetes surveillance to include data on several additional chronic diseases and conditions including: hypertension, mental illness, mood and/or anxiety disorders, heart failure, ischemic heart disease, acute myocardial infarction, stroke, osteoporosis, arthritis and neurological conditions. Asthma and COPD were added to the CCDSS in 2012.
The data presented in this report and subsequent updates can be accessed on the Public Health Agency of Canada’s Public Health Infobase.
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Monitoring Managing And Treating Asthma And Copd
Once the conditions are diagnosed, the medications used to manage asthma and COPD are similar and usually involve an inhaler of some sort. However, other types of treatment and therapies for each disease tend to differ. This section will explore the different approaches used to monitor and manage asthma and COPD in everyday life.
Copd In The Canadian Population
CCDSS Case Definitions
Prevalent COPD Case Definition
The case definition of diagnosed COPD is: an individual aged 35 years and older having at least one visit to a physician with a diagnosis of COPD in the first diagnostic field, or one hospital separation with a diagnosis of COPD in any diagnostic field ever, coded by ICD-9 491-492, 496 or ICD-10-CA J41-44. This case definition for COPD was validated by Gershon and colleagues.Footnote 44
Only the first diagnostic field was used in physician billing claims data as not all provinces and territories had more than one diagnostic field. All fields were included from the hospital separation file as this database allows for the recording of up to 25 diagnoses.
Based on this definition, once a case is detected, it is a prevalent case for life regardless of future contact with health services. Consequently, once someone is identified as a case, they are always included in the database as a case. All jurisdictions identified cases occurring as of 1995, with the exception of Quebec which began in 1996 and Nunavut which began in 2005.
Incident COPD Case Definition
Incident COPD cases were identified in the year where an individual met the case definition for the first time. A run-in period of five years, where data were collected and not reported, was employed to partially account for the prevalence pool effect; i.e., to ensure that an incident case was not a pre-existing prevalent case. .
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What Are Restrictive Diseases
These are diseases that occur outside your airways. The best example I can think of here is pregnancy. Its not a disease, but it certainly does restrict your airways. You have a baby inside you. It grows larger and larger. At some point, it begins to push up on your diaphragm.
It acts to squeeze or restrict your lungs. This makes it so your lungs are less compliant. This means they are unable to fully expand because of the baby taking up space. So, thats the most basic form of a restriction.
Obstructive diseases make it hard to exhale. Restrictive diseases make it hard to inhale. They cause less lung compliance. Another good example is kyphoscoliosis. People with this have deformed chest walls. This acts to limit the ability of the lungs to expand. Rheumatoid arthritis may also qualify.1,4,5
Neuromuscular diseases like ALS may impact inspiratory muscles. So, this can make it hard to inhale. Drug overdoses qualify here. They relax you so you weaken your drive to inhale.1,3
Pneumonia is inflammation of your alveoli. So, it takes up space making it hard to inhale. Obesity certainly may cause less room for lungs to expand, so it qualifies. Lung cancer takes up space outside airways, so it qualifies. 5
How To Protect Yourself From Covid
While everyone should be following social distancing and practicing good hand hygiene right now, its even more important to protect yourself if you have asthma or COPD. Consider these tips:
Stay at home as much as possible. To avoid being exposed to people who are sick right now, consider seeing your doctor via video visits or phone calls if you have a routine health issue. These telehealth visits are now being covered by Medicare and many private insurers.
Practice social distancing. The CDC has been recommending for weeks now to avoid close contact with others maintain a distance of at least six feet from others when possible and activities that include large crowds, such as religious services, family gatherings, and shopping. More research is showing that people without symptoms may have coronavirus and can transmit it to others, even though they dont yet look or seem sick. This new information makes social distancing all the more critical to avoid exposing yourself to coronavirus germs.
Wash your hands frequently with soap and water for at least 20 seconds, especially before eating and touching your face, and after going to the bathroom. If soap and water arent available, use an alcohol-based hand sanitizer that contains at least 60 percent alcohol.
Cover your cough or sneeze with the inside of your elbow or a tissue, then throw the tissue in the trash.
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The Anatomy Of The Lung
A quick review of lung anatomy may prove helpful here. Inside your chest is a set of lungs. When you take in a breath, air enters in your nose or mouth. The back of your nose or mouth is your pharynx. From there air enters your larynx and passes through your vocal cords. It then enters your bronchial airways.
Bronchial airways get smaller and smaller the further down you go. They continue getting smaller all the way to the terminal bronchioles. Air then passes to your respiratory bronchioles. These are surrounded by balloon-like sacs called alveoli. Alveoli are grouped together in grape-like clusters.
Respiratory bronchioles and alveoli are interconnected with small blood vessels. These are called capillary blood vessels. So, its here where gas exchange occurs. When you exhale air goes back all the way up and leaves your mouth or nose.
Managing Your Asthma During The Pandemic
- Keep taking your controller medication daily or as prescribed. This will help cut your risk of an asthma attack being triggered by any respiratory virus, including COVID-19.
- Carry your reliever inhaler with you every day, in case your asthma symptoms flare up.
- Monitor your asthma symptoms closely and follow your Asthma Action Plan to help you recognize and manage asthma symptoms, and know when to seek advice from your healthcare provider or emergency help.
- If you must travel, pack all asthma medications in your carry-on luggage so it is easily accessible. Pack extra asthma medication in case your travel plans change or are delayed. Be sure to check travel advice and advisories from the;Government of Canadas website.
- Take care of yourself. Get plenty of rest and fluids, and eat good nutritious food.
- Ensure that you speak with your healthcare provider about recommended vaccinations. Getting both the influenza vaccination and pneumococcal disease vaccinationare important steps people with asthma can take to help stay healthy.
- Reach out to Asthma Canadas Asthma & Allergy HelpLinecall-back service to connect with a Certified Respiratory Educator if you have questions about managing your asthma. Call 1-866-787-4050 or email;
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Accelerated Decline In Lung Function
Since COPD represents incomplete reversibility of airflow obstruction, then any risk factor that leads to accelerated loss of lung function will contribute to the development of COPD. Several risk factors for accelerated decline in include age, smoking, BHR, asthma and exacerbations or lower respiratory infections. Increasing age is associated with decline in lung function, both in asthma and in those without asthma.
Loss of lung function is accelerated by smoking by up to 50 ml per year, and there is an established doseâresponse relationship. The loss of lung function with smoking may even be greater in those with asthma, such that smokers with asthma can develop COPD. Importantly, quitting smoking slows the decline in lung function. In the Lung Health Study, the annual decline in FEV1 in people who quit smoking at the beginning of the 11 year study was 30 ml/year for men and 22 ml/year for women. Continued smoking led to a decline in FEV1 of 66 ml/year in men and 52 ml/year in women.
The deficits in lung function in asthma seem to arise early in the course of the disease, and may be an effect of incomplete lung growth. In one study, abnormal lung function at age 26 in patients with asthma was related to male sex, BHR at age 9 years, early onset of asthma and reduced lung function by age 9 years.
How Is Asthma Connected To The Immune System
Scientists are still studying exactly how asthma is connected to the immune system. They think the immune system has a role in the asthma response and the development of asthma.1
Scientists do not know exactly why some people develop asthma. Some think asthma could be caused by an immune response to viruses. They believe standard viruses could cause the immune system to develop the behavior that leads to asthma in some people.5,6
The causes of intrinsic asthma are not well understood. This is because it can be triggered by so many things. But some scientists also think an autoimmune response may have a role in causing it. This potential link could help people with intrinsic asthma, who are sometimes more difficult to treat. It is possible that intrinsic asthma could respond to treatment with medicine used for autoimmune conditions.1
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What Is Autoimmune Disease
Autoimmune disease is a disease where the bodys immune system attacks its own healthy cells and tissues. B cell receptors and T cell receptors of our body recognize bodys healthy tissue as antigen. So our immune system considers own body cell as foreign body and starts to act against it. Ultimately it causes a chronic inflammatory process and disrupts the normal function of the tissue.
Autoimmune disease affects 7 to 10 percent of persons in Europe and North America. The autoimmune disease causes disability and mortality.
Vaccine Distribution In Canada
As part of the Canadian Thoracic Societys COVID-19 Respiratory Roundtable panel representing Canadians living with lung disease, Asthma Canada signed a joint statement titled Prioritization of Canadians with Lung Disease in COVID-19 Vaccination Rollout. Alongside other lung health organizations, Asthma Canada is urging;federal, provincial and territorial governments to prioritize people living with lung disease who are at higher risk for more serious COVID-19 complications in the vaccination rollout.;From Canadians living with a lung disease such as asthma, chronic obstructive pulmonary disease , cystic fibrosis, lung cancer, pulmonary fibrosis, pulmonary hypertension, and pre- and post-lung transplant, there is widespread concern regarding when in the vaccine rollout in the provinces and territories they will have the opportunity to receive the vaccine.
We will continue to advocate for our community on this subject and will share more information as it becomes available.
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When To Get Medical Advice
See a GP if you have persistent symptoms of COPD, particularly if you’re over 35 and smoke or used to smoke.
Do not ignore the symptoms. If they’re caused by COPD, it’s best to start treatment as soon as possible, before your lungs become significantly damaged.
The GP will;ask about your symptoms and whether you smoke or have smoked in the past. They can organise;a breathing test;to help diagnose COPD and rule out other lung conditions, such as asthma.
Find out more about how COPD is diagnosed.
Q: Whats The Difference Between Asthma And Copd
Asthma occurs frequently in people with a family history of the disease and often begins in childhood. Symptoms include shortness of breath, wheezing, coughing, and chest tightness, and these symptoms flare up during an asthma attack. At other times, symptoms may fade or become minimal.
COPD is different and usually strikes later in life. Most people diagnosed with COPD either used to smoke, or still do. Some symptomssuch as chest tightness and coughingare similar to asthma. Other symptoms, such as mucus production, are distinct to COPD. Unlike asthma, symptoms rarely ever fade completely.
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