‘Recurrent infections will impact lung function’: Dr Praveen Valsalan K
Chronic obstructive pulmonary disease is a progressive disease in which the symptoms usually develop slowly and worsen over time. Dr Praveen Valsalan K, lead consultant and interventional pulmonologist, Aster Medcity, in an interview with Anna Jose, says that the disease can worsen and become irreversible if not treated on time. Excerpts:
How prevalent is Chronic Obstructive Pulmonary Disease (COPD) in India?
COPD is the third leading cause of death worldwide and India has the third highest burden of COPD in the world. In India, it is the second to third leading cause of death. The prevalence of the disease in India is 10-20%, according to the VARIOUS data of 2023.
What causes COPD?
Lungs can gets damaged due to several reasons and it can lead to inflammation which perpetuates. It does not happen overnight and takes some time. The most significant cause identified worldwide is smoking. However, in India, non-smoking COPDs are common mostly due to pollution and exposure to biomass fuel. Also, recurrent infections and diseases which can cause chronic scarring in the lungs like tuberculosis and long-standing asthmatics (if the patient is not on regular medication) can lead to COPD. Asthma is a reversible disease. However, if we do not treat it, this inflammation may become permanent, and there will not be any turning back.
How is the disease diagnosed?
We need to have a susceptible clinical history of exposure to smoke and pollution along with symptoms of breathlessness, recurrent cough and recurrent infections. In these patients, lung function testing (pulmonary function testing) is mandatory. If the lung function has reduced along with changes in lung volume and airway resistance, then a diagnosis of COPD can be made and medication can be started.
How can the disease be prevented?
By definition, COPD is a progressive disease. Patients, thus should stop getting exposed to pollution and smoke at the earliest, not letting the disease worsen. Recurrent infections are what worsens the course of the disease, lung function and lung structure. Lifestyle changes like avoiding exposure to smoke and pollution are important. It is always recommended to be physically active. Taking yearly flu vaccines and pneumococcal vaccines can help patients prevent infections. Using masks regularly can also help to a significant extent to prevent infections.
What are the treatment options available?
First and foremost, we give drugs to dilate the airways (called bronchodilators) and to improve the functioning of the organ. Airway obstruction can cause the retention of carbon dioxide. Drugs can open the airways and the carbon dioxide will come out and improve the oxygenation also.
Pulmonary rehabilitation is a part and parcel of COPD management. These patients need to put in a lot of effort (work of breathing is very high) to breathe and it leads to loss of muscle.
In rehabilitation, physical exercise along with breathing techniques aims to strengthen the muscles and improve their breathing capacity. Yoga can also help the patients breathe better. There are a few treatment options for the last-stage patients as well.