Professor Iven Young explains the causes and outlines the treatment of chronic obstructive pulmonary disease (COPD).

I am Professor Iven Young from the Department of Respiratory and Sleep Medicine at Royal Prince Alfred Hospital in Sydney. I have just recently joined the Editorial Advisory Board of the Virtual Respiratory Centre and my particular areas of interest are lung function testing, the treatment of asthma, chronic obstructive lung disease or COPD, and conditions causing high blood pressure in the lungs.

Many of you will have heard of the strangely named chronic obstructive pulmonary disease or COPD. This is so called because it is due to a complicated reaction of the airways and the lung tissue to exposure to noxious fumes and gases. In ours, as in most societies, cigarette smoking is by far the most prominent cause, and the disease progresses to cause very distressing shortness of breath and finally inability to cope with the activities of daily living.

Because the changes in the lung are largely irreversible, treatment has been difficult, but good results are now possible with a three-pronged attack: smoking cessation, appropriate inhaled drug therapy, and physical exercises designed to keep as high a level of general fitness as possible.

Early detection of COPD is essential so that management can prevent the development of irreversible changes. Smoking cessation remains the most important measure, and increasing success with this endeavour is being found with nicotine replacement treatment and counselling services.

Keeping generally fit is proving to be a major factor in enhancing quality of life in this condition, and it is important that patients with this often distressing disease understand that effective remedies are available.

There are a number of inhaled treatments that have now been shown to improve exercise tolerance and quality of life in this condition. Home oxygen therapy is also important for a relatively small group of patients with advanced disease when the lungs are no longer able to oxygenate the blood. It is important to understand that oxygen is not a treatment for the sense of breathlessness which is the hallmark of this disease. It will benefit a smaller number of sufferers, and your doctor can advise you if you should be assessed for this.

If you are a smoker, consultation with your doctor to allow early detection of this disease is of the utmost importance. Early detection and appropriate management of more advanced disease will be life-saving and life-enhancing, with less emergency visits to hospital to treat distressing severe breathlessness.

Reliable professional medical information through the internet is increasingly important, and I am very pleased to be part of the Editorial Advisory Board of the Virtual Medical Centre. Many thanks for your attention.

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