Conditions Treated

COPD/Emphysema/Chronic Bronchitis

These diseases are common diseases associated with smoking.

Chronic Bronchitis
Chronic bronchitis is caused by inflammation and swelling of the bronchial tubes. The swollen and inflamed tubes secrete too much phlegm which further irritates and blocks the airways. The most common cause of chronic bronchitis is cigarette smoking. The inhaled smoke contains numerous irritants to the lung. Read more...
Chronic bronchitis is not inherited and is not contagious to others.

Symptoms
Patients with chronic bronchitis always cough up phlegm on most days, usually in the morning. The amount of phlegm coughed up per day varies but is about one to three teaspoons. The phlegm is clear or white unless a chest infection is present. The other common symptom of chronic bronchitis is shortness of breath with exercise.

Treatment
Chronic bronchitis, like emphysema, is not curable but with treatment the symptoms can often be improved. Proper treatment also decreases the chance of being hospitalized. The following may be effective for patients with chronic bronchitis.

  • Stop smoking and avoid cigarette smoke of others.
  • Get regular exercise
  • Take medications (bronchodilators) as prescribed
  • Get yearly flu vaccine to prevent chest infections
  • Pneumovax injection to avoid one type of bacterial pneumonia
  • Attend a breathing rehabilitation program
  • Use oxygen, if indicated.
  • Daily drainage of the bronchial tubes may help (postural drainage)
  • Maintain adequate fluid intake
COMMON QUESTIONS AND ANSWERS
Q. How much exercise is safe?
We recommend regular walks, or any exercise you enjoy. Stop for a rest period when you feel short of breath.

Q. When should I call a physician?
Call at the first sign of any chest infection (fever, discolored phlegm) or any sudden increase in shortness of breath.

Q. Would is help to quit smoking?

Yes, it is well proven that the rate of decline in lung function decreases with quitting.

Emphysema
The word “emphysema” comes from a Greek word meaning “to inflate”. This occurs when small spaces in both lungs become permanently enlarged because of damage to their walls. These enlarged air spaces trap air in the lung (inflate) and interfere with normal lung function. Read more...
Causes
By far the most common cause of emphysema is cigarette smoking. Air pollution in large industrial cities may aggravate emphysema but usually does not cause it. Emphysema occurs more commonly in men than women and is more common after the age of fifty. Very rarely, emphysema is caused by an inherited absence of a protein which protects lung tissue against injury.

Symptoms
The most common symptoms of emphysema is shortness of breath, especially with exercise. Sometimes cold or hot, humid weather makes it worse. Emphysema may also cause wheezing (musical high-pitched sounds made during breathing), fatigue, and occasionally a dry cough.

Treatment
Emphysema is not curable but treatment can improve quality of life and decrease the symptoms. The following treatments often can help patients with emphysema:
  • Stop smoking and avoid cigarette smoke of others
  • Get regular exercise
  • Take medications (bronchodilators) as prescribed.
  • Get yearly flu vaccine to prevent chest infections.
  • Attend a breathing rehabilitation program
  • Use oxygen, if indicated.
  • Pneumovax injection once to avoid one type of bacterial pneumonia

COMMON QUESTIONS AND ANSWERS
Q. How much exercise is safe?
We recommend regular walks or any exercise you enjoy. Stop for a rest period when you feel short of breath.

Q. When should I call a physician?
Call at the first sign of any chest infection (fever, discolored phlegm) or any sudden increase in shortness of breath.

The Use of Steroids
Steroids (prednisone, methylprednisolone, and dexamethasone) have been used to treat asthma and other lung diseases for over 25 years. They are the most potent drugs used to treat asthma but, unfortunately, also have the largest number of unwanted side effects. Read more...
When used to treat asthma, steroids decrease the swelling and inflammation of the airways, thus relieving symptoms. These drugs can also reduce the inflammation associated with fibrosis of the lungs (scarring) and sarcoidosis. Steroids are prescribed only when they are required for treatment and when drugs with fewer side effects are not effective.

Short Term Side Effects
Side effects associated with short courses of steroids (less than one month) include the following: edema (swelling, especially of the legs or face), emotional problems (such as depression, euphoria and/or irritability), insomnia, confusion, stomach ulcers, appetite stimulation, muscle weakness, blurry vision, leg cramps, sweating and acne. Short course steroids may also raise the blood sugar in patients with diabetes or elevate blood pressure in patients with hypertension requiring close monitoring. The side effects from short course steroids can usually be controlled with appropriate medications, or reducing the dose of steroids.

Long Term Side Effects
Side effects caused by long term use of steroids (longer than one month) include the following: osteoporosis (fragile and weak bones), easy bruising of the skin, cataracts, weight gain with fullness in the face, increased risk of stomach ulcer, increased risk of infection, and suppression of adrenal function. Take oral steroids as directed (usually prescribed once a day) and with food to decrease stomach irritation. These risks of long term steroid therapy can be reduced by taking steroids as a single dose every other morning.

Cautions
When steroids have been taken for longer than one month, they must not be abruptly stopped. The dose needs to be gradually reduced to allow the adrenal glands sufficient time to regain their normal function. Full recovery of the adrenal function may take as long as 9 months after steroid therapy has been stopped. Patients on prolonged steroid therapy (or within 9 months of stopping prolonged steroids) who are under severe stress, such as surgery or severe infections, should have their dosage temporarily increased. The dosage of steroids should not be increased without directions from a physician.

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