Chronic lung diseases often go undetected

Behind supposedly harmless smoker's cough is often a serious lung disease
Chronic obstructive pulmonary disease is often dismissed by smokers as a supposedly harmless "smoker's cough" in the early stages and the disease as such remains unrecognized, according to the Institute for Quality and Efficiency in Health Care (IQWiG) on its patient information portal. However, symptoms such as persistent cough and frequent respiratory distress may be evidence of COPD (Chronic Obstructive Pulmonary Disease). A pulmonary function test by a pulmonologist (pulmonologist) could provide information here.

Often smokers consider the increased cough and respiratory distress as a "normal" side effect of their tobacco use and therefore see no reason to seek medical attention. However, the symptoms may already be the result of a serious lung disease, which is why urgently a medical examination is appropriate, reports the IQWiG. Here, in addition to the general examination of the body, the questioning of other diseases and a blood test, also a review of the performance of the lung. "Depending on the result, further examinations will be added, including to rule out other diseases such as asthma, heart failure or lung cancer," explains the IQWiG.

Cough and shortness of breath can be indications of chronic lung disease. (Image: psdesign1 / fotolia.com)

Impaired lung function initially unremarkable
In the early stages of COPD, according to the IQWIG, "the airways of those affected are initially narrowed so that they barely notice the gradual loss of lung function." Increasing impairment of lung function, however, causes increased respiratory problems over time, especially during physical exertion. There are also increased cough and expectoration. "At an advanced stage, the disease severely limits the quality of life" and "people with severe COPD have so severely restricted airways that they also suffer from respiratory distress during everyday activities or even at rest," reports the IQWiG. Anyone who is already out of breath when going for a walk or climbing stairs should therefore consult a doctor promptly.

Coughing sputum, shortness of breath and noises while breathing
Warning signs for COPD are, in addition to the shortness of breath, coughing and increased expectoration, even sounds when breathing like a whistle or hum. In addition, increased symptoms of cold or flu illnesses may be evidence of COPD. Typical are "so-called exacerbations, sudden and significant worsening of the disease," reports IQWIG. In addition to securing the diagnosis, the aim of the medical examinations is to find out how far COPD has progressed and what is the risk of subsequent complications. Subsequently, treatment will be planned on the basis of the results, with smokers first having to discontinue their tobacco use in order to avoid further deterioration of lung function.

Treatment aims to relieve the symptoms
Smoking is the most common but not the only possible cause of COPD. This can also be caused, for example, by regular contact with other pollutants such as dust or gases. The aim of the treatment is, above all, the greatest possible reduction of the symptoms in order to facilitate everyday life and to maintain or improve the quality of life. At the same time, the progression of COPD should be slowed down. A major component of COPD treatment is medications, where "depending on the stage of the disease, combinations of different medications are common," reports the IQWiG. In particular, drugs that expand the airways and thus facilitate breathing (bronchodilators), are used here. Cortisone-containing medications can be used to fight against airway inflammation, "but they play a lesser role in the treatment of COPD than asthma," explains the IQWiG. If the disease is very advanced, an additional treatment with oxygen may be required. Accompanying as supportive measures, for example, physical activities, breathing training, inhalations and diet changes are possible. (Fp)