“The initial symptoms of COPD are insidious and consist mainly of coughing and expectoration,” says Alcázar. “When the disease progresses, other alarm symptoms appear, such as difficulty breathing or crises (known as exacerbations).”
The chronic obstructive pulmonary disease has mainly two stages:
In the early stages of the disease, the oxygen concentration in the blood is decreased, but carbon dioxide values remain normal.
In the advanced stages, when the disease is more serious, carbon dioxide values rise while oxygen values decrease.
COPD manifests itself in different ways, both in the case of chronic bronchitis and emphysema, and the initial symptoms may appear after 5 or 10 years of smoking or be exposed to polluting gases.
Some symptoms may be:
- Coughing and increased mucus, usually on getting up in the morning.
- Tendency to suffer from chest colds.
- The sputum that is produced during these colds often turns yellow or green due to the presence of pus.
- As the years go by, these chest colds become more frequent.
- wheezing breath
- A sensation of suffocation when making an effort and, later, suffocation in daily activities, such as washing, dressing and preparing food.
- One-third of patients experience significant weight loss.
- Swelling in the legs due to heart failure.
A long-standing cough is closely linked to chronic obstructive pulmonary disease, and it is one of the symptoms of this type of disease.
A longstanding cough is said to occur when the cough persists for more than three weeks, and the specific causes are unknown. The general causes of long-term cough may be due to physical agents, such as gases, tobacco or different diseases.
The types of disease that can trigger this type of cough are otorhinolaryngological (“wax plug”, -a foreign body in the external auditory canal-, rhinitis, sinusitis, and tonsillitis), tracheobronchial (among which is chronic bronchitis and asthma ), pulmonary (including emphysema and cystic fibrosis ), pleural, and cardiac.
Tobacco and the diseases derived from this habit are usually the main cause of coughing in smokers. In non-smokers, the most important causes are asthma, chronic bronchitis, and gastroesophageal reflux. Long-lasting cough in children is usually due to asthma, viral respiratory infections, or psychogenic cough (those that appear for psychological reasons).
Family or personal history can also cause this type of cough. Establishing the diagnosis of this type of long-lasting cough requires a series of steps. In the first place, anamnesis is used; the patient’s family, physiological, or pathological history is investigated. Later, a physical examination is performed to assess the patient’s general condition, take his temperature, and check his heart and respiratory rates. Then other tests are done: an otorhinolaryngological examination is performed in case the cough could be due to problems of this type; the palpated thyroid and other neck structures; and thoracic diameters are measured, which may indicate obstructive or restrictive pathology.
It is also essential to rule out the existence of cardiovascular problems if murmurs or abnormal rhythms are heard. If necessary, other complementary examinations are carried out: pulmonary function tests, chest X-rays, spirometry with a bronchodilator test, a tuberculin test, a complete blood count or a cytological and microbiological study of sputum, among others.
Treating a longstanding cough is not easy since, according to various studies, in approximately 18 per cent of cases, this cough may be due to two or three simultaneous causes. It is said that the treatment takes effect when the cough has been eliminated. The drugs that can be administered to treat it, orally or by inhaled medication, will depend on the type of cough and its origin.
Chronic cough can be of various types, each associated with a type of disease, usually lung. Thus, for example, the morning cough is related to chronic bronchitis; nocturnal cough is associated with sympathy or asthma; cough with foul-smelling sputum is associated with lung abscess; and frothy cough is usually associated with pulmonary oedema, among many other types of long-term cough.