The small airways of the lung (<2mm in diameter) cause no problem for patients with healthy lungs. However, when exposed to repeated insults from noxious elements, such as cigarette smoke, they become a major site of impairment of airflow for which no medication is helpful. Most medications for airflow obstruction (the prime trouble in COPD) do not help these small airways. As time goes on, the restricted flow in these small airways, as well as that of the larger ones, results in disorder and destruction of the lung tissue itself.
Emphysema is the term for the destruction and dysfunction of the lung tissue resulting from narrowing of the airways, including the small ones. There is also destruction of elastic fibers in the lung tissues causing them to distend. This distension, called hyperinflation, is one of the principal causes of shortness of breath on exertion that patients with severe COPD experience. The ability to control the progression and symptoms associated with emphysema and hyperinflation has been the subject of several mechanical therapies. Surgical removal of portions of the lung, so-called volume reduction surgery, has been helpful to some, but requires a significant surgical procedure. Recently, the placement of tiny “valves” in selected airways, allowing areas of the lung to decompress, has been shown to improve symptoms, specifically shortness of breath with exertion.
Locally, the Lung Disease Center of Central PA and the Altoona Lung Specialists are offering evaluations and treatment opportunities for patients with severe COPD. Call 814-946-2845.