The flattened diaphragm is usually due to chronic obstructive pulmonary disease (COPD). It is a group of lung
diseases that block airflow as you exhale and make it increasingly difficult for you to breathe. Emphysema and chronic asthmatic bronchitis are the two main conditions that make up COPD. In all cases, damage to your airways eventually interferes with the exchange of oxygen and carbon dioxide in your lungs. COPD is a leading cause of death and illness worldwide. Most COPD is caused by long-term smoking and can be prevented by not smoking or quitting soon after you start. This damage to your lungs can't be reversed, so treatment focuses on controlling symptoms and minimizing further damage.
COPD primarily refers to obstruction in the lungs caused by chronic asthmatic bronchitis and emphysema. Many people with COPD have both.
Chronic asthmatic bronchitis
Chronic asthmatic bronchitis causes inflammation and narrowing of the airways that lead into your lungs. This may cause you to cough and wheeze. Chronic asthmatic bronchitis also increases mucus production, which can further block the narrowed tubes.
Emphysema damages the tiny air sacs in your lungs (alveoli) in two main ways. Alveoli are clustered like grapes and emphysema gradually destroys the inner walls of these clusters, reducing the amount of surface area available to exchange oxygen for carbon dioxide. In addition, emphysema also makes the alveoli walls weaker and less elastic, so they collapse with exhalation — trapping air in the alveoli. Shortness of breath occurs because the chest wall muscles have to work harder to expel the air.
Cigarette smoke and other irritants
COPD is typically caused by long-term exposure to airborne irritants, such as:
SInce you don't have wheezing, your COPD is due to emphysema.
There's no cure for COPD, and you can't undo the damage to your lungs. But COPD treatments can control symptoms, reduce your risk of complications and exacerbations, and improve your ability to lead an active life.
The most essential step in any treatment plan for smokers with COPD is to stop all smoking. It's the only way to keep COPD from getting worse — which can eventually result in losing your ability to breathe. But quitting smoking is never easy. And this task may seem particularly daunting if you've tried to quit before. Talk to your doctor about nicotine replacement products and medications that might help.
Doctors use several basic groups of medications to treat the symptoms and complications of COPD. You may take some medications on a regular basis and others as needed:
Bronchodilators. These medications — which usually come in an inhaler — relax the muscles around your airways. This can help relieve coughing and shortness of breath and make breathing easier. Depending on the severity of your disease, you may need a short-acting bronchodilator before activities, a long-acting bronchodilator that you use every day, or both.
Inhaled steroids. Inhaled corticosteroid medications can reduce airway inflammation and help you breathe better. But prolonged use of these medications can weaken your bones and increase your risk of high blood pressure
, cataracts and diabetes. They're usually reserved for people with moderate or severe COPD.
Antibiotics. Respiratory infections — such as acute bronchitis, pneumonia
— can aggravate COPD symptoms. Antibiotics can help fight bacterial infections, but are recommended only when necessary.
Oxygen therapy. If there isn't enough oxygen in your blood, you may need supplemental oxygen. There are several devices to deliver oxygen to your lungs, including lightweight, portable units that you can take with you to run errands and get around town. Some people with COPD use oxygen only during activities or while sleeping. Others use oxygen all the time.
Pulmonary rehabilitation program. These programs typically combine education, exercise training, nutrition advice and counseling. If you are referred to a program, you'll probably work with a range of health care professionals, including physical therapists, respiratory therapists, exercise specialists and dietitians. These specialists can tailor your rehabilitation program to meet your needs. Exercising regularly can significantly improve the efficiency of your cardiovascular system.
Surgery is an option for some people with some forms of severe emphysema who aren't helped sufficiently by medications alone:
Lung volume reduction surgery. In this surgery, your surgeon removes small wedges of damaged lung tissue. This creates extra space in your chest cavity so that the remaining lung tissue and the diaphragm work more efficiently. The surgery has a number of risks, and long-term results may be no better than for nonsurgical approaches.
Lung transplant. Single-lung transplantation may be an option for certain people with severe emphysema who meet specific criteria. Transplantation can improve your ability to breathe and be active, but it doesn't appear to prolong life and you may have to wait for a long time to receive a donated organ. So the decision to undergo lung transplantation is complicated.
Even with ongoing treatment, you may experience times when symptoms suddenly get worse. This is called an acute exacerbation, and it may cause lung failure if you don't receive prompt treatment. Exacerbations may be caused by a respiratory infection, a change in outdoor temperatures or high air pollution levels. Seek medical attention if you notice more coughing or a change in your mucus or if you have a harder time breathing.
(By Mayo clinic)