Chronic Obstructive Pulmonary Disease (COPD)
Chronic Obstructive Pulmonary Disease (COPD) is a preventable and treatable lung disease. People with COPD must work harder to breathe, which can lead to shortness of breath and/or feeling tired. Early in the disease, people with COPD may feel short of breath when they exercise. As the disease progresses, it can be hard to breathe out (exhale) or even breathe in (inhale). A person with COPD may have obstructive bronchiolitis (bron-kee-oh-lite-is), emphysema, or a combination of both conditions.
The amount of each of these conditions differs from person to person. Asthma is another disease that causes narrowing of the airways, making it hard to breathe at times, but asthma is not included in the definition of COPD. Some people do have a mix of both COPD and asthma. Chronic bronchitis is no longer considered a type of COPD, although this term is still used by healthcare providers to describe a patient who has a productive cough for three months in two consecutive years.
Obstructive bronchiolitis is a condition in which chronic inflammation and swelling cause the inside of the breathing tubes (airways) to be smaller than normal. This narrowing interferes with how well and how easily air empties out of the lungs (expiration).
What is emphysema?
The lungs are made up of more than 300 million tiny air sacs called alveoli. These air sacs are normally stretchy and springy. When you breathe in, the airs sacs expand like tiny balloons. Breathing out usually is passive (takes no effort) as the alveoli “spring” back to their original size. In emphysema, the walls of the air sacs (alveoli) of the lung are damaged and lose their stretchiness. As a result, they do not empty easily. Emphysema can also contribute to narrowing of the airways.
In COPD, less air flows in and out of the airways because of one or more of the following: The airways and air sacs lose their elastic quality. The walls between many of the air sacs are destroyed. The walls of the airways become thick and inflamed. The airways make more mucus than usual, which tends to clog them.
What Causes COPD?
Most cases of COPD occur as a result of long-term exposure to lung irritants that damage the lungs and the airways. In the United States, the most common irritant that causes COPD is cigarette smoke. Pipe, cigar, and other types of tobacco smoke also can cause COPD, especially if the smoke is inhaled.
Breathing in secondhand smoke, air pollution, and chemical fumes or dust from the environment or workplace also can contribute to COPD. (Secondhand smoke is smoke in the air from other people smoking.)
In rare cases, a genetic condition called alpha-1 antitrypsin deficiency may play a role in causing COPD. People who have this condition have low levels of alpha-1 antitrypsin (AAT)—a protein made in the liver. Having a low level of the AAT protein can lead to lung damage and COPD if you’re exposed to smoke or other lung irritants. If you have this condition and smoke, COPD can worsen very quickly.
What are the Signs and Symptoms of COPD?
An ongoing cough or a cough that produces large amounts of mucus (often called “smoker’s cough”) Shortness of breath, especially with physical activity Wheezing (a whistling or squeaky sound when you breathe) Chest tightness
These symptoms often occur years before the flow of air into and out of the lungs declines. However, not everyone who has these symptoms has COPD. Likewise, not everyone who has COPD has these symptoms.
Some of the symptoms of COPD are similar to the symptoms of other diseases and conditions. Your doctor can find out whether you have COPD.
If you have COPD, you may have colds or the flu (influenza) frequently. If your COPD is severe, you may have swelling in your ankles, feet, or legs; a bluish color on your lips due to a low blood oxygen level; and shortness of breath.
COPD symptoms usually slowly worsen over time. At first, if symptoms are mild, you may not notice them, or you may adjust your lifestyle to make breathing easier. For example, you may take the elevator instead of the stairs.
Over time, symptoms may become severe enough to see a doctor. For example, you may get short of breath during physical exertion. How severe your symptoms are depends on how much lung damage you have. If you keep smoking, the damage will occur faster than if you stop smoking. In severe COPD, you may have other symptoms, such as weight loss and lower muscle endurance.
Some severe symptoms may require treatment in a hospital. You—with the help of family members or friends, if you’re unable—should seek emergency care if: You’re having a hard time catching your breath or talking. Your lips or fingernails turn blue or gray. (This is a sign of a low oxygen level in your blood.) You’re not mentally alert. Your heartbeat is very fast. The recommended treatment for symptoms that are getting worse isn’t working.
COPD has no cure yet. However, treatments and lifestyle changes can help you feel better, stay more active, and slow the progress of the disease. Quitting smoking is the most important step you can take to treat COPD. Talk with your doctor about programs and products that can help you quit.
Also, try to avoid secondhand smoke. (Secondhand smoke is smoke in the air from other people smoking.) Other treatments for COPD may include medicines, vaccines, pulmonary rehabilitation (rehab), oxygen therapy, and surgery. Your doctor also may recommend tips for managing COPD complications.
Bronchodilators relax the muscles around your airways. This helps open your airways and makes breathing easier.
Inhaled steroids are used to treat people whose COPD symptoms flare up or worsen. These medicines may reduce airway inflammation.
The flu (influenza) can cause serious problems for people who have COPD. Flu shots can reduce your risk of the flu.
Pneumococcal Vaccine. This vaccine lowers your risk of pneumococcal pneumonia (nu-MO-ne-ah) and its complications. People who have COPD are at higher risk of pneumonia than people who don’t have COPD.
Pulmonary rehabilitation, or rehab, is a medically supervised program that helps improve the health and well-being of people who have lung problems.
If you have severe COPD and low levels of oxygen in your blood, oxygen therapy can help you breathe better. For this treatment, you’re given oxygen through nasal prongs or a mask.