COPD

What Is COPD?

Chronic obstructive pulmonary disease (COPD) is a group of diseases characterized by damage to the lungs, which makes it hard to breathe. The airways, which carry air in and out of your lungs, become partially blocked. The air sacs (small balloon-like structures at the end of each branch of the lungs) do not work properly, so that less air gets in and out when you breathe.

The Centers for Disease Control and Prevention estimated in 2005 that COPD caused 126,005 deaths in the United States that year. In 2005 more women died as a result of COPD than men (65,193 versus 60,812, respectively). COPD is the fourth leading cause of death in the United States and the world.

What Causes COPD?

In the United States, tobacco use is a leading cause of COPD. Cigarette smoking is considered the most common culprit, but pipe, cigar, and other types of tobacco smoking can also cause COPD. As well, asthma, air pollutants, workplace exposure to certain chemicals or dust, and frequent, severe lung infections during childhood can contribute to its development.

Family history can also increase your likelihood of developing COPD—if you smoke and COPD runs in your family, you’re at greater risk.

Symptoms

  • Coughing
  • Wheezing
  • Mucus production
  • Tightness in chest
  • Shortness of breath, especially with exercise

Testing

Early detection of COPD can help improve outcomes. If you’re a current or former smoker or are having breathing problems, you can see your doctor for a breathing test called spirometry, which can help detect COPD. A spirometry test measures how much air your lungs can hold and how fast you can blow air out of your lungs.

Your doctor will also listen to your lungs and ask you about your medical history and about your exposure to lung irritants. COPD is most often diagnosed in middle-aged and older individuals.

Other possible testing includes a test to rule out asthma as the cause of your breathing problems, a chest X-ray, and an arterial blood gas test. The blood test measures oxygen levels in the blood to determine if oxygen treatment is needed.

Based on the extent to which breathing is limited, COPD is classified by four levels of severity:

  • Risk for COPD—mild symptoms like chronic cough and mucus production
  • Mild COPD—mild breathing limitation with chronic cough and mucus production
  • Moderate COPD—worse symptoms than mild COPD, with shortness of breath during moderate or intense activity
  • Severe COPD—severe breathing limitation during light activity, risk for respiratory and heart failure

Medications and Prevention

There is no cure for COPD. Instead, the goal of treatment is to help you feel better, improve your overall health, help you stay active, and slow the damage to your lungs. And because the damage to your lungs caused by COPD can’t be reversed, taking measures to prevent its development is particularly important.

We know that tobacco use is a key factor in the development of COPD; therefore, avoiding exposure to tobacco by not smoking or using tobacco products and staying away from people who do smoke, is an important step in reducing your risk. Avoiding home and workplace air pollutants and preventing respiratory infections will also reduce your risk of developing COPD.

Staying away from tobacco smoke and other air pollutants is also an important part of treating COPD. Additional treatment for COPD will be based on the severity of symptoms—mild, moderate, or severe. Treatment may include medication, pulmonary (or lung) rehabilitation, oxygen treatment, or surgery.

Medications

Bronchodilators—these medications make it easier to breathe by relaxing the muscles around your airways. Most bronchodilators are taken using and inhaler and work for either four to six or twelve hours. They are used for people with mild, moderate, or severe COPD.

Inhaled steroids—some people with moderate or severe COPD use inhaled steroids, which reduce inflammation in the airways.

Pneumococcal vaccine and an annual flu shot—these vaccines are recommended in order to prevent pneumonia and breathing complications from the flu.

Pulmonary Rehabilitation

Pulmonary rehabilitation (rehab) may be recommended in addition to medications. The goal of pulmonary rehab is to help people with COPD stay active. A rehab program is managed by doctors, nurses, respiratory therapists, exercise specialists, and dieticians. It may include exercise, nutrition advice, and education about managing COPD.

Oxygen Treatment

People with severe COPD who have low levels of oxygen in the blood may be prescribed oxygen therapy, or use of supplemental oxygen. Oxygen therapy can help relieve shortness of breath and allow you perform daily activities, protect the heart and other organs from damage, improve sleep and alertness, and help you live longer.

Surgery

People with severe COPD may be candidates for surgery. Surgical options include a bullectomy, which removes a large air sac that may compress a good lung, and lung volume reduction surgery, in which damaged tissue is removed from the lung.

In very severe cases of COPD, lung transplant may be recommended.

Living with COPD

If you have COPD, it’s important that you know how to manage your symptoms and what to do if symptoms suddenly get worse.

Daily management involves following your doctor’s recommendations by taking medications as directed as well as following through with other recommended treatments, such as pulmonary rehab and oxygen treatment. As well, avoid lung irritants like tobacco smoke, air pollution, and anything else indicated by your doctor.

If your symptoms suddenly become worse, you may need to call your doctor. Call him or her if you experience sudden chest tightness, more coughing, a change in your mucus, or fever.

If you experience any of the following, you may need to spend time in the hospital:

  • A lot of difficulty catching your breath
  • Difficulty talking
  • Lips or fingernails have turned blue or gray
  • Loss of mental alertness
  • A very fast heartbeat
  • No relief of worsening symptoms with home treatment

You may also want to join a COPD support group such as the American Lung Association’s Better Breathers Clubs (http://www.lungusa.org/lung-disease/copd/connect-with-others/better-breathers-clubs/). Support groups can help you learn better ways to cope with COPD and can be a great source of social support.

Resources

American Lung Association

The Global Initiative for Chronic Obstructive Lung Disease

National Heart, Lung, and Blood Institute

American Thoracic Society

Sources

Chronic Obstructive Pulmonary Disease (COPD). Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/copd/#learn_more. (Accessed October 2010).

COPD. NIH (National Institutes of Health) Senior Health website. Available at: http://nihseniorhealth.gov/copd/toc.html. (Accessed October 2010).