COPD, or chronic obstructive pulmonary disease, is a lung condition usually caused by smoking. It affects more than 24 million people in the U.S., or 6 percent of the population (COPD Foundation, 2013). It is the third leading cause of death in the U.S. (American Lung Association, 2013).
People with COPD have difficulty breathing. In the early stage of COPD, they may feel breathless during physical activity. Eventually, they have trouble breathing even at rest.
The lungs’ airways are called bronchi, or “branches.” They divide and spread throughout the lung and end in tiny sacs. In someone with normal lungs, these sacs inflate upon the inhale and deflate upon the exhale. In people with COPD, the sacs don't work properly because they are damaged (this condition is also known as emphysema) or the bronchi become inflamed (chronic bronchitis).
Types of COPD
Most people with COPD have both emphysema and chronic bronchitis. In cases of chronic bronchitis, large amounts of mucous develop in the lungs, interfering with breathing.
Some forms of asthma are also categorized as COPD.
What Causes COPD?
Studies show that about 80 percent of COPD cases result from smoking (University of Maryland Medical Center, 2013). Prolonged exposure to secondhand smoke also can cause COPD. Other causes include environmental factors and genetics.
People who are exposed to chemical or cooking fumes, air pollution, dust (created in manufacturing, for example), and other lung irritants can develop COPD. The risk is greater when exposure occurs over a long time.
In rare cases, a lack of a certain type of protein in the blood can damage the lungs and cause COPD. This condition is genetic. Research is ongoing into other genetic causes.
Who Is at Risk for COPD?
Smokers are at the greatest risk of developing COPD. Others who may be at risk include:
- people with jobs that expose them to lung irritants, such as chemicals or smoke, including miners, people who work around diesel fumes, cooks, and furnace technicians
- people with HIV are 50 to 60 percent more likely to develop COPD (University of Maryland Medical Center, 2012)
- people 40 and over, as risk factors increase with age (University of Maryland Medical Center, 2012)
What Are the Symptoms of COPD?
A persistent cough, breathlessness, and fatigue are the major symptoms of COPD. Wheezing and tightness in the chest also are common, as are frequent respiratory infections.
How Is COPD Diagnosed?
Spirometry is the most common way to diagnose COPD. A spirometer measures air flow. Patients blow into a tube, and the device measures how quickly the lungs take in and exhale air. Reduced lung function is a primary indicator of COPD.
Chest X-rays or CT scans can help diagnose emphysema. They can also help rule out diseases other than COPD.
Blood tests can measure for a protein that, when lacking, leads to COPD. This is caused by a genetic condition and can be useful when diagnosing someone with a family history of COPD. Blood tests also can measure how well the lungs are processing oxygen and carbon dioxide.
Sputum or blood tests can diagnose a lung infection.
How Is COPD Treated?
There is no cure for COPD. But lifestyle changes can ease symptoms. Smokers with COPD should seek help for quitting immediately. Other lifestyle changes also need to be undertaken. Exercise, although difficult for some people with COPD, is important to overall health, as is good nutrition.
A variety of medications can ease the symptoms of COPD:
- Bronchodilators are usually taken via an inhaler. They relax the muscles of the lungs and open up airways.
- Short-acting inhalers, generally prescribed in the early stages of COPD, last four to six hours. They are used as needed.
- Long-acting inhalers, used during the later stages of the disease, are used every day and work for about 12 hours.
- Steroids reduce swelling in the airways. They are usually inhaled, often from a device that also contains a bronchodilator. For advanced cases of COPD, they are often taken in pill form. In oral form, steroids may have serious side effects such as weight gain, diabetes, osteoporosis, cataracts, and a vulnerability to infections (Mayo Clinic, 2013).
- Expectorants loosen mucus so it can be expelled by a cough. It is important to clear the lungs of mucus, which accumulates quickly in people with COPD and can lead to infections.
- A variety of antibiotics are prescribed to treat respiratory infections, especially during severe flare-ups of COPD.
Surgery may be performed in severe cases.
In lung volume reduction surgery, a portion of the lung is removed to improve airflow.
In extremely rare instances, a lung transplant may be considered.
If you have been diagnosed with COPD, keep lung irritants such as smoke and aerosols out of your home. On polluted days, stay inside with the windows closed.
Make essential activities such as cooking and cleaning easier by modifying your techniques. Get help if you need it.
Stay in touch with your doctor and be prepared to manage symptoms during flare-ups. Talk to your healthcare providers about exercises you can do to breathe easier.
Oxygen therapy helps some patients breathe easier.
Pulmonary rehabilitation is a multi-pronged approach of education and exercise designed to help patients better manage symptoms. A team of experts will offer coping mechanisms and other suggestions so you can get the most out of life.
What Is the Outlook for COPD?
There is no cure for COPD, but symptoms can be effectively managed to help patients live normal lives as long as possible.
The best way to prevent COPD is to never smoke, or to quit immediately if you already do smoke. Smoking causes the vast majority of cases. If you work in an environmentally hazardous job, talk to your supervisor about ways to protect yourself from harmful inhalants. Always get treatment for respiratory infections.