Chronic Obstructive Pulmonary Disease
Understanding COPD
Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory lung disease that causes obstruction of airflow from the lungs. Symptoms include difficulty breathing, coughing, mucus production (phlegm), and wheezing.
This disease is caused by long-term exposure to irritating gases or particles, most commonly from cigarette smoke.
This disease is characterized by progressively worsening shortness of breath.
Signs & Symptoms
Many people consider increased shortness of breath and coughing to be a normal part of the aging process.
In the early stages of the disease, you may not notice the symptoms.
COPD can develop over many years without any noticeable shortness of breath.
You begin to notice the symptoms at a more advanced stage of the disease.
Although it is incurable, COPD can be managed and treated. Therefore, it is important to know whether you have COPD.
COPD symptoms can vary from person to person, but common symptoms include:
• Shortness of breath*
• Frequent coughing, with or without phlegm**
• Increasing shortness of breath
• Feeling tired, especially during exercise or while performing daily activities
• Wheezing
• A feeling of pressure or tightness in the chest
Three main causes and risk factors
01
Smoking
COPD most commonly occurs in people aged 40 or older who have a history of smoking.
They may be current smokers or former smokers.
Although not everyone who smokes develops COPD, the vast majority of people with COPD—about 90%—have smoked at some point.
However, only one in five smokers will develop significant COPD.
Researchers are trying to determine why some smokers develop COPD while others do not.
Quit smoking helps slow the progression of the disease. This step makes treatment more effective.
02
Environmental Factors
COPD can also occur in people who have been exposed to and have had prolonged contact with hazardous pollutants in the workplace.
Some of these harmful lung irritants include certain chemicals, dust, or smoke.
Heavy or long-term exposure to secondhand smoke or other lung irritants at home, such as organic cooking fuels, can also cause COPD.
03
Genetic factors
Even if a person has never smoked or been exposed to pollutants over a long period of time, they can still develop COPD. Alpha-1 antitrypsin-related COPD is caused by a deficiency of the alpha-1 antitrypsin protein in the bloodstream. Alpha-1 antitrypsin.
Without the alpha-1 antitrypsin protein, white blood cells begin to damage the lungs, leading to a decline in lung function.
Diagnosis
Examinations may include:
01
Lung function test.
A lung function test measures the amount of air you can breathe in and out, as well as whether your lungs are delivering enough oxygen to your blood.
Spirometry can detect COPD even before you experience any symptoms of the disease.
02
Chest X-ray.
A chest X-ray can reveal emphysema, one of the main causes of COPD. An X-ray can also help rule out other possible lung problems or heart failure.
03
CT scan.
A CT scan of the lungs can help detect emphysema and determine whether you might benefit from surgery for COPD.
04
Arterial blood gas analysis.
This blood test measures how well the lungs take oxygen into the blood and remove carbon dioxide.
05
Laboratory tests.
Laboratory tests can be used to determine whether you have a genetic disorder known as alpha-1 antitrypsin (AAt) deficiency, which may be the cause of some cases of COPD. These tests can be performed if you have a family history of COPD and developed the condition at a young age—for example, before age 45.
How can I get tested?
Start by filling out RISK SCREENING which consists of 5 questions, and then talk to your doctor about getting a spirometry test.
Early screening can identify COPD before there is a significant decline in lung function.
Treatment
A COPD diagnosis isn’t the end of the world.
Most people have a mild form of the disease and require little treatment other than quitting smoking.
Even in the later stages of the disease, there are effective treatments available that can control symptoms, reduce the risk of complications and exacerbations (worsening of the disease), and improve your ability to lead an active life.
1. Quit smoking
The most important step in any COPD treatment plan is quit smoking. The source page describes it as the only way to prevent COPD from getting worse, which can ultimately impair breathing. However, quitting smoking is not easy.
Talk to your doctor about nicotine replacement products and medications that might help, as well as ways to deal with relapses into smoking.
Doctors may also recommend support groups for people who want to quit smoking.
You should also avoid exposure to secondhand smoke as much as possible.
2. Medications
Doctors use several types of medications to treat the symptoms and complications of COPD.
You may take some medications regularly and others as needed.
Bronchodilator
These medications, which are usually available in inhaler form, relax the muscles around the airways. This can help relieve coughing and shortness of breath and make breathing easier.
Inhaled steroids
Inhaled corticosteroids can reduce airway inflammation and help prevent exacerbations.
Inhaled steroids
Inhaled corticosteroids can reduce airway inflammation and help prevent exacerbations.
Combination inhaler
Some medications combine bronchodilators and inhaled steroids.
Oral steroids
For people experiencing moderate or severe acute exacerbations, short-term use of oral corticosteroids—for example, five days—prevents further worsening of COPD. However, long-term use of these medications can cause serious side effects, such as weight gain, diabetes, osteoporosis, cataracts, and an increased risk of infection.
Phosphodiesterase-4 inhibitors
This medication reduces inflammation in the airways and relaxes them. Common side effects include diarrhea and weight loss.
Theophylline
This very inexpensive medication can help improve breathing and prevent exacerbations.
Antibiotics
Respiratory tract infections, such as acute bronchitis, pneumonia, and influenza, can worsen COPD symptoms. Antibiotics help treat acute exacerbations, but are generally not recommended for prevention. However, the source page mentions a recent study showing that the antibiotic azithromycin prevents exacerbations, although it is not yet clear whether this is due to its antibiotic effects or its anti-inflammatory properties.
Prevention
The best way to prevent COPD is quit smoking and avoid secondhand smoke and other lung irritants.
If you experience COPD symptoms, getting treatment as soon as possible improves your prognosis.