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Chronic Obstructive Pulmonary Disease (COPD)

 

What is chronic obstructive pulmonary disease (COPD)?

Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory lung disease that causes obstructed airflow from the lungs. A diagnosis of COPD means you may have a lung-damaging disease or symptoms of both, such as chronic bronchitis or emphysema. These diseases can gradually progress and make it harder to breathe over time. People that are diagnosed with COPD are at an increased risk of developing heart disease, lung cancer and a variety of other conditions.

What causes COPD?

Lung damage caused by long-term smoking is the main cause of COPD. Tobacco smoke irritates the airways and triggers inflammation that narrows the airways. However, there can be other factors at play in the development of COPD, including:

You may be at higher risk for COPD if you are:

  • Female.
  • Over the age of 65.
  • Exposed to air pollution or tobacco smoke.
  • Diagnosed with asthma.
  • Work with chemicals, dust, or fumes.
  • Diagnosed with AAT.

What are symptoms of COPD?

COPD can have similar symptoms as those of asthma, like shortness of breath and blocked airflow. However, COPD is chronic and progressive, whereas asthma is short lived and often set off by allergens. The most common signs for COPD include:

  • Cough with mucus that persists for long periods of time.
  • Difficulty taking a deep breath.
  • Shortness of breath with mild exercise.
  • Shortness of breath with regular activity.
  • Wheezing.

The symptoms of COPD can become severe, so it is important to contact your provider if you start to have signs or symptoms. If you report your symptoms early, your provider may be able to change your treatment or medications to better manage your symptoms. Contact your provider within 24 hours if you notice:

  • Shortness of breath that worsens or occurs more often.
  • Changes in mucus, like color, odor, thickness, or with the presence of blood.
  • Swelling in your ankles, feet or legs that is new or worsens.
  • Unexplained weight loss.
  • Frequent headaches in the morning.
  • Fever with cold or flu symptoms.
  • Restlessness, confusion, or forgetfulness.
  • Unexplained fatigue.

How is COPD diagnosed?

COPD is a commonly misdiagnosed condition. To diagnose your condition, your provider will perform a physical examination and review your medical history. They will also ask you about any exposure you have had to lung irritants, especially cigarette smoke. A variety of tests may be needed:

  • Lung function tests – Most commonly called a spirometry test, this test measures the amount of air you can inhale and exhale and whether your lungs deliver enough oxygen to your blood. Other tests include measuring your lung volume and diffusing capacity and pulse oximetry.
  • Chest X-ray – can show emphysema and rule out other lung conditions.
  • CT scan – can help detect emphysema and determine whether you would benefit from a surgery for COPD. A CT scan can also be used to screen for lung cancer.
  • Arterial blood gas analysis – measures how well your lungs bring in oxygen to your blood and remove carbon dioxide.
  • Lab tests – can help to determine the cause of your symptoms and rule out other conditions, such as Alpha-1.

What are treatment options for COPD?

For many people, their COPD is a mild form for which little therapy is needed, other than to quit smoking. For more advanced stages, there are therapies available to help control symptoms, slow progression, reduce your risk of complications and improve your quality of life.

The most important step for treating COPD is to stop all forms of smoking. This can help keep COPD from getting worse and reducing your ability to breathe. Your provider can recommend nicotine replacement products and medications to aid in quitting. You should also avoid secondhand smoke when you can.

Medication can be a good treatment option to treat the symptoms and complications of COPD. The most common medications include:

  • Bronchodilators – typically come in an inhaler form that helps to relax the muscles around your airways. This can help to relieve coughing and shortness of breath and make breathing easier. 
  • Inhaled steroids – these medications can help to reduce airway inflammation and help prevent exacerbations.
  • Combination inhalers – combines bronchodilators and inhaled steroids into one inhaler.
  • Oral steroids – for patients with more frequent, severe cases, oral steroids may prevent further worsening of COPD. This medication can have potentially serious long-term side effects, so consult with your provider.

Lung therapies can be beneficial for people suffering from moderate or severe COPD:

  • Oxygen therapy – for people who do not have enough oxygen in their blood, supplemental oxygen may be needed. There are several devices that can deliver oxygen to your lungs, including lightweight devices to always carry with you. Oxygen therapy can be useful in improving quality of life.
  • Pulmonary rehabilitation program – combines education, exercise training, nutrition advice and counseling.

For people with severe forms of emphysema that aren’t experiencing relief with nonsurgical options, surgery may be recommended. Options include:

  • Lung volume reduction surgery – your surgeon removes small wedges of damaged lung tissue from the upper lungs. This then creates extra space in your chest cavity so the remaining healthier lung can expand and allows the diaphragm to work more efficiently. 
  • Lung transplant – in some severe cases, a total lung transplant may be needed to improve your ability to breathe and to be active. This surgery comes with significant risks and will require lifelong medication.

Even with treatment, you may experience times when your symptoms become worse for days or even weeks. If left untreated, these exacerbations can potentially lead to lung failure. If you notice a sustained increase in coughing, a change in mucus or experience a hard time breathing, contact your healthcare provider right away.

How can I prevent COPD?

Since COPD typically has a clear cause, there is a clear path of prevention and are ways to slow the progression of the disease. The majority of cases are directly related to long-term cigarette smoking, so the best way to prevent COPD is to stop smoking. 

Quitting smoking can be easier said than done. Your provider can recommend a tobacco cessation program that can help you quit for good. Other methods like chewing nicotine gum, wearing a patch and controlling your cravings with mediations are other good ways to aid in quitting smoking.

What are risk factors of COPD?

COPD can cause many complications, including:

  • Respiratory infections – including colds, the flu and pneumonia. Lung damage due to COPD can make it much more difficult to breathe and can cause further damage to lung tissue.
  • Heart problems – COPD can increase your risk of heart disease or heart attacks.
  • Lung cancer – COPD can increase your risk of lung cancer.
  • High blood pressure in lung arteries – COPD can cause high blood pressure in the arteries that are responsible for bringing blood to your lungs.
  • Depression – the effects of COPD can make it difficult to live your life, which can contribute to the development of depression.

If your symptoms are not improving with treatment or getting worse, or if you notice symptoms of an infection, contact your provider right away. Seek immediate medical attention if you cannot catch your breath, experience severe blueness of your lips or fingernail beds, have a rapid heartbeat or have trouble concentrating.