About COPD

Symptoms | Risk Factors | Diagnosis | Treatment

Chronic obstructive pulmonary disease (COPD) is a group of long-term lung diseases in which the lungs are damaged, making it hard to breathe. People with COPD have chronic bronchitis, emphysema or both. The disease is sometimes called chronic obstructive lung disease (COLD) or chronic airflow obstruction (CAO).

Being diagnosed with COPD means the airflow through the airways – the bronchial tubes that carry air in and out of lungs – is partially blocked, resulting in difficulty breathing. The airways become inflamed, which causes mucus-producing cells to develop and multiply. As the mucus increases, the airways begin to narrow, obstructing normal airflow and diminishing the elastic quality of the airways and the tiny air sacs at the end of the airways. These tiny air sacs are where the life-sustaining exchange of oxygen and carbon dioxide occurs. When they become damaged, less oxygen is absorbed into the body, which results in shortness of breath, fatigue, difficulty keeping up with normal activities, and eventually other health conditions.

Below is a brief description of the main conditions:

• Chronic bronchitis — inflammation occurs in the bronchial tubes, which causes the tubes to thicken and produce mucus. The inflammation may narrow these tubes, which makes it harder to breathe. A chronic cough brings up mucus.
• Emphysema — the lung tissue and the tiny air sacs (alveoli) at the end of the airways in the lungs become damaged, which impairs the ability of the lungs to absorb oxygen and release it into the bloodstream. The air gets trapped in the lungs and is breathed out again.

Symptoms

The signs and symptoms of COPD are different for each person, depending on whether the condition is mainly chronic bronchitis or mainly emphysema. A notable sign and symptom of chronic bronchitis is a cough that brings up mucus. However, neither a cough nor any other symptoms may be present with emphysema until the disease has progressed to the point where shortness of breath occurs. COPD develops slowly, and can worsen over time. Common signs include:

• Long-term (chronic) cough, sometimes called “smoker’s cough”
• Chronic sputum (mucus) production
• Shortness of breath that is persistent and gets worse, occurs during exercise, and worsens during respiratory infections, such as colds
• Repeated episodes of acute bronchitis
• Wheezing (a whistling or squeaky sound when breathing)
• Chest tightness

Risk Factors

Cigarette smoking is the most common irritant that causes COPD. Other factors include:

• Pipe, cigar, and other types of tobacco, especially if the smoke is inhaled
• Breathing in other fumes and dusts over a long period of time
• Secondhand smoke and genetic disorders

A person who has had frequent and severe lung infections, especially during childhood, may have a greater chance of developing lung damage that can lead to COPD. People at risk for COPD have normal lung function, as measured by forced expiratory volume (FEV1), which is the volume of air that can be forced out in one second after taking a deep breath.

Diagnosis

COPD is diagnosed based on medical history, results from a physical exam and breathing tests. A device called a spirometer is used in a spirometry test to measure lung capacity. The spirometer measures the FEV1 and the total amount exhaled, called the forced vital capacity (FVC). The spirometry test – the most sensitive and commonly used test for lung capacity – can detect COPD long before symptoms occur.

Based upon this breathing test, individuals are classified in the following COPD stages:

• Mild COPD (stage 1) – At this stage, individuals usually have no symptoms and do not seek treatment.
• Moderate COPD (stage 2) – Breathing tests show worsening airflow. At this stage, a person usually seeks medical attention.
• Severe COPD (stage 3) – This stage is characterized by greatly reduced lung function. Symptoms include shortness of breath with simple daily activities, weight loss, and repeated and sometimes severe COPD exacerbation.
• Very Severe COPD (stage 4) – Severe COPD with less than 30 percent of functioning lung capacity. Symptoms include blue skin color (cyanosis), especially in the lips, fingers, toes, fluid build-up in the legs and feet (edema), bloated abdomen, and life-threatening COPD exacerbation.

Other lab tests available for confirmed diagnosis of COPD include:

• Arterial blood gases test – Measures the amount of oxygen, carbon dioxide and acid in the blood.
• Oximetry – Measures oxygen saturation in the blood.
• Electrocardiogram (ECG, EKG) – Diagnoses certain heart problems that can cause shortness of breath.
• Transfer factor for carbon monoxide (DLCO) – Helps determine whether lungs are damaged. If so, the extent of the damage is used to assess the severity of COPD.
• Bronchodilator response – Helps determine whether lungs are damaged. If so, the extent of the damage is also used to assess the severity of COPD.

Treatment

Treatment for COPD may help prevent complications, prolong life and improve a person’s quality of life. Quitting smoking, avoiding second-hand smoke, and avoiding exposure to other lung irritants are the most effective ways to slow the progression of the disease.

Treatment may include medicines such as:

• Bronchodilators
• Steroids
• Flu Shots
• Pneumococcal vaccine

Severe Condition:

• Oxygen treatment and surgery to remove part of a lung or even to transplant a lung
• Pulmonary rehab program