COPD

COPD is Chronic Obstructive Pulmonary Disease

Chronic obstructive pulmonary disease (COPD) is a lung disease. Approximately 14 million people in the United States have COPD, and that number is rising. In fact, COPD is the fourth most common cause of death in the United States and Canada.

What is COPD?
COPD is a combination of debilitating lung conditions, usually including emphysema and chronic bronchitis.

In emphysema, the air sacs in the lungs (the alveoli) become over-inflated, like a balloon that has been blown up almost to the point of popping. The over-inflation is constant and due to damage to the alveoli walls.

Bronchitis is an inflammation of the bronchial tubes that connect the windpipe to the lungs. When these tubes are swollen and inflamed, air cannot flow freely to and from the lungs. The airways also become narrowed and clogged with heavy mucus. Chronic bronchitis is defined as bronchitis that lasts for three or more months for two years in a row.

Patients with COPD cannot breathe well because airflow into and out of the lungs is blocked by swelling and mucus while the over-inflated, damaged alveoli are unable to function properly in their job of air exchange. COPD can also cause high blood pressure in the lungs (pulmonary hypertension), leading to a form of heart disease called cor pulmonale.

What Causes COPD?
Long-term cigarette smoking causes nearly all cases of emphysema and chronic bronchitis. In fact, COPD develops in up to 20% of people who smoke. Other factors, such as secondhand smoke, air pollution, low birth weight, and other lung infections, also contribute to COPD.

COPD is more common in people who are white, who are older than 60, whose jobs require them to work around harmful chemical fumes and dust, who have chronic asthma, and who have a family history of emphysema.
Symptoms
Because people think that the symptoms of COPD are a part of getting older and not a sign of something more serious, they may have COPD for a long time before seeing a doctor. People who have COPD usually have the symptoms of both emphysema and chronic bronchitis.

The early stages of COPD include a mucus-producing cough, difficulty breathing, shortness of breath, wheezing, a tired feeling (even after simple daily activities), and trouble sleeping due to waking up short of breath or coughing.

The later stages of COPD include a blue tint to the lips, fingers, and toes (cyanosis), fluid accumulation in the legs and feet (edema), severe shortness of breath that makes any type of activity difficult or impossible, weight loss, and a morning headache upon waking.

Diagnosis
It is important that COPD is diagnosed in its early stages. The sooner a patient quits smoking and begins to avoid risk factors that worsen COPD, the better the chances of slowing the damage to the lungs. Doctors can make a tentative diagnosis of COPD by reviewing symptoms and performing a physical examination. Other tests may include:
• Chest x-rays to rule out conditions that have the same symptoms as COPD.
• Spirometry tests to determine how well air is moving in and out of the lungs.
• Blood tests to determine the amount of oxygen in the bloodstream.
• Electrocardiography (ECG or EKG) and echocardiography to rule out any heart problems that may be causing the symptoms.

If COPD is suspected in patients who are young or who have never smoked, doctors may test for a blood protein called alpha1-antitrypsin. People who do not have enough of this protein in their blood often develop COPD.

Treatment
The symptoms of COPD can be treated, but the disease cannot be cured. After the airways and lungs are damaged, the damage cannot be reversed. Treatment options include changes in lifestyle, medicines, and (in rare cases) surgery.

Lifestyle Changes
Changes that improve the symptoms of COPD include quitting smoking, eating a balanced diet, maintaining a healthy weight, avoiding polluted or smoggy areas, avoiding climates that are cold and dry or hot and humid, learning the breathing methods that make breathing easier and more comfortable (called breath training), staying as active as possible by participating in a doctor-approved exercise program, and getting a flu-shot every year to prevent respiratory infection.

Medicine
Medicines that are prescribed to help ease the symptoms of COPD include bronchodilators, corticosteroids, antibiotics, and oxygen treatments.

Surgery
Surgery is rarely used to treat COPD, but in cases where surgery is needed, doctors may recommend a procedure that removes part of the lung or a lung transplant. Doctors resort to these serious types of surgeries when the condition has not improved using other methods.


Resources

Texas Heart Institute www.texasheartinstitute.com/HIC/Topics/Cond/COPD.cfm

National Heart, Lung, and Blood Institute www.nhlbi.nih.gov/health/public/lung/copd/

American Heart Association www.americanheart.org/presenter.jhtml?identifier=4508
The American Lung Association www.lungusa.org (Diseases A to Z > C > COPD)