Chronic obstructive pulmonary disease

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at January 24, 2016
StartDiseasesChronic obstructive pulmonary disease

Chronic obstructive pulmonary disease or COPD is a term used to describe chronic inflammatory lung diseases that affect lung function by blocking airways and making it difficult to breathe. There is currently no cure for COPD, but there are many treatments that can help symptoms.

Contents

Definition & Facts

COPD is caused by prolonged damage to the lungs, usually by smoking cigarettes. This is a serious condition that causes other health complications and early death. COPD can include both chronic bronchitis and emphysema. With chronic bronchitis, the bronchial tubes become inflamed and create a lot of mucus. This can cause the airways to get blocked, which can make it difficult to breathe.

With emphysema, the tiny air sacs in the lung become damaged and lose elasticity, which prevents air getting in and out of the lungs. This can create a feeling of shortness of breath. COPD is a long-term, progressive disease, which means it gets worse as time goes on, and the damage that is done to the lungs cannot be reversed.

Symptoms & Complaints

It may take a long time for symptoms to appear with COPD. When they do appear, this means that the lungs have experienced significant damage. For individuals with chronic bronchitis, the main symptoms they will experience are daily chronic cough with sputum production, lasting for three or more months per year, over a span of two years.

Emphysema can cause shortness of breath which worsens during physical activity. Other symptoms of COPD include tightness in the chest; fast or rapid breathing; excessive mucus production; wheezing; chronic cough with clear, white, green or yellow sputum; respiratory infections; blue tinge to fingernail beds or lips; fatigue; depression and anxiety; increased heart rate; weakness; difficulties sleeping; or unexplained weight loss. Individuals with emphysema will also commonly experience episodes, lasting several days at a time in which their symptoms will increase in severity.

Causes

In developing countries, the most common cause of COPD is exposure to toxic fumes from workplace exposure, air pollution, dust and smoke. In developed countries, such as the United States, most cases of COPD are caused by long-term tobacco smoking. 25% of smokers develop COPD.

Long term exposure to irritants can caused irreversible damage to the respiratory structures such as the windpipe (trachea), the tubes in the lungs, and the air sacs, which contain blood vessels that allow the oxygen that is inhaled to enter the bloodstream.

This damage can lead to the chronic diseases that make up COPD: emphysema and chronic bronchitis. In some rare cases, however, COPD can develop as a result of a genetic disorder, called alpha 1-antitrypsin deficiency. Alpha-1-antitrypsin is a protein which is created in the liver, and is absorbed into the bloodstream to aid in lung protection. There are other genetic susceptibilities that may likely play a factor in the development of COPD in certain individuals.

Diagnosis & Tests

If an individual is experiencing these symptoms, it's important to see a doctor or a pulmonologist (a doctor that specializes in lung disorders). Before any appointment, it's wise to have any information ready for questions, including a detailed list of symptoms and when they occur, family history, and any prescribed medications.

After examination, the doctor may recommend some tests to confirm a diagnosis of COPD, such as pulmonary function tests, chest X-rays, CT scans, or arterial blood gas analysis. Arterial blood gas analysis is a blood test that determines how well the lungs function in bringing in oxygen and removing carbon dioxide in the blood. A CT scan may help detect emphysema or even lung cancer, which is common for smokers who develop COPD. Chest X-rays can help rule out other lung conditions or heart problems, and can show emphysema.

Pulmonary function tests, such as a spirometry, are common. With a spirometry, the patient blows into a large tube that is connected to a spirometer, which measures the amount of air the patient's lungs can hold, as well as how fast they can blow it out. This is an important test to have; spirometry can detect COPD before symptoms emerge, and can help track progression after diagnosis. There are a few other lung function tests that may be given to measure lung volume, diffusing capacity, and pulse oximetry.

Treatment & Therapy

Although COPD does not have a cure, there are many treatment options to help manage symptoms and prolong life. The most important step for anyone diagnosed with COPD is to quit smoking if the patient smokes at the time of diagnosis. Although damage cannot be reversed, quitting smoking can help stop the damage from worsening. If a patient does not quit, their symptoms will worsen, increasing their risk for other health problems such as heart failure and lung cancer.

There are also medications that can be given to manage symptoms. Bronchodilators, which are usually inhaled, are used to relax the muscles in a patient's airways to relieve coughing and make breathing easier. A patient may also be given inhaled steroids to reduce inflammation or oral steroids for severe cases. There are also available medications for relaxing airways and improve breathing ability.

Patients may also receive lung therapy including oxygen therapy in cases of low oxygen in the blood, and pulmonary rehabilitation, which combine education, exercise, and nutrition to improve quality of life. In severe cases, patients may undergo surgery to remove damaged sections of lungs or complete lung transplants.

Prevention & Prophylaxis

Prevention of COPD is simple; avoid smoking and use protection against any environmental toxins, such as the use of masks if working with fumes. If diagnosed, it's important to work hard to quit smoking, avoid air pollutants and smoke, and stick to all doctor's appointments and therapies.

It's also important to learn breathing exercises and relaxation techniques, exercise, and eat well. People with COPD can help reduce mucus buildup by controlled coughing, humidifiers, and drinking water. Despite having no cure, COPD can be managed and symptoms controlled to improve quality of life and prolong it.