Berkeley Family Practice

COPD

COPD (Chronic Bronchitis, Emphysema)

COPD (chronic obstructive pulmonary disease) is a progressive lung disease that makes it hard to breathe. "Progressive" means the disease gets worse over time, especially if one smokes.

COPD_Lung_Changes_Graphic
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Emphysema and chronic bronchitis are related lung disorders that can lead to COPD.

COPD can cause coughing that produces large amounts of mucus (a slimy substance), wheezing, shortness of breath, chest tightness, and other symptoms.

Someone with COPD is also more likely to have lung infections that can be fatal. The heart may also be affected in those with severe COPD. As COPD symptoms worsen, a person may have more difficulty with walking and exercising.

COPD Quick Facts

  • In COPD, the elastic quality of air sacs (alveoli) is lost. The airways collapse and obstruct the normal airflow. The airways may also become inflamed and thickened.
  • Lung function tests, such as spirometry may be used to diagnose COPD.
  • There is no cure for COPD, but there are medication that can help prevent complications, prolong life, and improve a person's quality of life.
  • COPD treatment may include bronchodilators, steroids (prednisone) and influenza and pneumococcal vaccines.
  • Quitting smoking, staying away from people who are smoking, and avoiding exposure to other lung irritants are the most important ways to reduce your risk of developing COPD or to slow the progress of the disease.
  • A pulmonary rehab program that offers exercise, physical therapy, dietary advice, and counseling may be recommended.
  • Oxygen treatment and surgery to remove part of a lung may be recommended for persons with severe COPD.
  • If you have a sudden worsening of signs or symptoms, it is important to contact your doctor and seek emergency treatment.

COPD and the Lungs

The air sacs are normally elastic and pull back to their original shape after being stretched and filled with air. This elastic quality helps to move the air quickly in and out of the lungs.

In COPD, the air sacs lose their elasticity causing the airways collapse. The air sacs cannot get the air out efficiently and stay inflated. This increases the size of the lungs although the amount of air moving in and out is reduced. The airways also become inflamed and produce more mucus which can further obstruct the flow of air.

COPD Severity

COPD can be classified by the severity of symptoms and results of various tests.

  • At risk (for developing COPD). Breathing test is normal. Mild signs that include a chronic cough and sputum production.
  • Mild COPD. Breathing test shows mild airflow limitation. Signs may include a chronic cough and sputum production. At this stage, you may not be aware that airflow in your lungs is reduced.
  • Moderate COPD. Breathing test shows a worsening airflow limitation. Usually the signs have increased. Shortness of breath usually develops when working hard, walking fast, or doing other brisk activities. At this stage, a person usually seeks medical attention.
  • Severe COPD. Breathing test shows severe airflow limitation. A person is short of breath after just a little activity. In very severe COPD, complications like respiratory failure or signs of heart failure may develop. At this stage, the quality of life is greatly impaired and the worsening symptoms may be life-threatening.

COPD Treatment

COPD cannot be cured. However, there are COPD treatments available that can help you breathe easier and prevent a worsening of symptoms

Quitting smoking is the single most important thing you can do to reduce your risk of developing chronic obstructive pulmonary disease (COPD) and slow the progress of the disease.

The goals of COPD treatment are to:

  • Relieve your symptoms with no or minimal side effects of treatment
  • Slow the progress of the disease
  • Improve exercise tolerance (your ability to stay active)
  • Prevent and treat complications and sudden onset of problems
  • Improve your overall health

Treatment options include the following:

  • COPD medication, including bronchodilators and inhaled corticosteroids
  • Pulmonary rehabliitation
  • Surgery
  • Oxygen

Your recommended treatment for COPD is based on a variety of factors, including the severity of symptoms and other medical conditions.

Managing COPD

Managing complications and preventing sudden onset of problems

People with chronic obstructive pulmonary disease (COPD) often have symptoms that suddenly get worse. This may included increased shortess of breath, chest tightness, more coughing, change in your sputum, and a fever. It is important to call your doctor if you have any of these signs or symptoms.

Sometimes the signs and symptoms are caused by a lung infection, such as pneumonia. If pneumonia is suspected, an antibiotic may be prescribed to fight off the infection.

Your doctor may also recommend additional medications to help with your breathing, such as corticosteroids or bronchodilators.

Your doctor may recommend that you be admitted to the hospital if symptoms are particularly severe and home treatment does not appear to provide sufficient relief.


Reference: The National Heart, Blood, and Lung Institute