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Chronic obstructive pulmonary disease

COPD; Chronic obstructive airways disease; Chronic obstructive lung disease; Chronic bronchitis; Emphysema; Bronchitis - chronic

Chronic obstructive pulmonary disease (COPD) is one of the most common lung diseases. Having COPD makes it hard to breathe.

There are two main forms of COPD:

  • Chronic bronchitis, which involves a long-term cough with mucus
  • Emphysema, which involves damage to the lungs over time

Most people with COPD have a combination of both conditions.

 

Causes

Smoking is the main cause of COPD. The more a person smokes, the more likely that person will develop COPD. But some people  smoke for years and never get COPD.

In rare cases, nonsmokers who lack a protein called alpha-1 antitrypsin can develop emphysema.

Other risk factors for COPD are:

  • Exposure to certain gases or fumes in the workplace
  • Exposure to heavy amounts of secondhand smoke and pollution
  • Frequent use of cooking fire without proper ventilation

Smoking Myths & Facts

  • Cigarette smoking is the leading cause of COPD.

     

    A. Myth

     

    B. Fact

    Correct Answer
  • Quitting smoking doesn't help once you have COPD.

     

    A. Myth

     

    B. Fact

    Correct Answer
  • Smoking both marijuana and tobacco increases your risk of COPD.

     

    A. Myth

     

    B. Fact

    Correct Answer
  • Most people can quit smoking on the first try.

     

    A. Myth

     

    B. Fact

    Correct Answer
  • Smokers have more COPD flare-ups than nonsmokers.

     

    A. Myth

     

    B. Fact

    Correct Answer
  • Men's lungs are more likely to be damaged by smoking than women's.

     

    A. Myth

     

    B. Fact

    Correct Answer
  • Smoking is not addictive.

     

    A. Myth

     

    B. Fact

    Correct Answer
  • How you smoke can affect how much nicotine gets into your body.

     

    A. Myth

     

    B. Fact

    Correct Answer
  • When you quit smoking, your heart rate and blood pressure return to normal levels.

     

    A. Myth

     

    B. Fact

    Correct Answer
  • Taking a puff of a cigarette can reduce your craving for more.

     

    A. Myth

     

    B. Fact

    Correct Answer

Symptoms


  • Cough, with or without mucus
  • Fatigue
  • Many respiratory infections
  • Shortness of breath (dyspnea) that gets worse with mild activity
  • Trouble catching one's breath
  • Wheezing

Because the symptoms develop slowly, some people may not know that they have COPD.

Exams and Tests

The best test for COPD is a lung function test called spirometry. This involves blowing out as hard as possible into a small machine that tests lung capacity. The results can be checked right away.

Using a stethoscope to listen to the lungs can also be helpful. But sometimes the lungs sound normal even when a person has COPD.

Imaging tests of the lungs, such as x-rays and CT scans, can be helpful. But sometimes the lungs look normal even when a person has COPD and a chest x-ray has been taken.

Some patients may need to have a blood test called arterial blood gas to measure the amounts of oxygen and carbon dioxide in the blood.

Treatment

There is no cure for COPD. But there are many things you can do to relieve symptoms and keep the disease from getting worse.

If you smoke, now is the time to quit.  This is the best way to slow lung damage.

 

Medicines used to treat COPD include:

  • Inhalers (bronchodilators) to help open the airways
  • Inhaled or oral steroids to reduce lung inflammation
  • Anti-inflammatory drugs to reduce swelling in the airways

In severe cases or during flare-ups, you may need to receive:

  • Steroids by mouth or through a vein (intravenously)
  • Bronchodilators through a nebulizer
  • Oxygen therapy
  • Assistance during breathing from a machine (through a mask, BiPAP, or endotracheal tube)

Your doctor may prescribe antibiotics during symptom flare-ups, because infections can make COPD worse.

You may need oxygen therapy at home if you have a low level of oxygen in your blood.

Pulmonary rehabilitation does not cure COPD. But it can teach you to breathe in a different way so you can stay active.

LIVING WITH COPD

You can do things every day to keep COPD from getting worse, protect your lungs, and stay healthy.

Walk to build up strength:

  • Ask the doctor or therapist how far to walk.
  • Slowly increase how far you walk.
  • Try not to talk when you walk if you get short of breath.
  • Use pursed lip breathing when you breathe out, to empty your lungs before the next breath.

Things you can do to make it easier for yourself around the home include:

  • Avoid very cold air
  • Make sure no one smokes in your home
  • Reduce air pollution by getting rid of fireplace smoke and other irritants

Eat healthy foods, including fish, poultry, or lean meat, as well as fruits and vegetables. If it is hard to keep your weight up, talk to a doctor or dietitian about eating foods with more calories.

Surgery may be used to treat COPD, but only a few patients benefit from these surgical treatments:

  • Surgery to remove parts of the diseased lung, which can help less-diseased parts work better in some patients with emphysema
  • Lung transplant for very severe cases

Test Your Knowledge of COPD Triggers

  • People with COPD should take care to avoid getting a cold or the flu.

     

    A. True

     

    B. False

    Correct Answer
  • The air quality outside can affect your COPD symptoms.

     

    A. True

     

    B. False

    Correct Answer
  • Secondhand smoke doesn't affect people with COPD.

     

    A. True

     

    B. False

    Correct Answer
  • Smoke from a wood-burning stove can trigger a flare-up.

     

    A. True

     

    B. False

    Correct Answer
  • Painting your living room can trigger COPD symptoms.

     

    A. True

     

    B. False

    Correct Answer
  • You can reduce your exposure to pollen by:

     

    A. Staying inside when the pollen count is high

     

    B. Using an air conditioner to filter air

     

    C. Removing indoor plants

     

    D. A and B

     

    E. All of the above

    Correct Answer
  • You can keep mold out of your home by controlling moisture.

     

    A. True

     

    B. False

    Correct Answer
  • Dust mites are common in dry areas of your home.

     

    A. True

     

    B. False

    Correct Answer
  • Which of the following can cause a flare-up?

     

    A. Pet dander

     

    B. Pet skin flakes

     

    C. Pet urine

     

    D. Pet saliva

     

    E. All of the above

    Correct Answer
  • Your appliances can cause indoor pollution.

     

    A. True

     

    B. False

    Correct Answer

Support Groups

You can ease the stress of illness by joining a support group. Sharing with others who have common experiences and problems can help you not feel alone.

Outlook (Prognosis)

COPD is a long-term (chronic) illness. The disease will get worse more quickly if you do not stop smoking.

If you have severe COPD, you will be short of breath with most activities. You may be admitted to the hospital more often.

Talk with your doctor about breathing machines and end-of-life care.

Possible Complications

With COPD, you may have other health problems such as:

  • Irregular heartbeat (arrhythmia)
  • Need for breathing machine and oxygen therapy
  • Right-sided heart failure or cor pulmonale (heart swelling and heart failure due to chronic lung disease)
  • Pneumonia
  • Pneumothorax
  • Severe weight loss and malnutrition
  • Thinning of the bones (osteoporosis)
  • Debilitation

When to Contact a Medical Professional

Go to the emergency room or call the local emergency number (such as 911) if you have a rapid increase in shortness of breath.

Prevention

Not smoking prevents most COPD. Ask your health care provider about quit-smoking programs. Medicines are also available to help you stop smoking.

References

Anderson B, Conner K, Dunn C, et al. Institute for Clinical Systems Improvement. Diagnosis and Management of Chronic Obstructive Pulmonary Disease (COPD). Updated March 2013. Available at: https://www.icsi.org/_asset/yw83gh/COPD.pdf. Accessed April 26, 2014.

Balkissoon R, Lommatzsch S, Carolan B, Make B. Chronic obstructive pulmonary disease: a concise review. Med Clin N. Am. 2011;95:1125-1141.

Shapiro SD, Reilly JJ Jr., Rennard SI. Chronic bronchitis and emphysema. In: Mason RJ, Broaddus VC, Martin TR, et al., eds. Murray & Nadel's Textbook of Respiratory Medicine. 5th ed. Philadelphia, PA: Elsevier Saunders; 2010:chap 39.

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    • Smoking tips to quit

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    • Spirometry

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    • Emphysema

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    • Bronchitis

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    • Quitting smoking

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    • COPD (chronic obstructive pulmonary disorder)

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    • Respiratory system

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    • Smoking tips t...

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    • Spirometry

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    • Emphysema

      Emphysema

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    • Bronchitis

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    • Quitting smoking

      Quitting smoking

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    • COPD (chronic obstructive pulmonary disorder)

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    • Respiratory system

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    A Closer Look

     

    Talking to your MD

     

    Self Care

     

    Tests for Chronic obstructive pulmonary disease

     
     

    Review Date: 4/26/2014

    Reviewed By: Denis Hadjiliadis, MD, Associate Professor of Medicine, Pulmonary, Allergy and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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