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What is COPD?

What is chronic obstructive pulmonary disease (COPD)?

COPD is a lung disease that makes it hard to breathe. It is caused by damage to the lungs over many years, usually from smoking.

COPD is often a mix of two diseases:

  • Chronic bronchitis (say "bron-KY-tus"). In chronic bronchitis, the airways that carry air to the lungs (bronchial tubes) get inflamed and make a lot of mucus. This can narrow or block the airways, making it hard for you to breathe.
  • Emphysema (say "em-fuh-ZEE-muh"). In a healthy person, the tiny air sacs in the lungs are like balloons. As you breathe in and out, they get bigger and smaller to move air through your lungs. But with emphysema, these air sacs are damaged and lose their stretch. Less air gets in and out of the lungs, which makes you feel short of breath.

COPD gets worse over time. You can't undo the damage to your lungs. But you can take steps to prevent more damage and to feel better.

What causes COPD?

COPD is almost always caused by smoking. Over time, breathing tobacco smoke irritates the airways and destroys the stretchy fibers in the lungs.

Other things that may put you at risk include breathing chemical fumes, dust, or air pollution over a long period of time. Secondhand smoke is also bad.

It usually takes many years for the lung damage to start causing symptoms, so COPD is most common in people who are older than 60.

You may be more likely to get COPD if you had a lot of serious lung infections when you were a child. People who get emphysema in their 30s or 40s may have a disorder that runs in families, called alpha-1 antitrypsin deficiency, but this is rare.

What are the symptoms?

The main symptoms are:

  • A long-lasting (chronic) cough.
  • Mucus that comes up when you cough.
  • Shortness of breath that gets worse when you exercise.

As COPD gets worse, you may be short of breath even when you do simple things like get dressed or fix a meal. It gets harder to eat or exercise, and breathing takes much more energy. People often lose weight and get weaker.

At times, your symptoms may suddenly flare up and get much worse. This is called a COPD exacerbation (say "egg-ZASS-er-BAY-shun"). An exacerbation can range from mild to life-threatening. The longer you have COPD, the more severe these flare-ups will be.

How is COPD diagnosed?

To find out if you have COPD, a doctor will:

  • Do a physical exam and listen to your lungs.
  • Ask you questions about your past health and whether you smoke or have been exposed to other things that can irritate your lungs.
  • Have you do breathing tests, including spirometry, to find out how well your lungs work.
  • Do chest X-rays and other tests to help rule out other problems that could be causing your symptoms.

If there is a chance you could have COPD, it is very important to find out as soon as you can. This gives you time to take steps to slow the damage to your lungs.

 

This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.

© 1995-2011 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.

How is COPD Treated?

The only way to slow COPD is to quit smoking. This is the most important thing you can do. It is never too late to quit. No matter how long you have smoked or how serious your COPD is, quitting smoking can help stop the damage to your lungs.

It’s hard to quit smoking. Talk to your doctor about treatments that can help. You will double your chances of quitting even if medicine is the only treatment you use to quit, but your odds get even better when you combine medicine and other quit strategies, such as counseling.1 To learn more about how to quit, go to www.smokefree.gov, or call 1-800-QUITNOW (1-800-784-8669).

Your doctor can prescribe treatments that may help you manage your symptoms and feel better.

  • Medicines can help you breathe easier. Most of them are inhaled so they go straight to your lungs. If you get an inhaler, it is very important to use it just the way your doctor shows you.
  • A lung (pulmonary) rehab program can help you learn to manage your disease. A team of health professionals can provide counseling and teach you how to breathe easier, exercise, and eat well.
  • In time, you may need to use oxygen some or most of the time.

People who have COPD are more likely to get lung infections, so you will need to get a flu vaccine every year. You should also get a pneumococcal shot. It may not keep you from getting pneumonia. But if you do get pneumonia, you probably will not be as sick.

There are many things you can do at home to stay as healthy as you can.

  • Avoid things that can irritate your lungs, such as smoke, pollution, and air that is cold and dry.
  • Use an air conditioner or air filter in your home.
  • Take rest breaks during the day.
  • Get regular exercise to stay as strong as you can.
  • Eat well so you can keep up your strength. If you are losing weight, ask your doctor or dietitian about ways to make it easier to get the calories you need.

What else should you think about?

Flare-ups: As COPD gets worse, you may have flare-ups when your symptoms quickly get worse and stay worse. It is important to know what to do if this happens. Your doctor can prescribe medicines to help. But if the attack is severe, you may need to go to the emergency room or call 911.

 

This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.

© 1995-2011 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.

10 FAQs About Living With COPD

COPD stands for chronic obstructive pulmonary disease. It refers to two long-term lung diseases -- chronic bronchitis and emphysema -- that often occur together. COPD makes it difficult for you to breathe. There is no cure for COPD, but you can take steps to manage the disease.

If you or someone you love has been diagnosed with COPD, you probably have many questions. Here are answers to some of the most frequently asked questions about living with COPD, its symptoms, treatment, and causes.

1. What happens to my lungs if I have COPD?

Tubes, called airways, carry air in and out of your lungs. If you have COPD, these airways may become partially blocked from swelling or mucus. This makes it more difficult to breathe.

At the end of the airways are many tiny balloon-like air sacs, which inflate and deflate when you breathe in and out. With COPD, these air sacs lose their elasticity. This can lead to the collapse of small airways and also make it more difficult for you to breathe.

2. What causes COPD?

Cigarette smoking is the most common cause of COPD. Being around secondhand smoke -- from others who smoke -- also plays a role in an individual developing COPD.

Other causes of COPD include long-term exposure to other irritants, such as:

  • Chemicals
  • Dust
  • Air pollution

In rare cases, genes may play a role in COPD. People who lack a protein called alpha 1 antitrypsin may be more likely to develop the disease. Without the protein, their lungs are more vulnerable to developing COPD. If they are smokers, their disease tends to progress more quickly.

 

3. What are the signs and symptoms of COPD?

These are the most common COPD symptoms:

  • A cough that doesn't go away
  • Coughing up lots of mucus
  • Shortness of breath, especially with activity
  • Wheezing
  • Tightness in the chest
  • Limitations in activity

 

4. How is COPD diagnosed?

To diagnose COPD, your doctor will ask about your symptoms and medical history, do a physical exam, and conduct breathing tests.

The most common breathing test used to confirm a diagnosis of COPD is spirometry. This easy, painless test involves breathing into a large hose connected to a machine, called a spirometer. The spirometer measures how much air your lungs can hold and how fast you can blow air out of your lungs.

Your doctor may suggest additional tests to rule out other lung problems, such as asthma or heart failure, or to plan treatment. These may include other lung function tests, a chest X-ray, or a test to measure the level of oxygen in your blood.

5. What are the treatments for COPD?

The goal of COPD treatment is to ease your symptoms, slow the progress of COPD, prevent or treat any complications, and improve your overall quality of life.

5. What are the treatments for COPD? continued...

COPD treatment may include:

  • Bronchodilators: medicines (often inhaled) that help open up the airways
  • Corticosteroids: medicines that reduce airway inflammation
  • Antibiotics: medicines to help fight bacterial infections
  • Flu or pneumonia vaccines: immunizations to reduce the chances of getting the flu or pneumonia
  • Pulmonary rehabilitation: a program of exercise, disease management, and counseling to help you stay as healthy and active as possible
  • Oxygen therapy: extra oxygen to reduce shortness of breath, protect organs, and enhance your quality of life

In severe cases of COPD, the doctor may suggest surgery to remove diseased lung tissue or to replace a diseased lung with a healthy one.

6. What can I do to stay healthier while living with COPD?

If you're a smoker, of course the most important thing you can do is to stop smoking. These are other things you can do:

  • Stay away from smoke, fumes, dust, and air pollution as much as you can
  • Take your medication exactly as your doctor prescribes it
  • See your doctor regularly - at least two times a year
  • Learn breathing exercises
  • Walk or do other light exercises several times a week
  • Eat healthy foods

7. Why is good nutrition so important when you're living with COPD?

It goes without saying that good nutrition is important for everyone. If you have COPD, a balanced diet can give you more energy and improve your health. People with COPD require more calories than that of a healthy person. That's because it can takes much more energy just to breathe when you have the disease.

8. What can I do to conserve energy when I have COPD?

There are many things you can do.

  • Put things you use most often in an easy-to-reach place
  • Use a small cart on wheels to move things around
  • Wear clothes and shoes that are easy to put on and take off
  • Do certain tasks sitting down
  • Take regular rest breaks
  • Ask family and friends for help

 

9. What are the complications of living with COPD?

With COPD, you are more likely to:

  • Get colds, the flu, or pneumonia
  • Have an enlarged heart
  • Have high blood pressure

 

10. When should I call for help?

You should call 9-1-1 right away if:

  • You can't walk or talk.
  • Your heart beats very fast or it has an irregular beat.
  • Your lips or fingernails turn blue.
  • You breathe fast and hard, even when on medicines.

 

This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.

© 1995-2011 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.

What Increases Your Risk?

Things that increase your risk for COPD include those you can control, such as smoking, and others that you cannot control, such as a family history of COPD.

Risks you can control

Tobacco smoking is the most important risk factor for COPD. Compared to smoking, other risks are minor.

  • About 15 to 20 out of 100 cigarette smokers get COPD with symptoms.3 Some studies show that up to half of long-term smokers older than age 60 get COPD.4
  • Pipe and cigar smokers have less risk of getting COPD than cigarette smokers, but they still have more risk than nonsmokers.
  • Smoking both tobacco and marijuana increases the risk of COPD more than smoking either one.5
  • The risk for COPD increases with both the amount of tobacco you smoke each day and the number of years you have smoked.

See a graph on how smoking affects the ability to breathe.

For more information, see the topic Quitting Smoking.

Risks you can partially control

  • Outside air pollution. Air pollution may make COPD worse. It may increase the risk of a flare-up, or COPD exacerbation, when your symptoms quickly get worse and stay worse. Try not to be outside when air pollution levels are high.
  • Indoor air pollution. Have good ventilation in your home to avoid indoor air pollution.
  • Secondhand smoke. It is not yet known whether secondhand smoke can lead to COPD. But a large study showed that children who were exposed to secondhand smoke were more likely to get emphysema than children who were not exposed.6 And people who are exposed to secondhand smoke for a long time are more likely to have breathing problems and respiratory diseases.
  • Occupational hazards. If your work exposes you to chemical fumes or dust, use safety equipment to reduce the amount of fumes and dust you breathe.

Risks you can't control

  • Family history of COPD. Some people may be more at risk than others for getting the disease, especially if they have low levels of the protein alpha-1 antitrypsin (alpha-1 antitrypsin deficiency), a disorder that runs in families.
  • Preterm birth. Preterm babies usually need to have long-term oxygen therapy because their lungs are not fully developed. This therapy can cause lung damage (neonatal chronic lung disease) that can increase the risk for COPD later in life.
  • Asthma. People with asthma or with airways that narrow in response to environmental triggers, such as pollen, rarely progress to COPD.

 

This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.

© 1995-2011 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.

Further Reading:

Treatment Overview

Although COPD cannot be cured, it can be managed. The goals of treatment are to:

  • Slow down the disease by avoiding tobacco smoke and air pollution.
  • Limit your symptoms, such as shortness of breath.
  • Increase your activity level.
  • Improve your overall health.
  • Prevent and treat flare-ups . A flare-up, or exacerbation, is when your symptoms quickly get worse and stay worse.

Many people are able to manage their COPD well enough to take part in their usual daily activities, hobbies, and family events.

Initial treatment

At first, treatment for COPD helps you breathe better and slow the disease. Much of the treatment includes things you do for yourself:

  • Quit smoking. This is so important. And it's never too late. No matter how long you have had COPD or how serious it is, quitting smoking will help slow down the disease and improve your quality of life. Today's medicines offer lots of help for people who want to quit. You will double your chances of quitting even if medicine is the only treatment you use to quit, but your odds get even better when you combine medicine and other quit strategies, such as counseling.1

For more information, see the topic Quitting Smoking.

  • Stay active. If you stay active, you may have less shortness of breath, have a better attitude about your life and the disease, and be less likely to feel depressed or isolated from friends and family. Exercise improves shortness of breath and will help you be more active.
  •  
  • Stay healthy. The flu, pneumonia, and other illnesses involving your lungs can make your COPD worse. Do your best to avoid them:
    • Wash your hands often.
    • Stay away from people who have a cold or the flu.
    • Talk with your doctor about getting a yearly flu vaccine and a pneumococcal shot. If you've already had one pneumococcal shot, ask your doctor if you should have a second shot. Sometimes a second shot is advised for people who got their first shot when they were younger than 65.
  • Eat regularly and well. Muscle weakness and weight loss are common with severe COPD. And they make it harder for your body to fight the disease.

Avoid triggers. Stay away from things that can trigger a flare-up, including indoor and outdoor air pollution, cold dry air, hot humid air, and high altitudes.

 

Learn how to breathe. Learn ways to breathe that improve airflow in and out of your lungs. Learn ways to clear your lungs to save energy and oxygen.

 

Rest often. Take rest breaks during household chores and other activities. Talk to an occupational or physical therapist about finding ways to do everyday activities with less effort.

 

 

Oxygen treatment

Oxygen treatment is mainly used to prevent right-sided heart failure or keep it from getting worse.

Medicines

  • Bronchodilators. These medicines open the bronchial tubes, which are your lungs' airways. This helps you breathe better. The medicines are either short-acting to help relieve your symptoms or long-acting to help prevent them.
  • Anti-inflammatory medicines such as corticosteroids. These may be pills that you take or medicine that you inhale. Inhaled medicines are used with an inhaler, which delivers more medicine directly to the lungs. If you use an inhaler, make sure that you know how to use it properly.

 

  • Expectorants. These medicines may make it easier to cough up mucus, but they are no longer commonly used.

Education and support

Treatment should also include:

  • Education. Educating yourself and your family about COPD and your treatment plan helps you and your family cope with your disease.
  • Counseling and support groups. Shortness of breath may lower your activity level. That can make you feel sad and alone because you cannot enjoy activities with your family and friends. But you should be able to lead a full life, including being sexually active. Counseling and support groups can help both you and your family.
  • Building a support network of family and friends. Learning that you have a disease that may shorten your life may cause depression or grief. Anxiety can make your symptoms worse and can cause flare-ups and make them last longer. Support from family and friends can lower your anxiety and stress.

 

 

Ongoing treatment

COPD flare-ups

COPD flare-ups, or exacerbations, are when your symptoms-shortness of breath, cough, and mucus production-quickly get worse and stay worse.

Work with your doctor to make a plan for dealing with a COPD flare-up. If you are prepared, you may be able to get it under control. Do not panic if you start to have one. Quick treatment at home may help you prevent serious breathing problems.

A flare-up can be life-threatening, and you may need to go to your doctor’s office or to a hospital. Treatment for flare-ups includes:

  • Medicines to help you breathe.
  • Anticholinergics (ipratropium, tiotropium)
  • Oral corticosteroids (prednisone, methylprednisolone)
  • Beta2-agonists (albuterol, metaproterenol)
  • Machines to help you breathe. The use of a machine to help with breathing is called mechanical ventilation. Ventilation is used only if medicine is not helping you and your breathing is getting very difficult.
  • Noninvasive positive pressure ventilation (NPPV) forces air into your lungs through a face mask.
  • With invasive ventilation, a breathing tube is inserted into your windpipe, and a machine forces air into your lungs.
  • Oxygen to help you breathe. Oxygen treatment involves getting extra oxygen through a face mask or through a small tube that fits just inside your nose. This can be done in the hospital or at home. For more information, see:
  • Other ongoing treatment
  • Treatment for depression. COPD can affect more than your lungs. It can cause stress, anxiety, and depression. These things take energy and can make your COPD symptoms worse. But anxiety and depression can be treated with counseling and medicine. If you feel very sad or anxious, call your doctor.
  • Treatment for muscle weakness and weight loss.  Many people with severe COPD have trouble keeping their weight up and their bodies strong. This can be treated by paying attention to eating regularly and well.
  • Pulmonary rehabilitation. Your doctor may also suggest a rehab program that is just for people with lung problems. It includes activities such as exercise and breath training.
  • Antibiotics. These medicines are used when a bacterial lung infection is considered likely. People with COPD have a higher risk of pneumonia and frequent lung infections. These infections often lead to COPD exacerbations, or flare-ups, so it's important to try to avoid them.

Treatment if the condition gets worse

As COPD gets worse, you may have more shortness of breath and more flare-ups. It will become harder to do your daily activities. A pulmonary rehabilitation program, which includes activities such as exercise and breath training, can help make it possible for you to do your daily activities.

Other treatment includes:

  • Medicines such as methylxanthines or oral corticosteroids.
  • Oxygen treatment, which increases the amount of oxygen in the blood and lungs. This may improve shortness of breath and help people with severe COPD live longer.
  • Surgery, which is not common. There are several types of surgery for severe COPD:
    • Lung volume reduction surgery removes part of one or both lungs, making room for the remaining lungs to work better.
    • Lung transplant replaces a diseased lung with a living lung from a person who has recently died.
    • Bullectomy removes bullae from the lungs in those who mainly have emphysema. Bullae are formed when the tiny air sacs in the lungs break into larger air spaces. They sometimes can become so large that they interfere with breathing.

Heart failure that affects the right side of the heart, called cor pulmonale, often occurs in people with COPD. Treatment may include oxygen and diuretic medicine.

What to think about

Treatment for COPD is getting better all the time. But COPD is a disease that keeps getting worse and can be fatal. You and your doctor should discuss what types of treatment you want if sudden, life-threatening breathing problems occur.

This discussion may include writing an advance directive. This is a document that your doctor and family can use if you become unable to tell them what your wishes are. For more information, see the topics:

This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.

© 1995-2011 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.