A to Z Disease

What Is COPD?

COPD stands for chronic obstructive pulmonary disease. It is characterized by a long-term blockage in the airways. Most of the time, COPD means you have bronchitis or emphysema that won't go away, which can lead to both immediate and lasting damage to your lungs and body.

What Happens With COPD?

When we breathe, air enters the lungs and moves through small tubes, called bronchial tubes. At the end of each of these bronchial tubes are small, balloon like sacs called alveoli. These act as filters between the air in the lungs and the blood that moves throughout the body. The thin walls of the alveoli allow oxygen from the air to go into the bloodstream and carbon dioxide to pass from the bloodstream into the lungs to be exhaled. This is what keeps the body's cells alive and functioning.

In people with COPD caused by emphysema, the alveoli filters become damaged. Their elasticity becomes reduced, limiting the ability for the alveoli to move as you inhale and exhale. They also become permanently enlarged, which increases the overall size of your lungs and puts greater strain on your chest muscles to breathe in and out.

In people with COPD caused by chronic bronchitis, the lining of the bronchial tubes become inflamed and thickened. This can narrow the airways. The air passageways can also become blocked because of increased mucus production caused by active and enlarged mucus glands. The cells that help move mucus out of the body can become damaged, reducing your ability to clear mucus from your air passages, which makes breathing difficult.

Causes of COPD

More than 85 percent of COPD cases are caused by smoking tobacco. A chemical in smoke stimulates inflammation in the lungs, leading to either chronic bronchitis or emphysema. Heavy smokers are at the greatest risk—cigarette smokers have more risk than cigar and pipe smokers. A very small number of cases (1 to 2 percent) are caused by a hereditary condition known as "familial emphysema." The remaining causes of COPD are unknown.

Signs & Symptoms of COPD

There are several signs and symptoms of COPD that you may experience:

• Shortness of Breath. For smokers, this may occur during exercise around age 40, and will get worse with age. But if you have "familial emphysema," you may develop symptoms much earlier. Gradually, the shortness of breath will occur even during simple activities.
• Chronic Cough. This is accompanied by an increased production of phlegm. Coughing up blood, called hemoptysis, is also a common symptom.
• Wheezing. This is a high-pitched sound passing through narrowed airways. It typically occurs at night.
• Chest Tightness. Often, the chest feels constricted, as if being wrapped in a tight blanket.

The Differences between COPD And Asthma

The symptoms of COPD can often be confused with those of asthma, but there are big differences between these two diseases.

• Age. COPD occurs later in adulthood, as early as age 40, and tends to worsen with age. Asthma typically develops in children and generally stays the same.
• Types of Triggers. COPD is primarily linked to smoking and not stimulate by common triggers of asthma, such as allergens or weather.
• Frequency of Symptoms. COPD symptoms are chronic while asthmatics have periodic attacks and are symptom-free between attacks.

Preventing COPD

The key to preventing COPD or to keep it from becoming worse is to not smoke. The longer you smoke, the worse the condition becomes. This is because a chemical in smoke stimulates inflammation in the lungs.

Diagnosing COPD

To diagnose COPD and get a good idea of how advanced your symptoms are, your doctor may choose to run some Pulmonary Function Tests, or PFTs.

• Spirometry. This simple test can be performed in most physicians' offices. To do the test, you'll inhale as deeply as possible through a tube, and then exhale, as forcefully and rapidly as you can. It measures how much air goes into and out of your lungs.
• Chest X-Ray. These may be ordered to help rule out other potential conditions.
• Other Tests. Other tests may be done to test different parts of the lungs and their ability to transfer air into the bloodstream. These tests may also be given periodically during treatment to determine how well certain therapies are working.

Treating COPD

While there is no cure for COPD, there are treatments that can help you manage the condition and breathe easier.

Medication Options

Drug treatments come in two major types: bronchodilators and inhaled steroids.

• Bronchodilators. These relax muscles inside bronchial tubes, which will help reduce overall airflow obstruction. They also improve the ability to clear mucus and the endurance of fatigued respiratory muscles. Bronchodilators also come in two main categories: anticholinergics and beta-antagonists.
  • Anticholinergics. These are used to decrease mucus secretions and are actually the drug of choice for COPD maintenance and may also help slow progression of disease.
  • Beta-agonists. These are used to dilate airways.
• Inhaled steroids, or "corticosteroids." These are used to treat inflamed airways. They work well in about 10 to15 percent of COPD patients, but overuse can weaken the bones and increase the risk of high blood pressure and diabetes.

Non-Medication Options

• Oxygen Therapy. It comes in a variety of different forms and can be delivered with a variety of devices.Ask your doctor about the options.
• Protein Therapy. This may be prescribed for those who have "familial emphysema," to help slow lung damage.
• Pulmonary Rehabilitation Program. Most hospitals offer these programs, which can improve fitness, even in severe cases. The programs usually include exercises for the lower and upper extremities, patient education, breathing retraining, and emotional support.
• Nutrition. For patients who lose a lot of weight, a high-fat, low-carbohydrate diet is recommended. If a patient is significantly overweight, losing weight is appropriate.
• Surgery. This can be done to remove portions of the damaged lungs. In the most severe cases, a full lung transplant may be required.

Although there are good treatment options available, the best way to prevent, or at least slow, the progress of COPD is to quit smoking and see your doctor so you can begin treatment.