Chronic Obstructive Pulmonary Disease
DefinitionChronic obstructive pulmonary disease (COPD) is a long-term lung disease. COPD makes it difficult to move air in and out of the lungs. It will make breathing difficult. COPD includes:
|Normal and Emphysemic Lung|
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CausesCOPD is caused by damage to the lungs. This damage is caused by:
- Cigarette smoking
- Inhaling toxins or other irritants
- Genetic predisposition that makes the lungs more vulnerable to damage from smoke or pollutants—includes alpha-1-antitrypsin deficiency
Risk FactorsCOPD is more common in adults who are older than 40 years old. Factors that increase your chance of developing COPD include:
- Smoking cigarettes
- Long-term exposure to secondhand or passive smoke (in any form)
- Family members with COPD
- Exposure to pollutants
- History of frequent childhood lung infections
- Smoking "exotic" forms of tobacco, such as Chinese waterpipes
SymptomsEarly symptoms of COPD include:
- Increased sputum production—mucus from deep in the lungs
- Shortness of breath with activity
- Increased shortness of breath
- Choking sensation when lying flat
- Trouble concentrating
- Weight loss
- Breathing through pursed lips
- Desire to lean forward to improve breathing
- Periods of more severe symptoms
DiagnosisYou will be asked about your symptoms and medical history. A physical exam will be done.Your doctor will need to test how impaired your lungs are. This may be done with:
- Lung function tests (spirometry)—to test the force of your breath
- Blood test—to test oxygen and carbon dioxide levels in the blood
TreatmentThere is no cure for COPD. Treatment aims to ease symptoms and improve quality of life.Treatment includes:
Smoking CessationQuitting smoking slows the disease. It is the most important part of treatment. There are many programs to help you quit, including:
- Behavior change program
- Combination of behavior program and medication
Environmental ManagementLimit the number of irritants in the air you breathe. It may help make breathing easier. Avoid smoke, dust, smog, extreme heat or cold, and high altitudes.
MedicationMedication for COPD may help by:
- Opening the airways
- Relaxing the breathing passages
- Decreasing inflammation
- Treating lung infections (antibiotics)
VaccinesThe flu and pneumonia can make your symptoms worse. Get vaccinated against pneumonia and the flu . The flu vaccine may also reduce COPD flare-ups.
OxygenOxygen therapy may be helpful if the oxygen levels in your blood are too low. It can relieve trouble breathing and improve energy. You may only need it for specific activities. It could also be given throughout the day.
ExerciseSpecial exercises can strengthen chest muscles. This can make it easier to breathe.Regular physical activity can reduce the workload on your lungs. It helps build their endurance. Physical activity is also associated with improved quality of life. Follow your doctor's recommendations for activity levels and restrictions.
Breathing and Coughing TechniquesSpecial methods of breathing can help bring more air into your lungs. It can also help force trapped air out of your lungs. Effective coughing techniques can help clear mucus from your lungs. Ask your doctor if these techniques can help you. Some examples include:
- Pursed-lip breathing
- Controlled coughing technique
NutritionEating habits to consider with COPD:
- Eat a healthy diet. It should be low in saturated fat. It should also be rich in fruits, vegetables , and whole grain foods.
- Maintain a normal weight. Excess weight causes the lungs and heart to work harder.
- It may be hard to eat because you feel full. Try eating several smaller meals during the day. This is better than a few large meals.
- Slow down your eating pace. This will make it easier to breathe.
- If you need to gain weight, add food or drinks throughout the day. Talk to a dietitian about how many calories you need each day.
Lifestyle ChangesThe following may help you manage COPD symptoms and avoid flare-ups:
- Pace your activities.
- Learn relaxation techniques and other methods to manage stress.
- Seek emotional support from professionals, family, and friends. Anxiety can increase the rate of respiration. This makes breathing more strenuous.
SurgeryA small number of patients may benefit from surgery. Surgery options include removing a part of the lung. You could also have a lung transplant.
PreventionTake these steps to reduce your chance of developing COPD:
- If you smoke, quit.
- Avoid exposure to second-hand smoke.
- Avoid exposure to air pollution or irritants.
- Wear protective gear if exposed to irritants or toxins at work.
American Lung Association
National Lung Health Education Program
Canadian Lung Association
Breathing techniques. Canadian Lung Association website. Available at: http://www.lung.ca/diseases-maladies/copd-mpoc/breathing-respiration/index%5Fe.php. Accessed September 11, 2014.
COPD. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated August 5, 2014. Accessed September 11, 2014.
Eisner MD, Balmes J, et al. Lifetime environmental tobacco smoke exposure and the risk of chronic obstructive pulmonary disease. Environmental Health: A Global Access Science Source. 2005;4:7.
Spirometry. National Lung Health Education Program website. Available at: http://www.nlhep.org/Pages/Spirometry.aspx. Accessed September 11, 2014.
What is COPD? National Heart Lung and Blood Institute (NHLBI) website. Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/copd. Updated July 31, 2013. Accessed September 11, 2014.
What you can do about a lung disease called COPD. Global Initiative for Chronic Obstructive Lung Disease website. Available at: http://www.goldcopd.org/uploads/users/files/GOLD%5FPatient%5FRevJan10.pdf. Published April 2002. Accessed September 11, 2014.
6/4/2008 DynaMed's Systematic Literature Surveillance. Availalbe at: http://www.ebscohost.com/dynamed: El Moussaoui R, Roede BM, et al. AbstractShort-course antibiotic treatment in acute exacerbations of chronic bronchitis and COPD: a meta-analysis of double-blind studies. Thorax. 2008;63:415-422.
11/6/2009 DynaMed's Systematic Literature Surveillance. Availalbe at: http://www.ebscohost.com/dynamed: Poole P, Chacko E, et al. Influenza vaccine for patients with chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2009;(4):CD002733.
12/14/2009 DynaMed's Systematic Literature Surveillance. http://www.ebscohost.com/dynamed: Donesky-Cuenco D, Nguyen HQ, et al. Yoga therapy decreases dyspnea-related distress and improves functional performance in people with chronic obstructive pulmonary disease: a pilot study. J Altern Complement Med. 2009;15:225-234.
11/7/2014 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Dhe J, Yang Y, et al. Chinese water-pipe smoking and the risk of COPD. 2014;146(4):924-931.
- Reviewer: Kari Kassir, MD
- Review Date: 08/2014
- Update Date: 11/07/2014
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