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Chronic Obstructive Pulmonary Disease
all information

Chronic Obstructive Pulmonary Disease

(COPD; Chronic Bronchitis; Emphysema)

En Español (Spanish Version)More InDepth Information on This Condition

Definition

In chronic obstructive pulmonary disease (COPD) the lungs have trouble pushing out oxygen poor air. If the lungs are filled with this air, there is no room for fresh air with oxygen. The term COPD refers to both the diseases emphysema and chronic bronchitis . Although changes to lung tissue differ with the two diseases, the causes and treatment are similar.

Normal vs Emphysemic Lung

Normal Lung and Emphysemic Lung

© 2008 Nucleus Medical Art, Inc.

Causes

COPD develops due to:

  • Cigarette smoking
  • Inhaling toxins or other irritants
  • Genetic predisposition that can make a person's lungs more susceptible to damage from smoke or pollutants (includes alpha-1-antitrypsin deficiency)

Risk Factors

Factors that increase your chance of developing COPD include:

  • Smoking cigarettes
  • Long-term exposure to second-hand or passive smoke
  • Family members with COPD
  • Exposure to pollutants
  • History of frequent childhood lung infections
  • Age: 50 or older

Symptoms

Early symptoms of COPD include:

  • Coughing in the morning
  • Coughing up clear sputum (mucus from deep in the lungs)
  • Wheezing
  • Shortness of breath with activity

As the disease progresses, symptoms may include:

  • Increased shortness of breath
  • Choking sensation when lying flat
  • Fatigue
  • Trouble concentrating
  • Heart problems
  • Weight loss
  • Breathing through pursed lips
  • Desire to lean forward to improve breathing
  • More frequent flare-ups (periods of more severe symptoms)

Diagnosis

The doctor will ask about your symptoms and medical history. A physical exam will be done.

Tests may include:

  • Chest x-ray —x-rays of the chest that may detect signs of lung infection
  • CT scan —a type of x-ray that uses a computer to make pictures of structures inside the chest
  • Blood tests—to assess the amount of oxygen and carbon dioxide in the blood
  • Lung function tests

Treatment

There is no treatment to cure COPD. Treatment aims to ease symptoms and improve quality of life.

Treatment includes:

Smoking Cessation

Quitting smoking slows the disease. Doctors consider it the most important part of treatment. Smoking cessation programs may include behavior modification and medications to help you quit.

Environmental Management

Limiting the number of irritants in the air you breathe may help make breathing easier. Avoid smoke, dust, smog, extreme heat or cold, and high altitudes.

Medication

Some may be taken by mouth. Nebulizers and inhalers deliver drugs directly to the lungs. Drugs for COPD may work in the following ways:

  • Opening the airways
  • Relaxing the breathing passages
  • Decreasing inflammation
  • Helping thin secretions and bring up mucus from the lungs
  • Treating lung infections (antibiotics)
    • If you have chronic bronchitis and mild-to-moderate COPD, you may not need antibiotics. If you do need them, a study found that shorter antibiotic treatment (five days or less) is as effective as longer treatment (more than five days). *

Oxygen

It is given to improve the air you breathe in. It increases the amount of available oxygen. This can increase energy levels and heart and brain function.

Flu Prevention

COPD makes patients prone to flu and pneumonia . Doctors recommend getting vaccinated to help reduce the risk of getting a severe flu. You should also avoid being around people who are sick.

Exercise

Special exercises can strengthen chest muscles and make breathing easier. Physical activity builds endurance and improves quality of life. Follow your doctor's recommendations for activity levels and restrictions.

Breathing and Coughing Techniques

Special methods of breathing can help bring more air into and force trapped air out of the lungs. Coughing helps clear the lungs of mucus.

Nutrition

  • Maintain a normal weight. Excess weight causes the lungs and heart to work harder.
  • Eat a healthy diet that is low in saturated fat and rich in fruits, vegetables, and whole grain foods.
  • Eat several small meals during the day. It makes breathing easier.
  • Avoid gas-producing foods. Large meals and excess gas swell the stomach, which pushes up on the diaphragm.
  • Drink fluids to keep mucus thin.

Lifestyle Changes

  • 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, making breathing more strenuous.

Surgery

A small number of patients may benefit from surgery.

Prevention

You can reduce your chances of developing COPD by:

  • Not smoking
  • Avoiding exposure to second-hand smoke
  • Avoiding exposure to air pollution or irritants
  • Wearing protective gear if exposed to irritants or toxins at work

RESOURCES:

American Lung Association
http://www.lungusa.org/

National Lung Health Education Program
http://www.nlhep.org/

CANADIAN RESOURCES:

The Canadian Lung Association
http://www.lung.ca/

Health Canada
http://www.hc-sc.gc.ca/

References:

COPD fact sheet. American Lung Association website. Available at: http://www.lungusa.org/site/c.dvLUK9O0E/b.4061173/apps/s/content.asp?ct=3052283 . Accessed July 15, 2008.

Eisner MD, Balmes J, Katz PP, 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.

It has a name: COPD. National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/public/lung/copd/ . Accessed July 15, 2008.

Spirometry. National Lung Health Education Program website. Available at: http://www.nlhep.org/ . Accessed July 15, 2008.

*6/4/2008 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : El Moussaoui R, Roede BM, Speelman P, Bresser P, Prins JM, Bossuyt PM. Abstract Short-course antibiotic treatment in acute exacerbations of chronic bronchitis and COPD: a meta-analysis of double-blind studies. Thorax. 2008;63:415-422. Epub 2008 Jan 30. Review.



Last reviewed October 2007 by Rosalyn Carson-DeWitt, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.


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