Chronic obstructive pulmonary disease (COPD)
Chronic obstructive pulmonary disease (COPD) is a common lung disease. 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.
Chronic obstructive pulmonary disease - Animation
For years, you've enjoyed relaxing with a cigarette in your hand, and looked forward to your cigarette breaks at work, but now, all of that smoking has caught up with you. You're coughing, wheezing, often out of breath. Could you have chronic obstructive pulmonary disease? Let's talk about chronic obstructive pulmonary disease, or COPD, for short. COPD is a lung disease that's usually caused by smoking, although some people who smoke for years never get the condition, while a few get COPD even if they've never lit up. Most people with COPD have a combination of a cough that just won't go away, called chronic bronchitis, and lung damage, called emphysema. The symptoms of COPD can sneak up on you slowly. Over time, you'll develop a cough that lingers, day after day. You'll feel tired, and have trouble catching your breath. Only your doctor can tell for sure whether this is COPD. To test for it, you'll need to breathe or blow into a machine as hard as you can, and hold that breath, as long as you can, in a test called spirometry. You may also need to have a blood test to determine how much oxygen and carbon dioxide is in your blood. If you have COPD, the ways things stand now, you'll have it for life, as there is no cure for this disease. However, there are ways to control the condition and help you breathe more easily. The first thing you do, absolutely need to do, is stop smoking, which will help slow down the damage to your lungs. A few medicines can help relieve COPD symptoms. You may breathe in a bronchodilator medicine through an inhaler to open up your airways, or take steroids to bring down the swelling in your lungs. If you're having real trouble breathing though, call your local emergency services number. You may need to visit the hospital for oxygen or breathing assistance. You may also need to take antibiotics during flare-ups, because getting an infection can make your COPD worse. Though it may be hard to exercise when you're feeling out of breath, staying active will help keep your muscles strong. Your doctor can teach you how to breathe in a different way so that you can exercise with COPD. You can help avoid the shortness of breath, the coughing, and the wheezing of COPD by butting out, kicking your cigarette habit as soon as possible. Not smoking is the absolute best way to prevent COPD. Ask your doctor about programs and medicines that may make it easier for you to quit.
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.
If a person has a rare condition in which they lack a protein called alpha-1 antitrypsin, they can develop emphysema even without smoking.
Alpha-1 antitrypsin
Alpha-1 antitrypsin (AAT) deficiency is a condition in which the body does not make enough of AAT, a protein that protects the lungs and liver from d...
Read Article Now Book Mark ArticleEmphysema
Emphysema is a lung disease involving damage to the air sacs (alveoli). There is progressive destruction of alveoli and the surrounding tissue that supports the alveoli. With more advanced disease, large air cysts develop where normal lung tissue used to be. Air is trapped in the lungs due to lack of supportive tissue which decreases oxygenation.
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 a cooking fire without proper ventilation
Overview of chronic obstructive pulmonary disease (COPD) - Animation
COPD is a respiratory disorder characterised by chronic air flow obstruction, which encompasses both emphysema and chronic bronchitis, which share similar etiologic factors, and often occur together. COPD is currently the sixth leading cause of death worldwide, and the fourth leading cause of death in the United States, where it affects over 16 million people. The most significant environmental risk factor for the development of COPD is cigarette smoking. Chronic exposure to cigarette smoke is thought to trigger an inflammatory response within the airways, recruiting immune cells to the alveoli. Immune cells release proteases, which damage the elastic components of the lung’s extracellular matrix (ECM), causing cell death, sagging and expansion of individual alveoli into the larger contagious air spaces. Loss of alveolar surface area reduces alveolar gas exchange, while loss of elasticity reduces the elastic recoil that assists expiration. Both factors contributing to the sensations of breathlessness typical of this condition. Smoking has also been linked to increase in the size and number of mucus secreting goblet cells in the large and small airways, as well as the disruption of mucociliary clearance. These cellular changes lead to excessive mucus production, which narrows the airways and must be cleared by cough, fulfilling the clinical definition of chronic bronchitis. The initial manifestations of COPD are cough, sputum production, and shortness of breath during exercise, especially when involving the arms.
Symptoms
Symptoms may include any of the following:
- Cough, with or without mucus
Cough
Coughing is an important way to keep your throat and airways clear. But too much coughing may mean you have a disease or disorder. Some coughs are d...
Read Article Now Book Mark Article - Fatigue
Fatigue
Fatigue is a feeling of weariness, tiredness, or lack of energy.
Read Article Now Book Mark Article - Frequent respiratory infections
- Shortness of breath (dyspnea) that gets worse with mild activity
Dyspnea
Breathing difficulty may involve:Difficult breathing Uncomfortable breathingFeeling like you are not getting enough air
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- Wheezing
Wheezing
Wheezing is a high-pitched whistling sound during breathing. It occurs when air moves through narrowed breathing tubes in the lungs.
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Because the symptoms develop slowly, many 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 air movement and lung capacity. The results can be checked right away.
Spirometry
Pulmonary function tests are a group of tests that measure breathing and how well the lungs are functioning.
Read Article Now Book Mark ArticleSpirometry
Spirometry is a painless study of air volume and flow rate within the lungs. Spirometry is frequently used to evaluate lung function in people with obstructive or restrictive lung diseases such as asthma or cystic fibrosis.
Using a stethoscope to listen to the lungs can also be helpful, showing prolonged expiratory time or wheezing. But sometimes, the lungs sound normal, even when a person has COPD.
Imaging tests of the lungs, such as x-rays and CT scans may be ordered. With an x-ray, the lungs may look normal, even when a person has COPD. A CT scan will almost always show signs of COPD if it is present.
x-rays
A chest x-ray is an x-ray of the chest, lungs, heart, large arteries, ribs, and diaphragm.
Read Article Now Book Mark ArticleCT scans
A chest CT (computed tomography) scan is an imaging method that uses x-rays to create cross-sectional pictures of the chest and upper abdomen....
Read Article Now Book Mark ArticleSometimes, a blood test called arterial blood gas may be done to measure the amounts of oxygen and carbon dioxide in the blood.
Arterial blood gas
Blood gases are a measurement of how much oxygen and carbon dioxide are in your blood. They also determine the acidity (pH) of your blood.
Read Article Now Book Mark ArticleIf your health care provider suspects you have alpha-1 antitrypsin deficiency, a blood test will likely be ordered to detect this condition.
Blood test
Alpha-1 antitrypsin (AAT) is a laboratory test to measure the amount of AAT in your blood. The test is also done to check for abnormal forms of AAT....
Read Article Now Book Mark ArticleTreatment
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.
Now is the time to quit
Smoking is the leading cause of chronic obstructive pulmonary disease (COPD). Smoking is also a trigger for COPD flare-ups. Smoking damages the air...
Read Article Now Book Mark ArticleSmoking tips to quit - Animation
You probably know by now that smoking damages your lungs, raising your risk for bronchitis, emphysema, and lung cancer. And, you're probably well aware that lighting up also puts you at risk for many different types of cancers, as well as eye disease like cataracts and premature wrinkles, you know why you shouldn't smoke, it's just the quitting part you can't seem to get past. Let's talk about some helpful tips to help you quit smoking, for good this time. It's a familiar story, one that plays out over and over again among smokers. You vow to quit, and you have every intention of doing it, and then the cravings hit. And you can't think about anything but having a cigarette. You get irritable, and you start putting on weight. You think, Just one cigarette wouldn't hurt, would it? And then, before you know it, you're smoking again. Most smokers have tried to quit, and failed, several times. Even if you've failed before, you can still succeed at quitting. Many people have. You just need to find the technique that works for you. So, here are a few tips that can help. First, set a quit date. Write it down on your calendar and tell a few friends, so you'll be too embarrassed to back out. Before your quit date, throw out every cigarette in your house, car, and office. Also toss every ashtray, lighter, and anything else you need to smoke. Wash your clothes and clean your furniture so you won't have that smoky smell hanging around your house. Next, call your doctor. Ask about smoking cessation programs in your area. Also learn about tools that can help you quit, like medicines that reduce the urge to smoke, and nicotine replacement gums, lozenges, patches, and sprays. And then, plan what you'll do instead of smoking. If you smoke with your morning cup of coffee, drink tea or go for a walk instead. If you need a cigarette to keep your mouth busy, try chewing sugarless gum or nibble on a carrot stick. Stick to places where smoking isn't allowed, like smoke-free restaurants. And finally, reward yourself for not smoking. Put all that money that you would have spent on cigarettes into a jar. And once you've collected enough money, use it to take a trip or buy something you've wanted for a long time. Don't get discouraged. Quitting smoking isn't easy. If it were, everyone would have done it by now. Be persistent, reward yourself for the progress you've made, and keep at it until you finally conquer the urge to smoke.
Medicines used to treat COPD include:
- Quick-relief drugs to help open the airways
Quick-relief drugs
Quick-relief medicines for chronic obstructive pulmonary disease (COPD) work quickly to help you breathe better. You take them when you are coughing...
Read Article Now Book Mark Article - Control drugs to reduce lung inflammation
Control drugs
Control medicines for chronic obstructive pulmonary disease (COPD) are medicines you take to control or prevent symptoms of COPD. You must use these...
Read Article Now Book Mark Article - Anti-inflammatory drugs to reduce swelling in the airways
- Certain long-term antibiotics
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 from a machine to help breathing by using a mask or through the use of an endotracheal tube
Machine
Positive airway pressure (PAP) treatment uses a machine to pump air under pressure into the airway of the lungs. This helps keep the windpipe open d...
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Your provider may prescribe antibiotics during symptom flare-ups, because an infection can make COPD worse.
Flare-ups
Chronic obstructive pulmonary disease (COPD) symptoms can worsen rapidly. You may find it hard to breathe. You may cough or wheeze more or produce ...
Read Article Now Book Mark ArticleYou may need oxygen therapy at home if you have a low level of oxygen in your blood.
Oxygen therapy
Because of your medical problem, you may need to use oxygen to help you breathe. You will need to know how to use and store your oxygen.
Read Article Now Book Mark ArticlePulmonary rehabilitation does not cure COPD. But it can teach you more about the disease, train you to breathe in a different way so you can stay active and feel better, and keep you functioning at the highest level possible.
LIVING WITH COPD
You can do things every day to keep COPD from getting worse, protect your lungs, and stay healthy.
Can do things every day
Your health care provider gave you the news: you have chronic obstructive pulmonary disease (COPD). There is no cure, but there are things you can d...
Read Article Now Book Mark ArticleWalk to build up strength:
- Ask the provider or respiratory therapist how far to walk.
- Slowly increase how far you walk.
- Avoid talking if you get short of breath when you walk.
- 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 or very hot weather
- Make sure no one smokes in your home
- Reduce air pollution by not using the fireplace and getting rid of other irritants
- Manage stress and your mood
Manage stress and your mood
People with chronic obstructive pulmonary disease (COPD) have a greater risk for depression, stress, and anxiety. Being stressed or depressed can ma...
Read Article Now Book Mark Article - Use oxygen if prescribed for you
Eat healthy foods, including fish, poultry, and lean meat, as well as fruits and vegetables. If it is hard to keep your weight up, talk to a provider or dietitian about eating foods with more calories, by eating small frequent meals.
Surgery or other interventions may be used to treat COPD. Only a few people benefit from these surgical treatments:
- One-way valves can be inserted with a bronchoscopy to help deflate parts of the lung that are hyperinflated (overinflated) in select patients.
- Surgery to remove parts of the diseased lung, which can help less-diseased parts work better in some people with emphysema (lung volume reduction surgery).
- Lung transplant for a small number of very severe cases.
Lung transplant
Lung transplant is surgery to replace one or both diseased lungs with healthy lungs from a human donor.
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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.
Support group
The following organizations are good resources for information on lung disease:American Lung Association -- www. lung. orgNational Heart, Lung, and B...
Read Article Now Book Mark ArticleOutlook (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 provider about breathing machines and end-of-life care as the disease progresses.
Possible Complications
With COPD, you may have other health problems such as:
Other health problems
If you have chronic obstructive pulmonary disease (COPD), you are more likely to have other health problems, too. These are called comorbidities. P...
Read Article Now Book Mark Article- Irregular heartbeat (arrhythmia)
Arrhythmia
An arrhythmia is a disorder of the heart rate (pulse) or heart rhythm. The heart can beat too fast (tachycardia), too slow (bradycardia), or irregul...
Read Article Now Book Mark Article - Need for breathing machine support with a mask (non-invasive ventilation) and oxygen therapy
- Right-sided heart failure or cor pulmonale (heart swelling and heart failure due to chronic lung disease)
Cor pulmonale
Cor pulmonale is a condition that causes the right side of the heart to fail. Long-term high blood pressure in the pulmonary arteries of the lung an...
Read Article Now Book Mark ArticleHeart failure
Heart failure is a condition in which the heart is no longer able to pump oxygen-rich blood to the rest of the body efficiently. This causes symptom...
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Pneumonia
Pneumonia is a breathing (respiratory) condition in which there is an infection of the lung. This article covers community-acquired pneumonia (CAP). ...
Read Article Now Book Mark Article - Collapsed lung (pneumothorax)
Pneumothorax
A collapsed lung occurs when air escapes from the lung. The air then fills the space outside of the lung between the lung and chest wall. This buil...
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Malnutrition
Malnutrition is the condition that occurs when your body does not get enough nutrients.
Read Article Now Book Mark Article - Thinning of the bones (osteoporosis)
Osteoporosis
Osteoporosis is a disease in which bones become fragile and more likely to break (fracture).
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- Increased anxiety
When to Contact a Medical Professional
Go to the emergency room or call 911 or the local emergency number if you have a rapid increase in shortness of breath.
Prevention
Not smoking prevents most cases of COPD. Ask your provider about quit-smoking programs. Medicines are also available to help you stop smoking.
Quit-smoking
Smoking is the leading cause of chronic obstructive pulmonary disease (COPD). Smoking is also a trigger for COPD flare-ups. Smoking damages the air...
Read Article Now Book Mark ArticleReviewed By
Denis Hadjiliadis, MD, MHS, Paul F. Harron, Jr. Professor of Medicine, Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Global Initiative for Chronic Obstructive Lung Disease (GOLD) website. Global Initiative for Chronic Obstructive Lung Disease: 2023 Report. goldcopd.org/2023-gold-report-2/. Accessed June 2, 2023.
Han MK, Lazarus SC. COPD: diagnosis and management. In: Broaddus VC, Ernst JD, King TE, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 7th ed. Philadelphia, PA: Elsevier; 2022:chap 64.
National Institutes of Health, National Heart, Lung, and Blood Institute website. COPD national action plan. www.nhlbi.nih.gov/health-topics/education-and-awareness/COPD-national-action-plan. Updated February 9, 2021. Accessed June 2, 2023.
Rochester CL, Nici L. Pulmonary rehabilitation. In: Broaddus VC, Ernst JD, King TE, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 7th ed. Philadelphia, PA: Elsevier; 2022:chap 139.