COPD
- Article
- 2021-02-01
COPD, or chronic obstructive pulmonary disease, is a progressive disease that makes breathing difficult. Progressive means that the disease gets worse over time.
COPD can cause a cough producing large amounts of a mucous substance, mucus, wheezing, shortness of breath, chest tightness, and other symptoms.
COPD can often be prevented. Cigarette smoking is the leading cause of COPD. Most people with COPD smoke or smoke. However, up to 25 percent of people with COPD never smoked. Long-term exposure to other lung irritants - such as air pollution, chemical fumes, or dust - can also contribute to COPD. A rare genetic condition called alpha-1 antitrypsin (AAT) deficiency can also cause the disease.
Overview
To understand COPD, it helps to understand how the lungs work.
COPD Basics. Learn who is at risk for COPD, what symptoms to watch for, and how the disease affects the lungs.
In the lungs, your bronchi branch many times into thousands of smaller, thinner tubes called bronchioles. These tubes end in clusters of small round air sacs called alveoli.
Small blood vessels called capillaries line the walls of the air sacs. When air reaches the air sacs, oxygen travels through the air sac walls into the blood in the capillaries. At the same time, a waste product called carbon dioxide (CO2) gas moves from the capillaries to the air sacs. This process, called gas exchange, brings oxygen to the body to use for vital functions and removes the CO2.
The airways and air sacs are elastic or stretchy. When you inhale, each air pocket fills with air, like a small balloon. When you exhale, the air sacs deflate and the air goes out.
In COPD, less air is flowing in and out of the airways because of one or more of the following:
- The airways and air sacs lose their elastic quality.
- The walls between many of the air pockets have been destroyed.
- The walls of the airways become thick and inflamed.
- The airways make more mucus than normal and can become blocked.
In the United States, the term COPD encompasses two main conditions: emphysema and chronic bronchitis. In emphysema, the walls between many of the air sacs are damaged. As a result, the air sacs lose their shape and become limp. This damage can also destroy the walls of the air sacs, leading to fewer and larger air pockets instead of many small ones. When this happens, the amount of gas exchange in the lungs is reduced.
In chronic bronchitis, the lining of the airways remains constantly irritated and inflamed, causing the lining to swell. A lot of thick mucus forms in the airways, making it difficult to breathe.
Most people with COPD have both emphysema and chronic bronchitis, but the severity of each condition varies from person to person. The general term COPD is thus more accurate.
Symptoms
Initially, COPD can cause no or only mild symptoms. As the disease gets worse, the symptoms usually get more severe. Common signs and symptoms of COPD include:
- A persistent cough or a cough that produces a lot of mucus; this is often referred to as smoker's cough.
- Shortness of breath, especially with physical activity
- Wheezing or a whistling or wheezing noise when breathing
- Tightness in the chest
If you have COPD, you may also have a common cold or other respiratory infections, such as the flu or the flu.
Not everyone with the symptoms described above has COPD. Likewise, not everyone with COPD has these symptoms. Some of the symptoms of COPD are similar to the symptoms of other diseases and conditions. Your doctor can determine if you have COPD.
If your symptoms are mild, you may not notice them or adjust your lifestyle to make breathing easier. For example, you can take the elevator instead of the stairs.
Over time, the symptoms can become severe enough to see a doctor. For example, you may become short of breath during physical exertion.
The severity of your symptoms will depend on how much lung damage you have. If you continue to smoke, the damage will happen faster than if you quitsmoking.
Severe COPD can cause other symptoms such as swelling in your ankles, feet, or legs; weight loss; and a lower endurance of the muscles.
Some serious symptoms may require hospital treatment. You - or, if you can't, family members or friends - should seek emergency care if you experience the following:
- You have trouble catching your breath or talking.
- Your lips or fingernails turn blue or gray, a sign of low oxygen in your blood.
- People around you notice that you are not mentally alert.
- Your heartbeat is very fast.
- The recommended treatment for symptoms that get worse is not working.
Contact your doctor as soon as you notice symptoms of COPD in yourself or a loved one.
Therapy
COPD cannot be cured yet. However, lifestyle changes and treatments can help you feel better, stay more active, and slow the progression of the disease.
The goals of COPD treatment include:
- Relieve your symptoms
- Slowing the progression of the disease
- Improving your exercise tolerance or your ability to stay active
- Prevent and treat complications
- Improving your overall health
To help with your treatment, your doctor may advise you to see a pulmonologist. This is a doctor who specializes in the treatment of lung conditions.
Managing COPD. Learn treatment options and healthy living tips to help manage COPD symptoms.
Read more tips for coping with COPD.
Lifestyle changes
STOP SMOKING AND AVOID LUNG IRRITANTS
Quitting smoking is the most important step you can take to treat COPD. Talk to your doctor about programs and products that can help you quit.
If you are having trouble quitting smoking yourself, consider joining a support group. Many hospitals, workplaces and community groups offer classes to help people quit smoking. Ask your family and friends to support you in your efforts to quit.
Also try to avoid secondhand smoke and places with dust, fumes, or other toxic substances that you can inhale.
For more information on how to quit smoking, read Smoking and Your Heart and Your Guide to a Healthy Heart from the National Heart, Lung and Blood Institute. While these resources focus on heart health, they provide basic information about how to quit smoking. For free help and support in quitting smoking, call the National Cancer Institute's Smoking Quitline at 1-877-44U-QUIT (1-877-448-7848).
OTHER LIFESTYLE CHANGES
If you have COPD, especially more severe forms, you may have difficulty eating enough due to symptoms such as shortness of breath and fatigue. As a result, you may not be getting all the calories and nutrients you need, which can worsen your symptoms and increase your risk of infections.
Talk to your doctor about following an eating plan that meets your nutritional needs. Your doctor may recommend that you eat smaller, more frequent meals; rest before eating; and taking vitamins or nutritional supplements.
Also, talk to your doctor about what types of activities are safe for you. You may find it difficult to stay active with your symptoms. However, physical activity can strengthen the muscles that help you breathe and improve your overall well-being.
Medicines
BRONCHODILATORS
Bronchodilators relax the muscles around your airways. This helps open your airways and makes breathing easier.
Depending on the severity of your COPD, your doctor may prescribe short-acting or long-acting bronchodilators. Short-acting bronchodilators last about 4–6 hours and should only be used as needed. Long-acting bronchodilators last about 12 hours or more and are used every day.
Most bronchodilators are taken with a device called an inhaler. This device delivers the medicine directly to your lungs. Not all inhalers are used in the same way. Ask your healthcare providers to show you the correct way to use your inhaler.
If your COPD is mild, your doctor may only prescribe a short-acting inhaled bronchial tube
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