Chronic Obstructive Pulmonary Disease (COPD)

What is chronic obstructive pulmonary disease (COPD)?

Chronic obstructive pulmonary disease (COPD) is a lung disease that makes it hard to breathe. It is caused by damage to the lungs over many years, usually from smoking.

COPD is often a mix of two diseases:

• Chronic bronchitis (say “bron-KY-tus”). In chronic bronchitis, the airways that carry air to the lungs (bronchial tubes) get inflamed and make a lot of mucus. This can narrow or block the airways, making it hard for you to breathe.
• Emphysema (say “em-fuh-ZEE-muh”). In a healthy person, the tiny air sacs in the lungs are like balloons. As you breathe in and out, they get bigger and smaller to move air through your lungs. But with emphysema, these air sacs are damaged and lose their stretch. Less air gets in and out of the lungs, which makes you feel short of breath.

COPD gets worse over time. You can't undo the damage to your lungs. But you can take steps to prevent more damage and to feel better.

What causes COPD?

COPD is almost always caused by smoking. Over time, breathing tobacco smoke irritates the airways and destroys the stretchy fibers in the lungs.

Other things that may put you at risk include breathing chemical fumes, dust, or air pollution over a long period of time. Secondhand smoke is also bad.

It usually takes many years for the lung damage to start causing symptoms, so COPD is most common in people who are older than 60.

You may be more likely to get COPD if you had a lot of serious lung infections when you were a child. People who get emphysema in their 30s or 40s may have a disorder that runs in families, called alpha-1 antitrypsin deficiency. But this is rare.

What are the symptoms?

The main symptoms are:

• A long-lasting (chronic) cough.
• Mucus that comes up when you cough.
• Shortness of breath that gets worse when you exercise.

As COPD gets worse, you may be short of breath even when you do simple things like get dressed or fix a meal. It gets harder to eat or exercise, and breathing takes much more energy. People often lose weight and get weaker.

At times, your symptoms may suddenly flare up and get much worse. This is called a COPD exacerbation (say “egg-ZASS-er-BAY-shun”). An exacerbation can range from mild to life-threatening. The longer you have COPD, the more severe these flare-ups will be.

How is COPD diagnosed?

To find out if you have COPD, a doctor will:

• Do a physical exam and listen to your lungs.
• Ask you questions about your past health and whether you smoke or have been exposed to other things that can irritate your lungs.
• Have you do a simple breathing test called spirometry to find out how well your lungs work.
• Do chest X-rays and other tests to help rule out other problems that could be causing your symptoms.

If there is a chance you could have COPD, it is very important to find out as soon as you can. This gives you time to take steps to slow the damage to your lungs.

How is it treated?

The only way to slow COPD is to quit smoking. This is the most important thing you can do. It is never too late to quit. No matter how long you have smoked or how serious your COPD is, quitting smoking can help stop the damage to your lungs.

It’s hard to quit smoking. Talk to your doctor about treatments that can help. Using medicines and support increases the chance that you will quit for good. To learn more about how to quit, go to www.smokefree.gov, or call 1-800-QUITNOW (1-800-784-8669).

Your doctor can prescribe treatments that may help you manage your symptoms and feel better.

• Medicines can help you breathe easier. Most of them are inhaled so they go straight to your lungs. If you get an inhaler, it is very important to use it just the way your doctor shows you.
• A lung (pulmonary) rehab program can help you learn to manage your disease. A team of health professionals can provide counseling and teach you how to breathe easier, exercise, and eat well.
• In time, you may need to use oxygen some or most of the time.

People who have COPD are more likely to get lung infections, so you will need to get a flu shot every year. You should also get the pneumonia vaccine. It may not keep you from getting pneumonia. But if you do get pneumonia, you probably will not be as sick.

There are many things you can do at home to stay as healthy as you can.

• Avoid things that can irritate your lungs, such as smoke, pollution, and cold, dry air.
• Use an air conditioner or air filter in your home.
• Take rest breaks during the day.
• Get regular exercise to stay as strong as you can.
• Eat well so you can keep your strength up. If you are losing weight, ask your doctor or dietitian about ways to make it easier to get the calories you need.

What else should you think about?

As COPD gets worse, you may have flare-ups when your symptoms suddenly get much worse. It is important to know what to do if this happens. Your doctor can prescribe medicines to help. But if the attack is severe, you may need to go to the emergency room or call 911.

Knowing you have a disease that gets worse over time can be hard. It’s common to feel sad or hopeless sometimes. If these feelings last, be sure to tell your doctor. Counseling and support groups can help you cope.

Be sure to talk to your doctor about what kinds of treatment you want if your breathing problems become life-threatening. You may want to write a living will. You can also choose a health care agent to make decisions in case you are not able to. It can be comforting to know that you will get the type of care you want.