What is chronic  obstructive pulmonary disease (COPD)? 

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 done breathing tests, including 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. You will double your chances of quitting even if medicine is  the only treatment you use  to quit, but your odds get even better when you combine medicine and other quit strategies, such as counseling. 

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 a pneumonia shot. 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 air that  is cold  and dry. 
• 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 up your strength. 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? 

Flare-ups: As  COPD gets worse, you may have flare-ups when your symptoms quickly get worse  and stay 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. 

Depression  and anxiety: Knowing that you have a disease that gets worse  over time can be hard. It’s common to feel sad or hopeless sometimes. Having trouble breathing can also make you feel very anxious. If these feelings last, be sure to tell your doctor. Counseling, medicine,  and support groups can help you cope. 

End-of-life issues: 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 surrogate to make decisions in case you are not physically or mentally capable of making those decisions.. It can be comforting  to know that you will get  the type of care that you wish.

Notes: Dr. M. Kristine Schlossberg

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EditText of this page (last edited February 17, 2010)