Chronic obstructive pulmonary disease (COPD) is a disease in which the lungs have difficulty expelling oxygen-depleted air. If all the space in the lungs is taken up by air that should be expelled, there is no room for fresh air, full of 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.
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, and perform a physical exam.
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—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 progression of the disease. Doctors consider it the most important aspect of treatment. Smoking cessation programs may include behavior modification and medications to help you gradually taper off cigarettes.
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
Medications may be taken by mouth or inhaled. 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)
Oxygen
Oxygen is given to supplement the air you breathe in. It can increase energy levels and heart and brain function by increasing the amount of available oxygen.
Flu Prevention
Because COPD makes patients prone to flu and pneumonia, doctors recommend getting vaccinated to help reduce the risk of getting severe pneumococcal disease. 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 College of Chest Physicians http://www.chestnet.org
American Lung Association http://www.lungusa.org/
CANADIAN RESOURCES:
BC Health Guide http://www.bchealthguide.org/
The Canadian Lung Association
http://www.lung.ca
References:
American Lung Association website. Available at: http://www.lungusa.org. Accessed October 11, 2005.
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.
National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/. Accessed October 11, 2005.
National Lung Health Education Program website. Available at: http://www.nlhep.org/. Accessed October 11, 2005.
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.
