Chronic obstructive pulmonary disease, or COPD, is a group of progressive lung diseases. The most common are emphysema and chronic bronchitis. Many people with COPD have both of these conditions.
Emphysema slowly destroys air sacs in your lungs, which interferes with outward air flow. Bronchitis causes inflammation and narrowing of the bronchial tubes, which allows mucus to build up.
COPD makes it harder to breathe. Symptoms may be mild at first, beginning with coughing and shortness of breath. As it progresses, it can become increasingly difficult to breathe.
You may experience wheezing and tightness in the chest. Some people with COPD have exacerbations, or flare-ups of severe symptoms.
The top cause of COPD is smoking. Long-term exposure to chemical irritants can also lead to COPD. It’s a disease that takes a long time to develop.
Diagnosis usually involves imaging tests, blood tests, and lung function tests.
There’s no cure for COPD, but treatment can help ease symptoms, lower the chance of complications, and generally improve quality of life. Medications, oxygen therapy, and surgery are some forms of treatment.
Untreated, COPD can lead to heart problems and worsening respiratory infections.
About 24 million people in the United States have COPD. As many as half are unaware that they have it.
At first, symptoms of COPD can be quite mild. You might be inclined to dismiss them as a cold.
Early symptoms include:
You might start making subtle changes, such as avoiding stairs and skipping physical activities.
Symptoms can get progressively worse and harder to ignore. As the lungs become more damaged, you may experience:
In later stages of COPD, symptoms may also include:
Immediate medical care is needed if:
Symptoms are likely to be much worse if you currently smoke or are regularly exposed to smoke.
In developed countries like the United States, the single biggest cause of COPD is cigarette smoking. About 90 percent of people who have COPD are smokers or former smokers. Among smokers, 20 to 30 percent develop COPD. Many others develop lung conditions or have reduced lung function.
Most people with COPD are over 40 years old and have at least some history of smoking. The longer you smoke, the greater your risk of COPD is. In addition to cigarette smoke, cigar smoke, pipe smoke, and secondhand smoke can cause COPD.
Your risk of COPD is even greater if you have asthma and smoke.
You can also develop COPD if you’re exposed to chemicals and fumes in the workplace. Long-term exposure to air pollution and inhaling dust can also cause COPD.
In developing countries, along with tobacco smoke, homes are often poorly ventilated, forcing families to breathe fumes from cooking and heating fuel.
There may be a genetic predisposition to developing COPD. Up to 5 percent of people with COPD have a deficiency in a protein called alpha-1-antitrypsin. This deficiency causes the lungs to deteriorate and also can affect the liver. There may be other genetic factors at play as well.
COPD isn’t contagious.
There’s no single test for COPD. Diagnosis is based on symptoms, a physical exam, and test results.
When you visit the doctor, be sure to mention all of your symptoms. Tell your doctor if:
During the physical exam, your doctor will use a stethoscope to listen to your lungs as you breathe. Based on all this information, your doctor may order some of these tests to get a more complete picture:
These tests can determine if you have COPD, or perhaps some other condition, such as asthma or heart failure.
Treatment can ease symptoms, prevent complications, and generally slow disease progression. Your healthcare team may include a lung specialist (pulmonologist) and physical and respiratory therapists.
Bronchodilators are medications that help relax the muscles of the airways so you can breathe easier. They’re usually taken through an inhaler. Glucocorticosteroids can be added to reduce inflammation in the airways.
To lower risk of other respiratory infections, ask your doctor if you should get a yearly flu shot, pneumococcal vaccine, and a tetanus booster that includes protection from pertussis or whooping cough.
If your blood oxygen levels are low, you can receive oxygen through a mask or nasal prongs to help you breathe better. A portable unit can make it easier to get around.
Surgery is reserved for severe COPD or when other treatments have failed, which is more likely when you have emphysema. One type of surgery is called bullectomy. That’s when surgeons remove large air sacs (bullae) from the lungs. Another is lung volume reduction surgery, which removes damaged lung tissue.
Lung transplant is an option in some cases.
Certain lifestyle changes may also help alleviate your symptoms or provide relief.