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COPD / Asthma

What is COPD?

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.

What are the symptoms of COPD?

At first, symptoms of COPD can be quite mild. You might be inclined to dismiss them as a cold.

Early symptoms include:

  • occasional shortness of breath, especially after exercise
  • mild but recurrent cough
  • needing to clear your throat often, especially first thing in the morning

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:

  • shortness of breath, after even mild exercise such as walking up a flight of stairs
  • wheezing, or noisy breathing
  • chest tightness
  • chronic cough, with or without mucus
  • need to clear mucus from your lungs every day
  • frequent colds, flu, or other respiratory infections
  • lack of energy

In later stages of COPD, symptoms may also include:

  • fatigue
  • swelling of the feet, ankles, or legs
  • weight loss

Immediate medical care is needed if:

  • you have bluish or gray fingernails or lips, as this indicates low oxygen levels in your blood
  • you have trouble catching your breath or cannot talk
  • you feel confused, muddled, or faint
  • your heart is racing

Symptoms are likely to be much worse if you currently smoke or are regularly exposed to smoke.

What causes COPD?

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.

Diagnosing COPD

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:

  • you’re a smoker, or have smoked in the past
  • you’re exposed to lung irritants on the job
  • you’re exposed to a lot of secondhand smoke
  • there’s a family history of COPD
  • you have asthma or other respiratory conditions
  • you take over-the-counter or prescription medications

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:

  • A spirometry is a noninvasive test to assess lung function. During the test, you’ll take a deep breath and then blow into a tube connected to the spirometer.
  • Imaging tests include a chest X-ray or CT scan. These images can provide a detailed look at your lungs, blood vessels, and heart.
  • An arterial blood gas test involves taking a blood sample from an artery to measure your blood oxygen levels.

These tests can determine if you have COPD, or perhaps some other condition, such as asthma or heart failure.

Treatment for COPD

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.

Medication

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.

Oxygen therapy

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

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.

Lifestyle changes

Certain lifestyle changes may also help alleviate your symptoms or provide relief.

These include:

  • If you smoke, quit. Your doctor can recommend appropriate products or support services.
  • Whenever possible, avoid secondhand smoke and chemical fumes.
  • Get the nutrition your body needs. Work with your doctor or dietician to create a healthy eating plan.
  • Talk to your doctor about how much exercise is safe for you.

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