What is chronic obstructive pulmonary disease (COPD)?
Chronic obstructive pulmonary disease (COPD) is a condition in
which some of your airways are permanently blocked. COPD makes it
harder for you to breathe. It causes strain on your heart. It
increases the blood pressure in your lungs (pulmonary
hypertension) and makes your heart get bigger (cor pulmonale).
How does it occur?
There are 2 main types of COPD: chronic bronchitis (inflamed
airways) and emphysema (damage to the lung tissue). Chronic
bronchitis and emphysema result from irritation of your airways
over a long time, usually from smoking and sometimes from air
pollution. Other causes are on-the-job exposure to irritants such
as dust or chemicals, or frequent lung infections.
Chronic bronchitis and emphysema can occur separately but often
they develop together. In chronic bronchitis, the insides of the
airways thicken and swell. This makes the passageway for air
smaller. The damaged airways make more mucus, which can block the
airways and make it hard to breathe. In emphysema, the tiny air
sacs (alveoli) in the lungs may become badly damaged or destroyed
and lose their ability to stretch (get bigger and smaller). This
makes it harder for you to breathe out carbon dioxide after
breathing in air. As the carbon dioxide collects in your lungs,
there is less room for oxygen to be breathed in.
COPD is not contagious. You cannot give it to someone or get it
from someone else.
What are the symptoms?
Symptoms of COPD include:
- deep, persistent cough that produces lots of mucus (sputum)
- thick sputum that is hard to cough up
- wheezing
- shortness of breath, trouble breathing
- rapid breathing
- blue-purple color of the skin (cyanosis), especially of the
hands, feet, and lips
- weight loss
- frequent lung infections
- swelling in the legs, ankles, and feet.
In the early stages of the disease you may not have any symptoms.
How is it diagnosed?
Your healthcare provider will ask you about:
- your symptoms and if you are less active because of the
symptoms
- your smoking habits
- exposure to other people's smoke (secondhand smoke) and other
irritants such as aerosol sprays, industrial chemicals, and
air pollution
- your medical history, for example, if you have had asthma.
Your healthcare provider will examine you. You may have the
following tests:
- a pulmonary function test called spirometry (you breathe into
a tube to measure airflow into and out of your lungs to see
how well your lungs are working)
- chest X-ray
- blood tests
- lab tests of sputum.
How is it treated?
The damage to your lungs cannot be reversed, so treatment aims to:
- Relieve symptoms to help you breathe better and feel better.
- Help you be more physically active.
- Treat infections when they happen.
- Help prevent complications.
- Help prevent the condition from getting worse.
For smokers the most important part of treatment is to quit
smoking. Talk to your healthcare provider about ways to stop
smoking. You might find it helpful to join a quit-smoking program
or to use nicotine patches or gum.
Your healthcare provider may prescribe:
- Medicine that relaxes and opens the airways (called a
bronchodilator). This makes it easier to breathe. Some forms
of this medicine are taken as pills or liquid. Some are
inhaled. Some need to be used with a nebulizer. A nebulizer is
a machine used to inhale moisturized medicine through a face
mask or breathing tube.
- Steroid medicines to reduce inflammation.
- Antibiotics to treat bacterial infection.
- Medicine (called an expectorant) that loosens the mucus and
helps you cough it up.
Ask your healthcare provider if you can help your symptoms with:
- regular exercise, such as walking or riding a stationary
bicycle, according to your healthcare provider's
recommendations
- breathing exercises
- oxygen therapy to make breathing easier
- a humidifier to increase air moisture
- changes in your work environment to reduce exposure to
irritants.
Also ask your healthcare provider how much fluid you should drink
every day.
A pulmonary rehab program can help you learn how to live and feel
better with COPD. The program may offer supervised exercise and
information about a healthy diet. It can help you learn about how
your lungs work and how to care for your COPD. Ask your provider
if there is such a program in your area.
In rare cases of severe COPD, surgery may be an option. Surgery
can remove the most diseased part of the lungs, or a lung
transplant might be considered, depending on your overall health.
How long will the effects last?
COPD cannot be cured. Once you have COPD, it does not get better,
but taking good care of yourself is the best way to keep it from
getting worse. The best way to take care of yourself is to avoid
things that may have caused the COPD, such as tobacco smoke or
exposure to dust, fumes, or chemicals at the workplace. This will
give you the greatest chance of stopping the disease from getting
worse.
How can I take care of myself?
Follow these guidelines to take care of yourself:
- If you smoke, quit.
- Follow your healthcare provider's advice for treating COPD.
Take all of your medicine according to your provider's
instructions.
- Avoid secondhand smoke, air pollution, and extreme changes in
temperature and humidity.
- Ask about getting flu and pneumonia shots.
- Avoid close contact with people who have colds or the flu.
- Eat healthy foods.
- Eat high-calorie snacks between meals if you are underweight.
- Take vitamin and mineral supplements if recommended by your
healthcare provider.
- Be as active as you comfortably can.
- Get plenty of rest and sleep.
- Consider lifestyle changes such as changing jobs or moving to
a less polluted climate or lower altitude.
- If you plan to travel, discuss your plans with your healthcare
provider. It's good to make sure there will be no problems
with high altitude, humidity, temperature, pressurized
airplane cabins, or smoggy cities, especially if you are using
oxygen.
An exacerbation is a worsening of the usual symptoms of COPD. You,
or sometimes a family member, are usually the first to know when
your lung disease is getting worse. Watch for:
- shortness of breath that gets worse
- more coughing, often with chest tightness
- an increase in sputum (you notice you are coughing up more
sputum)
- a change in how the sputum looks, such as a change in color or
streaks of blood
- sputum that has gotten thicker and stickier and harder to
cough up
- new or worsening wheezing
- fever.
Any one of these symptoms might be a warning sign. An exacerbation
is when any 2 of these things are happening. If you can catch
these changes really early, you may be able to prevent a trip to
the hospital. Ask your healthcare provider for instructions on
what to do when you have these symptoms.
Call your healthcare provider if you have:
- chest pain
- fever
- sputum that thickens or changes in color
- blood in the phlegm
- worsening shortness of breath
- shortness of breath even when you are resting.
When should I get emergency help?
It is important to know the difference between earlier signs and
symptoms of sickness and the signs of an emergency. You are in an
emergency situation if:
- You cannot talk.
- It is hard to walk because you are short of breath.
- Your lips or fingernails turn gray or blue.
- Your heart is beating very fast.
- Your medicine does not help for very long or does not help at
all.
- You are breathing fast and hard.
- You feel like you are going to die.
- You are having bad chest pain that does not go away within
about 5 minutes.
Call 911 to get emergency help right away. Do not turn up your
oxygen unless your healthcare provider tells you to do this.
How can I help prevent COPD?
85% of COPD cases are caused by tobacco smoke. This includes the
smokers themselves and people who are exposed to secondhand smoke.
In most cases you can prevent COPD by never smoking and not being
around others who are smoking.
This content is reviewed periodically and is subject to
change as new health information becomes available. The
information is intended to inform and educate and is not a
replacement for medical evaluation, advice, diagnosis or
treatment by a healthcare professional.
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