Chronic obstructive pulmonary disease
COPD; Chronic obstructive airways disease; Chronic obstructive lung disease; Chronic bronchitis; Emphysema; Bronchitis - chronic
Chronic obstructive pulmonary disease (COPD) is a common lung disease. Having COPD makes it hard to breathe.
There are two main forms of COPD:
- Chronic bronchitis, which involves a long-term cough with mucus
- Emphysema, which involves damage to the lungs over time
Most people with COPD have a combination of both conditions.
Causes
Smoking is the main cause of COPD. The more a person smokes, the more likely that person will develop COPD. But some people smoke for years and never get COPD.
In rare cases, nonsmokers who lack a protein called alpha-1 antitrypsin can develop emphysema.
Other risk factors for COPD are:
- Exposure to certain gases or fumes in the workplace
- Exposure to heavy amounts of secondhand smoke and pollution
- Frequent use of a cooking fire without proper ventilation
Symptoms
Symptoms may include any of the following:
- Cough, with or without mucous
- Fatigue
- Many respiratory infections
-
Shortness of breath (
dyspnea
) that gets worse with mild activity
Dyspnea
Breathing difficulty may involve:Difficult breathingUncomfortable breathingFeeling like you are not getting enough air
- Trouble catching one's breath
- Wheezing
Because the symptoms develop slowly, some people may not know that they have COPD.
Exams and Tests
The best test for COPD is a lung function test called spirometry . This involves blowing out as hard as possible into a small machine that tests lung capacity. The results can be checked right away.
Spirometry
Pulmonary function tests are a group of tests that measure breathing and how well the lungs are functioning.
Using a stethoscope to listen to the lungs can also be helpful. But sometimes, the lungs sound normal, even when a person has COPD.
Imaging tests of the lungs, such as x-rays and CT scans , can be helpful. With an x-ray, the lungs may look normal, even when a person has COPD. A CT scan will usually show signs of COPD.
x-rays
A chest x-ray is an x-ray of the chest, lungs, heart, large arteries, ribs, and diaphragm.
CT scans
A chest CT (computed tomography) scan is an imaging method that uses x-rays to create cross-sectional pictures of the chest and upper abdomen....
Sometimes, a blood test called arterial blood gas may be done to measure the amounts of oxygen and carbon dioxide in the blood.
Treatment
There is no cure for COPD. But there are many things you can do to relieve symptoms and keep the disease from getting worse.
If you smoke, now is the time to quit. This is the best way to slow lung damage.
Medicines used to treat COPD include:
- Inhalers (bronchodilators) COPD -- quick-relief drugs to help open the airways
- Inhaled COPD -- control drugs or oral steroids to reduce lung inflammation
- Anti-inflammatory drugs to reduce swelling in the airways
- Certain long-term antibiotics
In severe cases or during flare-ups, you may need to receive:
- Steroids by mouth or through a vein (intravenously)
- Bronchodilators through a nebulizer
- Oxygen therapy
-
Assistance from a machine to help breathing by using a mask,
BiPAP
, or through the use of an endotracheal tube
BiPAP
CPAP stands for continuous positive airway pressure. CPAP pumps air under pressure into the airway of the lungs, keeping the windpipe open during sl...
Your health care provider may prescribe antibiotics during symptom flare-ups , because an infection can make COPD worse.
Flare-ups
COPD exacerbation; Chronic obstructive pulmonary disease exacerbation; Emphysema exacerbation; Chronic bronchitis exacerbation
You may need oxygen therapy at home if you have a low level of oxygen in your blood.
Oxygen therapy
Oxygen - home use; COPD - home oxygen; Chronic obstructive airways disease - home oxygen; Chronic obstructive lung disease - home oxygen; Chronic bro...
Pulmonary rehabilitation does not cure COPD. But it can teach you to breathe in a different way so you can stay active and feel better.
LIVING WITH COPD
COPD - day to day; Chronic obstructive airways disease - day to day; Chronic obstructive lung disease - day to day; Chronic bronchitis - day to day; ...
You can do things every day to keep COPD from getting worse, protect your lungs, and stay healthy.
Walk to build up strength:
- Ask the provider or therapist how far to walk.
- Slowly increase how far you walk.
- Avoid talking if you get short of breath when you walk.
- Use pursed lip breathing when you breathe out, to empty your lungs before the next breath.
Things you can do to make it easier for yourself around the home include:
- Avoid very cold air or very hot weather
- Make sure no one smokes in your home
- Reduce air pollution by not using the fireplace and getting rid of other irritants
-
Manage stress in your mood
Manage stress in your mood
No definition available for this article.
Eat healthy foods, including fish, poultry, and lean meat, as well as fruits and vegetables. If it is hard to keep your weight up, talk to a provider or dietitian about eating foods with more calories.
Surgery may be used to treat COPD. Only a few people benefit from these surgical treatments:
- Surgery to remove parts of the diseased lung, which can help less-diseased parts work better in some people with emphysema
- Lung transplant for a small number of very severe cases
Support Groups
You can ease the stress of illness by joining a support group . Sharing with others who have common experiences and problems can help you not feel alone.
Support group
The following organizations are good resources for information on lung disease:American Lung Association -- www. lung. orgNational Heart, Lung, and B...
Outlook (Prognosis)
COPD is a long-term (chronic) illness. The disease will get worse more quickly if you do not stop smoking.
If you have severe COPD, you will be short of breath with most activities. You may be admitted to the hospital more often.
Talk with your provider about breathing machines and end-of-life care as the disease progresses.
Possible Complications
With COPD, you may have other health problems such as:
-
Irregular heartbeat (
arrhythmia
)
Arrhythmia
An arrhythmia is a disorder of the heart rate (pulse) or heart rhythm. The heart can beat too fast (tachycardia), too slow (bradycardia), or irregul...
- Need for breathing machine and oxygen therapy
-
Right-sided heart failure or
cor pulmonale
(heart swelling and
heart failure
due to chronic lung disease)
Cor pulmonale
Cor pulmonale is a condition that causes the right side of the heart to fail. Long-term high blood pressure in the arteries of the lung and right ve...
Heart failure
Heart failure is a condition in which the heart is no longer able to pump oxygen-rich blood to the rest of the body efficiently. This causes symptom...
-
Pneumonia
Pneumonia
Pneumonia is a breathing (respiratory) condition in which there is an infection of the lung. This article covers community-acquired pneumonia (CAP). ...
-
Pneumothorax
Pneumothorax
A collapsed lung occurs when air escapes from the lung. The air then fills the space outside of the lung, between the lung and chest wall. This bui...
- Severe weight loss and malnutrition
-
Thinning of the bones (
osteoporosis
)
Osteoporosis
Osteoporosis is a disease in which bones become fragile and more likely to break (fracture).
- Debilitation
- Increased anxiety
When to Contact a Medical Professional
Go to the emergency room or call the local emergency number (such as 911) if you have a rapid increase in shortness of breath .
Shortness of breath
Breathing difficulty may involve:Difficult breathingUncomfortable breathingFeeling like you are not getting enough air
Prevention
Not smoking prevents most COPD. Ask your provider about quit-smoking programs. Medicines are also available to help you stop smoking.
References
Anderson B, Conner K, Dunn C, et al. Institute for Clinical Systems Improvement. Diagnosis and Management of Chronic Obstructive Pulmonary Disease (COPD). 9th edition. Updated March 2013. www.icsi.org/_asset/yw83gh/COPD.pdf . Accessed July 21, 2015.
Celli BR, Zuwallack RL. Pulmonary rehabilitation. In: Broaddus VC, Mason RJ, Ernst JD, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine . 6th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 105.
Criner GJ, Bourbeau J, Diekemper RL, et al. Prevention of acute exacerbations of COPD: American College of Chest Physicians and Canadian Thoracic Society Guideline. Chest . 2015;147(4):894-942. PMID: 25321320 www.ncbi.nlm.nih.gov/pubmed/25321320 .
Han MK, Lazarus SC. COPD. In: Broaddus VC, Mason RJ, Ernst JD, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine . 6th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 44.
-
Smoking tips to quit
Animation
-
Chronic obstructive pulmonary disease
Animation
-
Spirometry - illustration
Spirometry is a painless study of air volume and flow rate within the lungs. Spirometry is frequently used to evaluate lung function in people with obstructive or restrictive lung diseases such as asthma or cystic fibrosis.
Spirometry
illustration
-
Emphysema - illustration
Emphysema is a lung disease involving damage to the air sacs (alveoli).There is progressive destruction of alveoli and the surrounding tissue that supports the alveoli. With more advanced disease, large air cysts develop where normal lung tissue used to be. Air is trapped in the lungs due to lack of supportive tissue which decreases oxygenation.
Emphysema
illustration
-
Bronchitis - illustration
Bronchitis is the inflammation of the bronchi, the main air passages to the lungs. It generally follows a viral respiratory infection. Symptoms include coughing, shortness of breath, wheezing and fatigue.
Bronchitis
illustration
-
Quitting smoking - illustration
The many methods of quitting smoking include counseling and support groups, nicotine patches, gums and sprays, and incremental reduction.
Quitting smoking
illustration
-
COPD (chronic obstructive pulmonary disorder) - illustration
Chronic obstructive pulmonary disease (COPD) refers to chronic lung disorders that result in blocked air flow in the lungs. The two main COPD disorders are emphysema and chronic bronchitis, the most common causes of respiratory failure. Emphysema occurs when the walls between the lung's air sacs become weakened and collapse. Damage from COPD is usually permanent and irreversible.
COPD (chronic obstructive pulmonary disorder)
illustration
-
Respiratory system - illustration
Air is breathed in through the nasal passageways, travels through the trachea and bronchi to the lungs.
Respiratory system
illustration
-
Spirometry - illustration
Spirometry is a painless study of air volume and flow rate within the lungs. Spirometry is frequently used to evaluate lung function in people with obstructive or restrictive lung diseases such as asthma or cystic fibrosis.
Spirometry
illustration
-
Emphysema - illustration
Emphysema is a lung disease involving damage to the air sacs (alveoli).There is progressive destruction of alveoli and the surrounding tissue that supports the alveoli. With more advanced disease, large air cysts develop where normal lung tissue used to be. Air is trapped in the lungs due to lack of supportive tissue which decreases oxygenation.
Emphysema
illustration
-
Bronchitis - illustration
Bronchitis is the inflammation of the bronchi, the main air passages to the lungs. It generally follows a viral respiratory infection. Symptoms include coughing, shortness of breath, wheezing and fatigue.
Bronchitis
illustration
-
Quitting smoking - illustration
The many methods of quitting smoking include counseling and support groups, nicotine patches, gums and sprays, and incremental reduction.
Quitting smoking
illustration
-
COPD (chronic obstructive pulmonary disorder) - illustration
Chronic obstructive pulmonary disease (COPD) refers to chronic lung disorders that result in blocked air flow in the lungs. The two main COPD disorders are emphysema and chronic bronchitis, the most common causes of respiratory failure. Emphysema occurs when the walls between the lung's air sacs become weakened and collapse. Damage from COPD is usually permanent and irreversible.
COPD (chronic obstructive pulmonary disorder)
illustration
-
Respiratory system - illustration
Air is breathed in through the nasal passageways, travels through the trachea and bronchi to the lungs.
Respiratory system
illustration
-
Chronic obstructive pulmonary disease
(In-Depth)
-
Chronic obstructive pulmonary disease
(Alt. Medicine)
-
Pulmonary hypertension
(Alt. Medicine)
-
Gastroesophageal reflux disease
(Alt. Medicine)
-
Obstructive sleep apnea
(In-Depth)
-
Bronchitis
(Alt. Medicine)
-
Pneumonia
(In-Depth)
-
Rheumatoid arthritis
(In-Depth)
-
Gastroesophageal reflux disease and heartburn
(In-Depth)
-
Heart failure
(In-Depth)
Review Date: 6/22/2015
Reviewed By: Denis Hadjiliadis, MD, MHS, Associate Professor of Medicine, Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Internal review and update on 07/24/2016 by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.