Chronic obstructive pulmonary disease (COPD), which includes chronic bronchitis
and emphysema, is a long-term lung disease that makes it hard to breathe.
When you have COPD, it’s hard to get air through the airways and
into and out of the air sacs.
Smoking is the most common cause of COPD. Other risk factors include family
history, exposure to dusts or chemicals in the workplace and home, and
air pollution.
Symptoms
Many people don't recognize the symptoms of COPD until later stages of
the disease. Sometimes people think they are short of breath or less able
to go about their normal activities because they are "just getting
older."
Shortness of breath can be an important symptom of lung disease. If you
experience any of these symptoms, or think you might be at risk for COPD,
it is important to discuss this with your doctor:
Chronic cough
Shortness of breath while doing everyday activities (dyspnea)
Frequent respiratory infections
Blueness of the lips or fingernail beds (cyanosis)
Fatigue
Producing a lot of mucus (also called phlegm or sputum)
Wheezing
Exacerbation
During an exacerbation your symptoms are worse than usual. Flare-up is
another name for exacerbation. This can last for a few days or longer.
You may need different medicines. You may need to go to the hospital.
Diagnosis
To diagnose your condition, your doctor will review your signs and symptoms,
discuss your family and medical history, and discuss any exposure you've
had to lung irritants — especially cigarette smoke. Your doctor
may order several tests to diagnose your condition.
Tests may include:
Lung (pulmonary) function tests. These tests measure the amount of air you can inhale and exhale, and whether
your lungs deliver enough oxygen to your blood. During the most common
test, called spirometry, you blow into a large tube connected to a small
machine to measure how much air your lungs can hold and how fast you can
blow the air out of your lungs. Other tests include measurement of lung
volumes and diffusing capacity, six-minute walk test, and pulse oximetry.
Chest X-ray. A chest X-ray can show emphysema, one of the main causes of
COPD. An X-ray can also rule out other lung problems or heart failure.
CT scan. A CT scan of your lungs can help detect emphysema and help determine if
you might benefit from surgery for
COPD. CT scans can also be used to screen for lung cancer.
Arterial blood gas analysis. This blood test measures how well your lungs are bringing oxygen into
your blood and removing carbon dioxide.
Laboratory tests. Lab tests aren't used to diagnose
COPD, but they may be used to determine the cause of your symptoms or rule
out other conditions. For example, lab tests may be used to determine
if you have the genetic disorder alpha-1-antitrypsin deficiency, which
may be the cause of
COPD in some people. This test may be done if you have a family history of
COPD and develop
COPD at a young age.
Treatment
Treatment can ease symptoms, prevent complications, and generally slow
disease progression. Your healthcare team may include a pulmonologist
and physical and respiratory therapists.
Medication
Bronchodilators are medications that help relax the muscles of the airways,
widening the airways so you can breathe easier. They’re usually
taken through an inhaler or a nebulizer. 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 (whooping cough).
Oxygen therapy
If your blood oxygen level is too low, you can receive supplemental oxygen
through a mask or nasal cannula 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 a form of severe emphysema.
One type of surgery is called bullectomy. During this procedure, surgeons
remove large, abnormal air spaces (bullae) from the lungs.
Another is lung volume reduction surgery, which removes damaged upper lung tissue.
Lung transplantation is an option in some cases.
Lifestyle changes
Certain lifestyle changes may also help alleviate your symptoms or provide relief.
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.
