COPD | My Site

What is COPD (chronic obstructive pulmonary disease) ?

COPD is an umbrella term for a range of progressive lung diseases. Chronic bronchitis and emphysema can both result in COPD. A COPD diagnosis means you may have one of these lung-damaging diseases or symptoms of both. COPD can progress gradually, making it harder to breathe over time.

Chronic bronchitis

Chronic bronchitis irritates your bronchial tubes, which carry air to and from your lungs. In response, the tubes swell and mucus (phlegm or “snot”) builds up along the lining. The build-up narrows the tube’s opening, making it hard to get air into and out of your lungs. Small, hair-like structures on the inside of your bronchial tubes (called cilia) normally move mucus out of your airways. But the irritation from chronic bronchitis and/or smoking damages them. The damaged cilia can’t help clear mucus.

Emphysema

Emphysema is the breakdown of the walls of the tiny air sacs (alveoli) at the end of the bronchial tubes, in the “bottom” of your lung. Your lung is like an upside-down tree. The trunk is the windpipe or “trachea,” the branches are the “bronchi,” and the leaves are the air sacs or “alveoli.” The air sacs play a crucial role in transferring oxygen into your blood and carbon dioxide out. The damage caused by emphysema destroys the walls of the air sacs, making it hard to get a full breath.

What’s the difference between asthma and COPD ?

Asthma and COPD are similar in many ways, including similar symptoms like shortness of breath and blocked airflow. However, COPD is chronic and progressive. Asthma is often set off by allergens. COPD’s main cause is smoking. People with asthma don’t automatically develop COPD. People with COPD don’t always have asthma. However, it’s possible to have both of these respiratory conditions. If you do have both, you need to treat both.

Who gets COPD ?

The primary, or main, cause of COPD is smoking. But not all smokers develop the disease.

What causes COPD ?

Smoking tobacco causes up to 90% of COPD cases. Tobacco smoke irritates airways, triggering inflammation (irritation and swelling) that narrows the airways. Smoke also damages cilia so they can’t do their job of removing mucus and trapped particles from the airways.

How is COPD diagnosed ?

Spirometry: to see how well your lungs work. For this test, you blow air into a tube attached to a machine. This lung function test measures how much air you can breathe out and how fast you can do it.

Pulse oximetry: This test measures the oxygen in your blood.

Arterial blood gases (ABGs): These tests check your oxygen and carbon dioxide levels.

Electrocardiogram (ECG or EKG): This test checks heart function and rules out heart disease as a cause of shortness of breath.

Chest X-ray or chest CT scan: Imaging tests look for lung changes that COPD causes.

What are the stages of chronic obstructive pulmonary disease ?

Mild COPD (stage 1 or early stage)

The first sign of COPD is often feeling out of breath with light exercises, like walking up stairs. Because it’s easy to blame this symptom on being out of shape or getting older, many people don’t realize they have COPD. Another sign is a phlegmy cough (a cough with mucus) that’s often particularly troublesome in the morning.

Moderate to severe chronic obstructive pulmonary disease (stages 2 and 3)

In general, shortness of breath is more evident with more advanced COPD. You may develop shortness of breath even during everyday activities. Also, exacerbations of COPD — times when you experience increased phlegm, discoloration of phlegm, and more shortness of breath — are generally more common in higher stages of COPD. You also become prone to lung infections like bronchitis and pneumonia.

Very severe chronic obstructive pulmonary disease (stage 4)

When COPD becomes severe, almost everything you do can cause shortness of breath. This limits your mobility. You may need supplemental oxygen from a portable tank.

How is chronic obstructive pulmonary disease managed ?

Bronchodilators: These medicines relax airways. You inhale a mist containing bronchodilators that help you breathe easier.

Anti-inflammatory medications: You inhale steroids or take them as a pill to lower inflammation in the lungs.

Supplemental oxygen: If blood oxygen is low (hypoxemia), you may need a portable oxygen tank to improve your oxygen levels.

Antibiotics: COPD makes you prone to lung infections, which can further damage your weakened lungs. You may need to take antibiotics to stop a bacterial infection.

Vaccinations: Respiratory infections are more dangerous when you have COPD. It’s especially important to get shots to prevent flu and pneumonia.

Anticholinergics: These drugs relax the muscle bands that tighten around the airways and help clear mucus from the lungs. Relaxed muscles let more air in and out. With the airways open, the mucus moves more freely and can therefore be coughed out more easily. Anticholinergics work differently and more slowly than fast-acting bronchodilators.

Leukotriene modifiers: These medications affect leukotrienes, chemicals that occur naturally in the body that cause tightening of airway muscles and production of mucus and fluid. Leukotriene modifiers block the chemicals and decrease these reactions, helping improve airflow and reducing symptoms in some people.

Expectorants: These products thin mucus in the airways so you can cough it out more easily. You should take these medications with about 8 ounces of water.

Antihistamines: These medicines relieve stuffy heads, watery eyes, and sneezing. Although effective at relieving these symptoms, antihistamines can dry the air passages, making breathing difficult, as well as causing difficulty when coughing up excess mucus. Take these medications with food to reduce upset stomach.

Antivirals: Your provider might prescribe these to treat or prevent illnesses caused by viruses, most frequently to treat or prevent influenza (“the flu”). Influenza is particularly dangerous for people who have COPD.

How can I avoid COPD ?

Not smoking is the best thing you can do to avoid developing COPD. If you’d like to quit, smoking cessation programs can help you. Also, avoid any environment that has poor air quality — air that has particles like dust, smoke, gases and fumes.

Why should people with COPD watch for signs of infection ?

People with COPD have difficulty clearing their lungs of bacteria, dusts and other pollutants in the air. This makes them at risk for lung infections that may cause further damage to the lungs. Therefore, it is important to watch for signs of infection and follow these tips to help prevent infections. You probably won’t be able to avoid infections entirely, but these tips will help you prevent infections as much as possible.

What are warning signs of an infection, especially if I have chronic obstructive pulmonary disease ?

While you can treat most infections successfully, you must be able to recognize an infection’s immediate symptoms for proper and effective care. These may include:

Increased shortness of breath, difficulty breathing or wheezing.
Coughing up increased amounts of mucus.
Yellow- or green-coloured mucus (may or may not be present).
Fever (temperature over 101°F) or chills (may or may not be present).
Increased fatigue or weakness.
Sore throat, scratchy throat or pain when swallowing.
Unusual sinus drainage, nasal congestion, headaches or tenderness along upper cheekbones.
If you have any of these symptoms, contact your healthcare provider right away, even if you don’t feel sick.

What is the outlook for COPD ?

COPD progresses at a different rate for every person. Once it progresses, you can’t reverse the lung damage from COPD but, by following a healthy lifestyle and getting treatment as early as possible, you can manage symptoms and feel much better. Life expectancy for someone with COPD varies from person to person. It depends on how early your provider finds the disease, your general health (including other diseases you might have), and how you manage your treatment. Some people live quite a long time after diagnosis. Other people, with more severe disease, don’t fare as well.

When should I call my healthcare provider if I have COPD ?

Call your healthcare provider if you experience any of the warning signs of an infection. Also, call your provider if you have any symptoms that cause concern.

How can I manage COPD at home ?

You can take several steps to make breathing easier and slow the progression of the disease:

Quit smoking.
Take prescribed medications as directed by your provider.
Ask your doctor about a pulmonary rehabilitation program, which teaches you how to be active with less shortness of breath.
Maintain a healthy weight.
Get an annual flu shot.
Avoid air polluted by chemicals, smoke, dust or fumes.

How can I avoid irritants that might make COPD worse ?

Asking those around you not to smoke.
Sitting in non-smoking sections of public places.
Avoiding underground parking garages.
Avoiding high traffic or industrialized areas.
Not using perfumes, scented lotions or other highly scented products that may irritate your lungs.
Reducing exposure to dust by regularly changing filters on heaters and air conditioners and using a dehumidifier.
Keeping pets out of the house, especially if you wheeze.
Using an exhaust fan when cooking to remove smoke and odours.
Staying indoors when the outside air quality is poor and pollen counts are high.