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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.

 

Smoking Myths & Facts

  • Cigarette smoking is the leading cause of COPD.

     

    A. Myth

     

    B. Fact

    Correct Answer
  • Quitting smoking doesn't help once you have COPD.

     

    A. Myth

     

    B. Fact

    Correct Answer
  • Smoking both marijuana and tobacco increases your risk of COPD.

     

    A. Myth

     

    B. Fact

    Correct Answer
  • Most people can quit smoking on the first try.

     

    A. Myth

     

    B. Fact

    Correct Answer
  • Smokers have more COPD flare-ups than nonsmokers.

     

    A. Myth

     

    B. Fact

    Correct Answer
  • Men's lungs are more likely to be damaged by smoking than women's.

     

    A. Myth

     

    B. Fact

    Correct Answer
  • Smoking is not addictive.

     

    A. Myth

     

    B. Fact

    Correct Answer
  • How you smoke can affect how much nicotine gets into your body.

     

    A. Myth

     

    B. Fact

    Correct Answer
  • When you quit smoking, your heart rate and blood pressure return to normal levels.

     

    A. Myth

     

    B. Fact

    Correct Answer
  • Taking a puff of a cigarette can reduce your craving for more.

     

    A. Myth

     

    B. Fact

    Correct Answer

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
  • 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.

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.

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

Your health care provider may prescribe antibiotics during symptom flare-ups, because an infection can make COPD worse.

You may need oxygen therapy at home if you have a low level of oxygen in your blood.

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

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:

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

Test Your Knowledge of COPD Triggers

  • People with COPD should take care to avoid getting a cold or the flu.

     

    A. True

     

    B. False

    Correct Answer
  • The air quality outside can affect your COPD symptoms.

     

    A. True

     

    B. False

    Correct Answer
  • Secondhand smoke doesn't affect people with COPD.

     

    A. True

     

    B. False

    Correct Answer
  • Smoke from a wood-burning stove can trigger a flare-up.

     

    A. True

     

    B. False

    Correct Answer
  • Painting your living room can trigger COPD symptoms.

     

    A. True

     

    B. False

    Correct Answer
  • You can reduce your exposure to pollen by:

     

    A. Staying inside when the pollen count is high

     

    B. Using an air conditioner to filter air

     

    C. Removing indoor plants

     

    D. A and B

     

    E. All of the above

    Correct Answer
  • You can keep mold out of your home by controlling moisture.

     

    A. True

     

    B. False

    Correct Answer
  • Dust mites are common in dry areas of your home.

     

    A. True

     

    B. False

    Correct Answer
  • Which of the following can cause a flare-up?

     

    A. Pet dander

     

    B. Pet skin flakes

     

    C. Pet urine

     

    D. Pet saliva

     

    E. All of the above

    Correct Answer
  • Your appliances can cause indoor pollution.

     

    A. True

     

    B. False

    Correct Answer

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.

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)
  • Need for breathing machine and oxygen therapy
  • Right-sided heart failure or cor pulmonale (heart swelling and heart failure due to chronic lung disease)
  • Pneumonia
  • Pneumothorax
  • Severe weight loss and malnutrition
  • Thinning of the bones (osteoporosis)
  • 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.

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.

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    • Smoking tips to quit

      Smoking tips to quit

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    • Chronic obstructive pulm...

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    • Spirometry

      Spirometry

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    • Emphysema

      Emphysema

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    • Bronchitis

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    • Quitting smoking

      Quitting smoking

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    • COPD (chronic obstructive pulmonary disorder)

      COPD (chronic obstructiv...

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    • Respiratory system

      Respiratory system

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    • Smoking tips to quit

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    • Chronic obstructive pulm...

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    • Spirometry

      Spirometry

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    • Emphysema

      Emphysema

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    • Bronchitis

      Bronchitis

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    • Quitting smoking

      Quitting smoking

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    • COPD (chronic obstructive pulmonary disorder)

      COPD (chronic obstructiv...

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    • Respiratory system

      Respiratory system

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    A Closer Look

     

    Talking to your MD

     

    Self Care

     

    Tests for Chronic obstructive pulmonary disease

     
     

    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.

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