Definition

Chronic obstructive pulmonary disease (COPD) is a lung disease that gets worse over time. It makes it hard to move air in and out of the lungs. Forms of COPD include:

These diseases often happen together. The causes and treatment are alike.

Normal Lung and Lung with Emphysema
Normal Lung and Emphysemic Lung

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Causes

COPD is caused by damage to the lungs from:

  • Cigarette smoking
  • Inhaling toxins or other irritants like wood smoke or dust and fumes at work
  • Alpha-1 antitrypsin gene deficiency (rare)

Risk Factors

Things that raise your chance of COPD are:

  • Smoking cigarettes or other forms of tobacco
  • Long-term exposure to secondhand or passive smoke (in any form)
  • Exposure to pollutants
  • Alpha-1 antitrypsin deficiency

Symptoms

Early problems are:

  • Coughing
  • Coughing up mucus from deep in the lungs
  • Wheezing
  • Shortness of breath with activity

As the disease gets worse, problems may be:

  • Shortness of breath that gets worse
  • A choking feeling when lying flat
  • Feeling very tired
  • Problems with focus
  • Weight loss
  • Breathing through pursed lips
  • Leaning forward to breathe better
  • Flare-ups of these symptoms

Diagnosis

You will be asked about your symptoms and health history. A physical exam will be done. It will focus on your breathing. This may be enough to make the diagnosis.

Lung function tests will be done to confirm the diagnosis. This can be done with spirometry to test the force of your breath.

Treatment

There is no cure for COPD. It will get worse over time. The goal of treatment is to ease symptoms and improve quality of life. A plan will be made with the care team.

A pulmonary rehabilitation program can be helpful. It offers education and tips to stay healthy. Other treatments are:

Smoking Cessation

Smoking will worsen COPD. There are a number of tools to help quit smoking, such as:

  • Behavior change programs
  • Medicine
  • Nicotine replacement therapy, such as gum, patches, or sprays

Medicine

Medicine may be given to:

  • Relax and open the airways
  • Decrease swelling and mucus
  • Treat flare ups

COPD increases the risk of problems from flu and pneumonia. Pneumonia and the flu vaccines are both recommended for people with COPD.

Oxygen

COPD makes it hard for oxygen to pass through the lungs and into the body. Oxygen therapy can increase the amount of oxygen that gets into the lungs and into the body. It can also ease breathing and improve energy.

Weight Management

Being overweight can make it harder to breathe. A weight loss plan may be needed.

Some find it hard to eat well with COPD. It can lead to unhealthy weight loss. Nutrition support may help.

Surgery or Procedures

Some people may need procedures or surgery to help the lungs work better. Options are:

  • Bronchoscopic lung reduction—a procedure to block off parts of the lung.
  • Lung volume reduction surgery—removing a section of the lung to let other parts of it expand
  • Lung transplant—replaces a damaged lung with a donor lung

Prevention

The risk of COPD can be lowered by:

  • Not smoking
  • Avoiding places where people smoke
  • Avoiding air pollution and other irritants
RESOURCES:

American Lung Association
http://www.lung.org

National Lung Health Education Program
http://www.nlhep.org

CANADIAN RESOURCES:

Health Canada
http://www.canada.ca

The Lung Association
http://www.lung.ca

REFERENCES:

COPD. EBSCO DynaMed website. Available at:https://www.dynamed.com/condition/copd. Updated December 30, 2019. Accessed January 9, 2020.

Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global strategy for the diagnosis, management, and prevention of COPD. GOLD 2019.

Living with COPD. National Heart Lung and Blood Institute website. Available at: https://www.nhlbi.nih.gov/health-topics/copd. Accessed Janury 9, 2020.

Last reviewed September 2019 by EBSCO Medical Review Board Kari Kassir, MD  Last Updated: 1/9/2020