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Chronic Obstructive Pulmonary Disease

(COPD)

 

Definition

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

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

Normal Lung and Lung with Emphysema

Normal Lung and Emphysemic Lung

Copyright © Nucleus Medical Media, Inc.

 

Causes    TOP

COPD is caused by damage to the lungs. This damage can be caused by:

  • Cigarette smoking
  • Inhaling toxins or other irritants like wood smoke or dusts and fumes at work
  • Changes in certain genes—allow more damage to the lungs (example alpha-1-antitrypsin deficiency)
 

Risk Factors    TOP

Things that increase your chance of developing COPD include:

  • Smoking cigarettes
  • Long-term exposure to secondhand or passive smoke (in any form)
  • Family members with COPD
  • Exposure to pollutants
  • Past health with frequent childhood lung infections
  • Smoking unusual forms of tobacco, such as Chinese waterpipes
 

Symptoms    TOP

Early symptoms of COPD include:

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

As the disease gets worse, symptoms may include:

  • Increased shortness of breath
  • Choking sensation when lying flat
  • Fatigue
  • Trouble staying focused
  • Weight loss
  • Breathing through pursed lips
  • Lean forward to improve breathing
  • Bouts of severe symptoms
 

Diagnosis    TOP

You will be asked about your symptoms and past health. A physical exam will be done. Tests will show how well the lungs are working:

  • Lung function tests (spirometry)—to test the force of your breath
  • Blood test—to measure the oxygen and carbon dioxide levels in the blood

COPD may be diagnosed based on these tests and symptoms. Pictures of your lungs may be done to rule out other lung issues. This may be done with chest x-ray or CT scan.

 

Treatment    TOP

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 rehab program can be helpful. It offers education and tips to stay as healthy as possible. Treatment steps include:

Smoking Cessation

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

  • Behavior change program
  • Medicine
  • Nicotine replacement—may be gum, patches, spray or more

Medication

Medicine can help to ease symptoms. They may:

  • Relax and open the airways
  • Decrease swelling and mucus
  • Treat flare up of symptoms

Medicine may be taken as pills, liquids, or inhaled straight to the lungs. They may be long term control medicine or for emergency use.

Oxygen    TOP

COPD makes it hard for oxygen to pass through the lungs and into the body. Oxygen therapy will increase the amount of oxygen that gets into your lungs. This will then increase the amount of oxygen that gets into the body. It can ease breathing and improve energy levels. Oxygen therapy may only be need it for physical activity in early stages. It may be needed throughout the day in later stages.

Exercise    TOP

Regular exercise helps the heart and body work better. This will lower the workload on the lungs. Exercise can also improve overall health and mood. Cardio exercises like walking and strength exercise are both helpful. Yoga may also be helpful because of breathing training. An activity plan can be made with care team or during pulmonary rehab.

Special exercises can also make chest muscles stronger. This can help to ease to breathing.

Weight Management    TOP

Being overweight can make breathing harder. 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 to improve nutrition and improve weight.

Complication Prevention    TOP

Education about possible irritants is helpful. Smoke, dust, smog, extreme heat or cold, and high altitudes can all make breathing worse. Most can be avoided or limited. There are also steps to decrease the impact it will have.

COPD increase the risk of problems with flu and pneumonia. Vaccinations can prevent these infections or decrease illness. Pneumonia and the flu vaccines are both recommended for people with COPD.

Special methods can ease shortness of breath. Some examples include:

  • Pursed-lip breathing
  • Controlled coughing technique

Long term health issues can be stressful. This can make symptoms worse and decrease quality of life. The impact of stress may be decreased with:

  • COPD support groups
  • Professional counseling
  • Relaxation tools such as meditation or yoga

Surgery or Procedures    TOP

Certain surgeries or procedures may help the lungs work better. They are not appropriate for everyone. Options include:

  • Lung volume reduction surgery—section of lung is removed. This will let other areas expand more.
  • Bronchoscopic lung reduction—procedures to block off areas of the lung.

A lung transplant will replace damaged lungs with donor lungs. It will require a lifetime of medicine to keep the body from rejecting the lungs. It is not an option for everyone.

 

Prevention    TOP

To reduce your chance of developing COPD:

  • If you smoke, quit.
  • Avoid being in smoky areas or others who smoke.
  • Avoid air pollution or irritants as much as possible.
  • Wear protective gear at work. Follow rules for working with or around irritants or toxins.

Your doctor may give you certain medicine to lower the risk of flare ups.

RESOURCES:

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

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

CANADIAN RESOURCES:

Health Canada
http://www.hc-sc.gc.ca

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

REFERENCES:

COPD. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T115557. Updated September 1, 2018. Accessed October 15, 2018.

Living with COPD. National Heart Lung and Blood Institute website. Available at: https://www.nhlbi.nih.gov/health-topics/copd. Accessed October 15, 2018.

Patient Education: Teaching the Patient with Chronic Obstructive Pulmonary Disease (COPD). EBSCO Nursing Reference Center website. Available at:
...(Click grey area to select URL)
Updated March 28, 2018. Accessed October 15, 2018.

Spirometry. National Lung Health Education Program website. Available at:
...(Click grey area to select URL)
Accessed October 15, 2018.

11/6/2009 DynaMed Plus Systematic Literature Surveillance. Available at: http://www.dynamed.com/topics/dmp~AN~T115557/COPD : Poole P, Chacko E, et al. Influenza vaccine for patients with chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2009;(4):CD002733.

12/14/2009 DynaMed Plus Systematic Literature Surveillance. http://www.dynamed.com/topics/dmp~AN~T115557/COPD : Donesky-Cuenco D, Nguyen HQ, et al. Yoga therapy decreases dyspnea-related distress and improves functional performance in people with chronic obstructive pulmonary disease: a pilot study. J Altern Complement Med. 2009;15:225-234.

11/7/2014 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T115557/COPD : Dhe J, Yang Y, et al. Chinese water-pipe smoking and the risk of COPD. 2014;146(4):924-931.



Last reviewed September 2018 by Kari Kassir, MD
Last Updated: 10/15/2018

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