Chronic obstructive pulmonary disease

Definition

Chronic obstructive pulmonary disease (COPD) is one of the most common lung diseases. Having COPD makes it hard to breathe.

There are two main forms of COPD:

Most people with COPD have a combination of both conditions.

Alternative Names

COPD; Chronic obstructive airways disease; Chronic obstructive lung disease; Chronic bronchitis; Emphysema; Bronchitis - chronic

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:

Symptoms


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. But sometimes the lungs look normal even when a person has COPD and a chest x-ray has been taken.

Some patients may need to have a blood test called arterial blood gas 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:

In severe cases or during flare-ups, you may need to receive:

Your doctor may prescribe antibiotics during symptom flare-ups, because infections 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.

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:

Things you can do to make it easier for yourself around the home include:

Eat healthy foods, including fish, poultry, or lean meat, as well as fruits and vegetables. If it is hard to keep your weight up, talk to a doctor or dietitian about eating foods with more calories.

Surgery may be used to treat COPD, but only a few patients benefit from these surgical treatments:

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 doctor about breathing machines and end-of-life care.

Possible Complications

With COPD, you may have other health problems such as:

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 health care 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). Updated March 2013. Available at: https://www.icsi.org/_asset/yw83gh/COPD.pdf. Accessed April 26, 2014.

Balkissoon R, Lommatzsch S, Carolan B, Make B. Chronic obstructive pulmonary disease: a concise review. Med Clin N. Am. 2011;95:1125-1141.

Shapiro SD, Reilly JJ Jr., Rennard SI. Chronic bronchitis and emphysema. In: Mason RJ, Broaddus VC, Martin TR, et al., eds. Murray & Nadel's Textbook of Respiratory Medicine. 5th ed. Philadelphia, PA: Elsevier Saunders; 2010:chap 39.