Chronic obstructive pulmonary disease

Definition

Chronic obstructive pulmonary disease (COPD) is one of the most common lung diseases. It makes it difficult 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 leading cause of COPD. The more a person smokes, the more likely that person will develop COPD. However, 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 of COPD develop slowly, some people may not know that they are sick.

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, and the test does not involve exercising, drawing blood, or exposure to radiation.

Using a stethoscope to listen to the lungs can also be helpful. However, sometimes the lungs sound normal even when COPD is present.

Pictures of the lungs (such as x-rays and CT scans) can be helpful, but sometimes look normal even when a person has COPD (especially chest x-ray).

Sometimes patients 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. However, there are many things you can do to relieve symptoms and keep the disease from getting worse.

Persons with COPD MUST stop smoking. This is the best way to slow down the lung damage.

Medications used to treat COPD include:

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

Antibiotics are prescribed 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 the lung disease, but it can teach you to breathe in a different way so you can stay active. Exercise can help maintain muscle strength in the legs.

Walk to build up strength.

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

Eat a healthy diet with 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, but only a few patients benefit from these surgical treatments:

Support Groups

People often can help ease the stress of illness by joining a support group in which members share common experiences and problems.

See also: Lung disease - support group

Outlook (Prognosis)

COPD is a long-term (chronic) illness. The disease will get worse more quickly if you do not stop smoking.

Patients with severe COPD will be short of breath with most activities and will be admitted to the hospital more often. These patients should talk with their doctor about breathing machines and end-of-life care.

Possible Complications

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 doctor or health care provider about quit-smoking programs. Medicines are also available to help kick the smoking habit. The medicines are most effective if you are motivated to quit.

References

Hoogendoorn M, Feenstra TL, Hoogenveen RT, Rutten-van Mölken MP. Long-term effectiveness and cost-effectiveness of smoking cessation interventions in patients with COPD. Thorax. 2010;65(8):711-718.

Agarwal R, Aggarwal AN, Gupta D, Jindal SK. Inhaled corticosteroids vs placebo for preventing COPD exacerbations: a systematic review and metaregression of randomized controlled trials. Chest. 2010; 137(2):318-325.

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