Chronic obstructive pulmonary disease (COPD)
Chronic obstructive pulmonary disease (COPD) is an umbrella term for lung diseases that make it hard to breathe. It develops slowly and generally affects people aged 40 and over.
COPD includes emphysema and chronic bronchitis. Emphysema decreases lung tissue elasticity, which makes it hard for the lungs to expand. Emphysema leads to the destruction of lung tissue. With chronic bronchitis, inflammation causes the airways to become narrower and clogged with mucus.
Causes and triggers
The most common cause of COPD is smoking. Secondhand smoke, exposure to dusty environments, and pollution can also increase the risk of developing the condition. In rare cases, alpha-1 antitrypsin (AAT) deficiency can lead to COPD, as this protein helps protect the lungs. Frequent lung infections as a child also increases the risk of COPD.
When lungs are already compromised, the following factors can make symptoms worse:
- Airborne particles:
- Indoors (dust, cleaning products, perfumes)
- Outdoors (humidity, pollen, smog, forest fire smoke)
- Extreme temperatures (hot or cold)
- Respiratory infection (colds, flu)
Symptoms
People who have COPD may experience one or more symptoms. In the early stages of the disease, respiratory symptoms are present mainly on exertion. Respiratory symptoms will appear more easily as the disease progresses. Symptoms include the following:
- Fatigue
- More frequent respiratory tract infections that take longer to clear up
- Shortness of breath, increasing difficulty breathing
- Persistent cough
- Excessive mucus (phlegm) production
- Wheezing
- Unexplained weight loss
Prevention
Some people with COPD may also experience something called "exacerbations" or "flare ups." When this happens, their symptoms suddenly get much worse and stay worse for at least 48 hours. The following actions can help prevent COPD exacerbations:
- Quit smoking
- Avoid air pollutants, both indoors and outdoors
- Avoid extreme temperatures:
- When it's cold, dress warmly and cover your nose and mouth with a scarf
- When it's hot, keep cool, drink plenty of water, and wear light clothing and a hat to go outside
- Stay active to improve the supply and circulation of oxygen in the blood (depending on your care team's recommendations)
- Eat healthy (to prevent obesity and support your immune system)
- Wash your hands regularly and get vaccinated against common viral infections (flu, COVID-19, respiratory syncytial virus)
- Make an action plan and care plan with your care team to manage your COPD
A COPD action plan is a personalized plan. It is created with the care team based on the patient's symptoms and prescribed medications. It helps patients identify signs of an exacerbation and remember what to do so they can quickly treat their symptoms.
Treatment
COPD is a chronic, persistent disease that tends to get worse over time. That's why it's so important to maintain a healthy lifestyle to slow its progression. Treatment can prevent complications, reduce symptoms, and improve your quality of life.
If you smoke and are diagnosed with COPD, you should quit smoking as soon as possible. It's the best way to slow the progression of the disease. You may also be prescribed medications (e.g., bronchodilator or anti-inflammatory inhalers) to improve airflow to the lungs. It's very important to use them as directed for optimal effectiveness. When in doubt, ask your health care provider.
Pulmonary rehabilitation programs can help with multiple aspects of COPD: psychosocial impacts, exercise programs, nutrition, breathing techniques, etc. Be sure to ask a member of your care team before starting any exercise program.
Lastly, oxygen therapy may be prescribed your blood oxygen levels are too low. Surgery is only used as a last resort, should other treatments prove inadequate or ineffective.