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Chronic Obstructive Pulmonary Disease

Also Known as COPD, Emphysema, Chronic Bronchitis

Chronic obstructive pulmonary disease or COPD involves a cluster of diseases related to poor airflow through the lungs causing shortness of breath, coughing and other symptoms. COPD is divided up into two major conditions: chronic bronchitis and emphysema. COPD is also related to the condition known as chronic asthmatic bronchitis. All of these conditions cause damage to the airways and results in interference of the exchange of oxygen with carbon dioxide within the alveoli of the lungs.

Many people die from COPD throughout the world. Most cases are directly caused by smoking for a long time and can be prevented by being a non-smoker or quitting smoking before you have smoked too long. You can't fix the damage that has already happened to your lungs but you can prevent further damage by quitting smoking.

The symptoms of COPD begin to occur after there has been a great deal of lung damage from exposure to cigarette smoke or due to other reasons. The symptoms come and go at first and finally have symptoms that last all of the time. Everyone has different symptoms from their COPD but the main symptoms are shortness of breath, especially with activity, wheezing and tightness in the chest.

If you have chronic bronchitis, you are likely a smoker or former smoker. You have a cough that lasts at least three months out of a year and this must last for two years to be called chronic bronchitis. The cough generally gets better with quitting smoking. Other major symptoms include clearing your throat often, primarily in the morning, yellowish sputum when you cough and shortness of breath, especially when the disease has progressed and is an end-stage disease. You often get recurrent respiratory infections and pneumonia.

If you have chronic asthmatic bronchitis, you have all the same symptoms of chronic bronchitis but you also have spasm of the bronchial tree, which causes wheezing and asthma symptoms. The asthma symptoms can be sporadic or can be something you have on a daily basis. Your bronchial passageways collapse when you exhale, which traps air behind the airways, leading to wheezing and distention of the lungs.

In emphysema, there is inflammation of the lungs, including the tiny alveoli at the end of the bronchial passages. The small airways and alveoli are damaged so the outflow of the lungs is blocked. In chronic bronchitis, there is phlegm buildup in the airways along with inflammation that blocks or narrows the bronchial passages. There is mucus production that is frequently coughed up. If you have asthmatic symptoms, the damage to the bronchial airways causes spasm of the airways and you hear a wheezing sound when you breathe.

Most COPD is caused by long term smoking histories in people who have smoked for 10 years or more. It also depends on how many cigarettes per day you have smoked. Other things can cause COPD symptoms, including cigar smoke, pipe smoke, secondhand smoke, air pollution and occupational fumes. Even gastroesophageal reflux disease can cause acid to get inside the lungs and can damage the bronchial tree. It can also cause wheezing and worsened COPD symptoms. Rarely, alpha 1 antitrypsin disease can cause COPD in those who have inherited the condition.

Risk factors for emphysema include exposure to any type of tobacco smoke for at least ten years, occupational exposure to fumes, chemicals, dust and vapors, having severe gastroesophageal airway disease, being of an older age and inheriting alpha 1 antitrypsin disease.

Good tests for emphysema include spirometry or pulmonary function testing. This involves breathing into a tube and determining the flow of air through the lungs. A chest x-ray can tell if the lungs are over-inflated or damaged with scar tissue or heart failure. Blood gases can tell if the oxygen and carbon dioxide levels in the body are not perfect. Sputum can show if there is a secondary cancer or infection. A CT scan of the chest will show detailed images of the lungs and the heart to see if there is hyper-inflation or damage to the lungs.

To date, there is no specific cure for COPD but you can do a lot by stopping smoking. This alone can take care of many of the symptoms. There are medications for COPD, including bronchodilators-inhalers you take to open up the bronchial passages. You can also take inhaled steroids, which reduce inflammation in the lungs and help breathing when taken over the long haul. Antibiotics are necessary for secondary infections that are common to the disease. Some people need to have lung volume reduction surgery in order to get rid of big blebs in the lungs and to help the lungs work more efficiently. In some cases, a person needs to have a lung transplant, especially if they have stopped smoking.

Most emphysema patients use oxygen to help them feel better and bring it with them wherever they go. There is breathing therapy that people with COPD can do to "exercise" their lungs.