Chronic obstructive pulmonary disease (COPD) is a degenerative lung disease that causes obstructed airflow from the lungs and difficulty breathing. According to the Centers for Disease Control and Prevention (CDC), 16 million Americans have been diagnosed with COPD. But millions more might be unknowingly living with the disease.
“COPD is a spectrum of diseases where patients had classically been diagnosed with either chronic bronchitis or emphysema in the past,” says Laura Frye, MD, a pulmonary disease specialist at University of Utah Health. “Those are the two most common types of disease under the COPD umbrella.”
Chronic bronchitis is the long-term inflammation of the bronchial tubes and produces a bothersome cough with mucus. Emphysema is when the air sacs in the lungs are damaged, causing them to rupture and become stretchy. The combination of inflamed, narrow airways and stretchy air sacs leads to difficulty emptying the lungs, causing air to become trapped and the lungs to hyperinflate.
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What causes COPD?
COPD is commonly caused by long-term exposure to harmful irritants, with cigarette smoke as the number one cause. Approximately 75 percent of COPD deaths are attributed to cigarette smoking. However, non-smokers can develop COPD too. Prolonged exposure to air pollution, secondhand smoke, or harmful fumes and chemicals found in some homes and workplaces can cause the disease.
Genetics can also play a part in developing COPD. The American Lung Association says a small number of people have a rare form of COPD caused by a genetic condition, called alpha-1 antitrypsin deficiency-related emphysema. People who have this form of COPD lack the ability to produce alpha-1, which is a lung-protecting protein that can be replaced in cases of deficiency.
Do I have COPD?
COPD is a progressive disease, meaning the symptoms worsen over time. If you’re experiencing the following symptoms and they’re not getting better with treatment, it’s time to see a doctor:
- Shortness of breath, especially during physical activity
- A chronic cough, especially one that produces mucus
- Chest tightness
- Frequent respiratory infections
“We always look for that nagging smoker’s cough and shortness of breath,” Frye says. “And then we’re seeing frequent respiratory infections. As the disease progresses, you can really see them using their chest wall muscles to breathe.”
To determine if you have COPD, your doctor will perform a lung function test. The most common one uses a spirometer, which is a large tube that you forcefully blow into for one second and then until your lungs are empty. The test measures the amount of air you’re capable of inhaling and exhaling. This is often called a forced expiratory volume (FEV1) test. Your doctor may also perform a chest x-ray, a CT scan of your lungs, or an arterial blood gas analysis, which is a blood test that measures levels of oxygen and carbon dioxide in your blood.
I’ve gotten a COPD diagnosis. What now?
If you’re a smoker diagnosed with COPD, your first course of action should be to quit. Kicking this habit can stop the disease from getting worse, thus maintaining your quality of life for longer.
“Smokers are going to lose lung function faster than somebody who’s not a smoker,” Frye says. “While we can’t reverse the damage that’s been done, we can slow the progression of the disease.”
Frye says it is also important for COPD patients to toss their tobacco because smokers cannot be candidates for certain advanced treatments, such as lung volume reduction surgery or lung transplants.
How do I treat my COPD?
There is currently no cure for COPD, but there are some common treatments you can undergo to manage your symptoms on a short- and long-term basis. These treatments can help all COPD patients regardless of smoking status and age.
Bronchodilators: These are medications that come in an inhaler and help relax the muscles surrounding your airways. These can help relieve cough and shortness of breath, making it easier to breathe.
Inhaled steroids: Inhaled steroids can reduce inflammation in the airways and help prevent sudden symptom flare-ups.
Home oxygen therapy: Patients are given a portable device to breathe in additional oxygen through a tube or mask to help stabilize blood oxygen levels.
Along with these therapies, smokers must kick their cigarettes to the curb. Your doctor can talk to you about smoking cessation programs to help you quit for good.