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Chronic Obstructive Pulmonary Disease (COPD)

Chronic obstructive pulmonary disease (COPD) refers to two lung diseases, chronic bronchitis and emphysema, characterized by obstruction to airflow that interferes with normal breathing. COPD is the fourth leading cause of death in America according to the American Lung Association.

What is Chronic Bronchitis?

Chronic bronchitis is the inflammation and eventual scarring of the lining of the bronchial tubes. When the bronchi are inflamed and/or infected, less air is able to flow to and from the lungs. The inflammation eventually leads to scarring of the lining of the bronchial tubes and excessive mucus production. As the lining of the bronchial tubes becomes thickened, a cough develops and airflow may be impeded.

What is Emphysema?

Emphysema starts with the destruction of air sacs (avoeoli) in the lungs where oxygen from the air is exchanged for carbon dioxide in the blood. The walls of the air sacs are thin and fragile in individuals with emphysema. Damage to the air sacs is irreversible and results in permanent damage to the tissue of the lower lungs. As these air sacs are destroyed, the lungs deliver less oxygen to the bloodstream, causing shortness of breath.

Risk Factors
  • Smoking is the primary risk factor
  • Air pollution
  • History of childhood respiratory infections
  • Heredity
  • Occupational exposure to certain industrial pollutants
Signs and Symptoms
  • Constant coughing spells
  • Sputum (mucus) production
  • Shortness of breath with normal activity
  • Wheezing (a whistling or squeaky sound when you breath)
  • Chest tightness
Diagnosis
  • Medical and family history
  • Physical exam
  • History regarding use of tobacco or other lung irritants
  • Breathing test called spirometry - this test measures how much air your lungs can hold and how fast you can blow air out of your lungs after taking a deep breath
  • Chest X-ray - a picture of your lungs
  • Arterial blood gas - a blood test that measures the oxygen level in your blood
  • Bronchodilator reversibility testing - using the spirometry and adding a drug called bronchodilators that relaxes and opens the muscles around the airways
Treatment

There are many different treatments that can help you cope with COPD and live life to the fullest. Remember, your health care provider should direct your care and select the treatment specifically for you.

Tobacco Cessation

This is critical in patients with COPD. Once a patient has quit smoking the rate of decline of lung functions slows considerably. The use of tobacco in any form is a great health concern. Even if you don't smoke, reduce your exposure to secondhand smoke. If you use tobacco products, prepare yourself to quit as soon as possible.

  • Set a date to stop and mark it on your calendar. Twenty-four hours before the start date make everyone aware of your goal to stop.
  • Remove the smell of tobacco by cleaning your house and car. Remember to get rid of lighters, ashtrays and matches.
  • You can use over-the-counter aids such as nicotine patches and gum. Contact your health insurance provider to see if Nicotine replacement therapy is a covered service.
  • Know what your triggers are that make you want to use tobacco products and be prepared with chewing gum, celery or carrot sticks.
  • Kentucky has a free Quit Now program that helps you quit using tobacco products. You can contact the Quit Now program at (800) 784-8669.

Breathing Techniques

Learning proper breathing technique is very important.

  1. Breathe out through pursed lips, like when whistling. This slows down your breathing and makes each breath be more useful for your body.
  2. Lean forward while exercising.
  3. Belly breathing - this is down by allowing your belly to stick out while breathing in and then pulling your belly in while breathing out.

Exercise

Muscles become weak when not used. This includes the muscles for your chest. Strengthening these muscles will help decrease shortness of breath. You might start by walking inside your house, then try walking outside (but not when the temperature/humidity is high or when the air quality is poor).

Oxygen

Supplemental oxygen is a very helpful treatment that helps many patients with severe COPD lead a more normal life. Use only as ordered by your physician.

Medications

  1. Bronchodilators - to relax the muscles around the breathing tubes
  2. Corticosteroids - to reduce the swelling in the breathing tubes
  3. Mucolytics - a drug that dissolves thick mucus making breathing easier
  4. Meter-dose inhalers or dry powder inhalers
  5. Nebulizer treatments - delivers a mist of medication to your lungs, through a mouthpiece or mask using a machine with the medication attached through a small piece of tubing
  6. Pulmonary rehabilitation - these programs usually include exercises for upper and lower extremities, education, breathing retraining and psychological support
  7. Immunization - patients should discuss flu and pneumonia vaccines with their health care provider
  8. Lung volume reduction surgery - in selected patients, used to improve shortness of breath by removing areas of major lung damage from emphysema

 

Last Updated 9/28/2012
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