COPD: symptoms, cause, treatment and prevention

COPD

Overview

Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory disease of the lungs that causes airway obstruction. Symptoms include difficulty breathing, coughing, mucus production (sputum) and shortness of breath. It is usually caused by prolonged exposure to irritating gases or particles, usually from cigarette smoke. People with COPD are at greater risk of developing heart disease, lung cancer and a variety of other conditions.

Chronic bronchitis is an inflammation of the lining of the bronchial tubes, which carry air to and from the air sacs (alveoli) of the lungs. It is characterized by daily cough and mucus production (sputum).

Emphysema is a condition in which the alveoli at the end of the smallest airways (bronchioles) of the lungs are destroyed due to damage to tobacco smoke and other irritating gases and particles.

Although COPD is a progressive disease over time, COPD is treatable. With proper management, most people with COPD can achieve better symptom control and quality of life, as well as a reduced risk of other associated conditions.

Symptoms

Symptoms of COPD often do not appear until severe lung damage, and they tend to worsen over time, especially if smoking exposure persists.

Signs and symptoms of COPD may include:

1. Shortness of breath, especially during physical activity
2. Explosion
3. Chest tightness
4. Chronic cough that may produce mucus (sputum) that may be clear, white, yellow or green
5. Frequent respiratory diseases
6. Weakness
7. Unintentional weight loss (in recent stages)
8. Swelling in the ankles, feet or legs
9. People with COPD are also more likely to experience episodes called exacerbations, in which their symptoms become worse than normal day-to-day variations and persist for at least a few days.

When to see a doctor

Talk to your doctor if your symptoms do not improve with treatment or worsen, or if you notice signs of infection, such as a fever or a change in sputum.

Seek medical attention immediately if you are unable to breathe, if you experience severe darkening of your lips or nail beds (cyanosis) or rapid heartbeat, or if you feel foggy and have trouble concentrating.

Causes

The main reason for COPD in developed countries is smoking. In developing countries, COPD is more common in people exposed to fossil fuels.

Only chronic smokers develop clinically visible COPD, although many smokers with a long history of smoking can develop reduced lung function. Some smokers have a very unusual lung condition. They may not be as well diagnosed as COPD until a thorough examination is done.

How your lungs are affected

The air passes through your windpipe (trachea) to your lungs through two large tubes (bronchi). Inside your lungs, these tubes often divide - like tree branches - into many tiny tubes (bronchioles) that end in clusters of tiny air sacs (alveoli).

Air sacs have very small walls filled with small blood vessels (capillaries). The oxygen in the air you breathe passes into these bloodstream and enters your bloodstream. At the same time, carbon dioxide is released - a gas that is a by-product of metabolic waste.

Your lungs are dependent on the natural inclination of the bronchial tubes and air sacs to expel air from your body. COPD causes them to lose their firmness and stretch too much, leaving a certain amount of air trapped in your lungs as you exhale.

Emphysema

Open the pop-up dialog box

Bronchitis

Bronchitis Open the pop-up dialog box

Causes of airway obstruction

Emphysema. This lung disease causes the destruction of weak walls and elongated alveoli. Small airways collapse as you exhale, disrupting the flow of air through your lungs.

Chronic bronchitis. In this condition, your bronchial tubes become inflamed and thin and your lungs produce more mucus, which can further block the narrowed tubes. You have a persistent cough trying to clear your airways.

Cigarette smoke and other irritants

In many people with COPD, the lung injuries that lead to COPD are caused by long-term smoking. But there may be other factors that play a role in the development of COPD, such as genetic predisposition to the disease, since not all smokers develop COPD.

Other irritating substances can cause COPD, including cigarette smoke, cigarette smoke, pipe smoke, air pollution, and exposure to dust, smoke or fumes.

Deficiency of Alpha-1-antitrypsin

In about 1% of people with COPD, the disease is caused by a genetic disease that causes low levels of protein called alpha-1-antitrypsin (AAt). AAt is made in the liver and is absorbed into the bloodstream to help protect the lungs. Deficiency of Alpha-1-antitrypsin can cause liver disease, lung disease or both.

Risk factors

Risk factors for COPD include:

Exposure to tobacco smoke. The most significant risk factor for COPD is long-term cigarette smoking. The more years you smoke and the more packs you smoke, the greater your risk. Pipe smokers, cigar smokers and marijuana smokers also may be at risk, as well as people exposed to large amounts of secondhand smoke.

People with asthma. Asthma, a chronic inflammatory airway disease, may be a risk factor for developing COPD. The combination of asthma and smoking increases the risk of COPD even more.

Occupational exposure to dusts and chemicals. Long-term exposure to chemical fumes, vapors and dusts in the workplace can irritate and inflame your lungs.

Exposure to fumes from burning fuel. In the developing world, people exposed to fumes from burning fuel for cooking and heating in poorly ventilated homes are at higher risk of developing COPD.

Genetics. The uncommon genetic disorder alpha-1-antitrypsin deficiency is the cause of some cases of COPD. Other genetic factors likely make certain smokers more susceptible to the disease.

Complications

COPD can cause many complications, including:

Respiratory infections. People with COPD are more likely to catch colds, the flu and pneumonia. Any respiratory infection can make it much more difficult to breathe and could cause further damage to lung tissue.

Heart problems. For reasons that aren't fully understood, COPD can increase your risk of heart disease, including heart attack

Lung cancer. People with COPD have a higher risk of developing lung cancer.

High blood pressure in lung arteries. COPD may cause high blood pressure in the arteries that bring blood to your lungs (pulmonary hypertension).

Depression. Difficulty breathing can keep you from doing activities that you enjoy. And dealing with serious illness can contribute to the development of depression.

Prevention

Unlike some diseases, COPD typically has a clear cause and a clear path of prevention, and there are ways to slow the progression of the disease. The majority of cases are directly related to cigarette smoking, and the best way to prevent COPD is to never smoke — or to stop smoking now.

If you're a longtime smoker, these simple statements may not seem so simple, especially if you've tried quitting — once, twice or many times before. But keep trying to quit. It's critical to find a tobacco cessation program that can help you quit for good. It's your best chance for reducing damage to your lungs.

Occupational exposure to chemical fumes and dusts is another risk factor for COPD. If you work with these types of lung irritants, talk to your supervisor about the best ways to protect yourself, such as using respiratory protective equipment.

Here are some steps you can take to help prevent complications associated with COPD:

Quit smoking to help reduce your risk of heart disease and lung cancer.

Get an annual flu vaccination and regular vaccination against pneumococcal pneumonia to reduce your risk of or prevent some infections.

Talk to your doctor if you feel sad or helpless or think that you may be experiencing depression.