This Issue | Editorial | Feature | E-mail

Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.
World Health Organization

Chronic Obstructive Pulmonary Disease?

Edited Kelly Rudnick, MS, MPH

Guyana Journal, February 2009

What is Chronic Obstructive Pulmonary Disease?
COPD or chronic obstructive pulmonary disease is a serious lung disease that worsens over time, making it difficult to breathe. In the United States, COPD includes two main conditions, namely, emphysema and chronic obstructive bronchitis. Most people who have COPD have both of these conditions. COPD develops slowly. Over time, COPD may prevent you from performing daily activities, such as walking or taking care of yourself. There is no cure for COPD. However, lifestyle changes and treatment can help you feel better and slow the progress of disease.

What causes COPD?
COPD generally develops after long-term exposure to irritants that permanently damage the lungs and airways. In the United States, COPD is diagnosed most frequently in people with a history of smoking. Current or past tobacco use (cigarette, pipe, or cigar) can cause COPD, especially if the smoke is inhaled. In addition, long-term exposure to second-hand tobacco smoke can also irritate your lungs and increase your risk for developing COPD. While many people who are diagnosed with COPD have a history of smoking, approximately 1 in 6 individuals with COPD have never smoked. Certain industrial irritants, such as fumes, chemicals and dust can also contribute to COPD.

In some people who have never smoked, COPD is caused by a rare genetic condition, alpha-1 antitrypsin (AAT). People who have this condition have low levels of AAT, a protein made in the liver. Having low levels of AAT can lead to lung damage and COPD if you are exposed to lung irritants, such as smoke or chemical fumes. If you have this condition and are exposed to lung irritants, COPD can worsen quickly.

Who is at risk for COPD?
Currently, it is estimated that 12 million Americans have been diagnosed with COPD while another 12 million may have COPD but remain undiagnosed. Most people who have COPD are at least 40 years old when symptoms begin, although people younger than 40 can develop COPD. The main risk factor for COPD is smoking. Most people who have COPD are current or past smokers. People who have had long-term exposure to other lung irritants, such as air pollution, dust in the workplace, or chemical fumes are also at an increased risk for COPD.

What are the Signs and Symptoms of COPD?
Many of the signs and symptoms of COPD are similar to those of other diseases or conditions. Because of this, many times the disease may go unnoticed until it has reached an advanced state. The first symptom that an affected person may notice is shortness of breath, especially during physical activity. However, other signs of COPD may develop earlier, including a persistent cough that produces large amounts of mucus. This cough is sometimes referred to as smoker’s cough. Some may experience wheezing or a whistling sound when they breathe. In addition, if you have COPD, you may get more frequent colds or flu.
COPD symptoms usually worsen over time. At first, symptoms are mild, but over time, they become bad enough to see a doctor. The severity of the symptoms depends on how much lung damage a person has. If you have more severe disease, you may have swelling of the arms and legs or a bluish tint around the mouth or fingertips that is caused by low levels of oxygen in the blood. In addition, your heartbeat may be very fast and you may not be mentally alert. Some people may experience other symptoms, such as weight loss and weakened muscles. If you have any of these severe symptoms, you may require treatment in a hospital and should seek emergency care.

How is COPD diagnosed?
If you are over the age of 40 and have any of the symptoms mentioned, a doctor might suspect COPD. Your doctor may ask if you smoke or have been exposed to any other lung irritants. The may ask about your family history and about your symptoms (cough, shortness of breath, mucus production). To diagnose COPD, you may need one or more tests. A diagnosis of COPD is confirmed by a lung function test called spirometry. A lung function test measures how much air you can breathe in and out and how fast you can breathe air out. Spirometry can detect COPD before symptoms appear or can determine the severity your disease. Other tests that your doctor may perform include chest x-rays or computed tomography (CT) scan to view images of your heart and lungs, and a blood gas test to measure the level of oxygen in your blood.

How is COPD treated and prevented?
There is no cure for COPD. However, lifestyle changes and treatments may slow the progress of the disease and allow you to stay active. Quitting smoking and avoiding second-hand smoke are the most important steps in treating your COPD. Other treatments may include vaccines, certain medicines, lung rehabilitation, oxygen therapy, surgery, and managing complications (colds, flu, or lung infections, for example). Your family doctor may suggest that you see a pulmonologist, a doctor who specializes in treating people with lung disorders.

Living with COPD
Because there is no cure for the disease, people with COPD must learn to manage their symptoms and take the right steps to slow the progress of their disease. If you have COPD, it’s important to visit the doctor regularly and to take all of your medications as prescribed by your doctor. You should quit smoking and, whenever possible, avoid lung irritants, such as second-hand smoke, chemicals, fumes, and dust. To manage the symptoms of COPD, do daily activities slowly, place items you use regularly within easy reach, and find simple ways to complete daily chores.

In the case of an emergency, you should keep the phone numbers of your doctor, the hospital, and a person who goes with you to your doctor in a handy place. In addition, you should always carry a list of all medications that you are taking to ensure that you tell your doctors the correct information. Finally, if you believe your symptoms are worsening or you have signs of an infection, you should contact your doctor immediately.

You can obtain more information on COPD from the National Heart Lung and Blood Institute .

Kelly Rudnick is a Senior Content Development Specialist in Horsham, PA.