Chronic Obstructive Pulmonary Disease is a condition in which the lung airways (bronchial tubes) become inflamed and narrowed and the air sacs become damaged. When the damage is severe, it may also become difficult to get enough Oxygen into the blood and to get rid of excess carbon dioxide. These changes all lead to shortness of breath and other symptoms. Unfortunately, the symptoms of COPD cannot be completely eliminated with treatment and the condition usually worsens over time.
The term COPD includes both chronic bronchitis (inflammation of the bronchial tubes) and emphysema (destruction of the air sacs). The effects of chronic bronchitis and emphysema on breathing are similar, although there are some differences in symptoms, effects on the body, and treatment.
To understand why COPD develops, it is important to understand how the lungs work. Normally, air that we breathe passes from the nose and mouth through the airways to the tiny air sacs of the lung, called alveoli. In the air sacs, oxygen that we breathe passes through the walls of air sacs into the bloodstream. Carbon dioxide passes in the reverse direction, out of the bloodstream, back into the alveoli, and is then eliminated by breathing out. Carbon dioxide is a waste product of the body's metabolism, and must be regularly removed.
In people who develop COPD, irritating gases and particles are inhaled while smoking or breathing smoke filled air (secondhand smoke) or other fumes or particles, such as air pollution. These gases and particles can injure the airways and lungs and cause irritation (inflammation). Over time, the inflammation becomes chronic, damages the lung tissue, and may cause scarring. This lung damage makes it more difficult to breathe in and out and makes it harder for oxygen and carbon dioxide to pass across the walls of the air sacs.
Any disease that interferes with airflow out of the lungs can cause COPD. Most people with COPD have chronic bronchitis and emphysema, and some also have asthma.
Chronic Bronchitis : Chronic bronchitis is the term used to describe people who have a chronic cough that produces sputum, which is a result of bronchial inflammation. This condition is frequently seen in people who smoke cigarettes. Chronic bronchitis can scar the airways and reduce airflow.
Emphysema : Emphysema is the term used to describe damage to the air sacs in the lung. This damage can also restrict airflow.
Asthma : Asthma is also a chronic inflammatory disorder of the airways. The triggers for this inflammation include exposure to inhaled allergens, respiratory irritants, and viral infections. The inflammation leads to relapsing and remitting episodes of wheezing, breathlessness, chest tightness, and coughing, particularly at night or in the early morning.
Smoking cigarettes significantly increases the risk of developing COPD. However, approximately 20 percent of people who develop COPD have never smoked.
Other factors that increase the risk of developing COPD include an abnormal sensitivity and exaggerated response to inhaled substances (called airway responsiveness), other exposures, such as secondhand exposure to smoke and workplace exposure to environmental dust or organic materials, or exposure to air pollution. COPD can run in families.
Genetic risk factors for COPD include severe deficiency of alpha-1 antitrypsin, a protein that protects the lungs.
People with chronic obstructive pulmonary disease are at risk for worsening symptoms as a result of respiratory infections. Avoiding these infections and treating them quickly if they occur are important parts of COPD therapy.
Here are some typical triggers and ways to control them:
Coughing and spitting up phlegm (mucus)
Wheezing (a whistling or squeaking noise as you breathe)
Shortness of breath at first with activity and, as disease worsens, at rest
The first and most important part of any treatment plan for COPD is for smokers to stop smoking. This is true regardless of how long ago you were diagnosed with COPD and how severe your disease is. Studies of people with COPD show that worsening of the disease is slowed in people who stop smoking.
Currently, there is no cure for COPD; however, many treatments are available for the symptoms and complications of this disorder. Most patients require ongoing treatment to keep symptoms under control.
To reach these goals, your personal asthma treatment plan may include:
Bronchodilators : Medications that help open the airways, called bronchodilators, are a mainstay of treatment for chronic obstructive pulmonary disease. Bronchodilators help to keep airways open and possibly decrease secretions.
Glucocorticoid : Glucocorticoids (also called steroids, although they are very different from muscle building steroids) are a class of medication that has anti-inflammatory properties. Glucocorticoids can be taken with an inhaler, as a pill, or as an injection.
Cough medicines Cough medicines are not generally recommended for people with COPD because they have not been shown to improve COPD symptoms. Although cough can be a bothersome symptom, cough suppressants should be avoided since suppressing cough may increase the risk of developing an infection.