Chronic obstructive pulmonary disease (COPD) is a preventable and treatable illness that not only affects the lungs, but also has a significant impact on other body systems. These "extrapulmonary effects" are thought to contribute to the severity of COPD in people who are diagnosed with the disease.
COPD is characterized by limitation of airflow - both into and out of the lungs - that is not fully reversible. This airflow limitation usually worsens over time and is associated with an abnormal inflammatory response of the lungs to noxious stimuli.
Statistics
COPD is the third-leading cause of death in this country. It kills over 126,000 Americans annually. Historically, COPD has been a disease that has occurred more frequently in men; however, since 2000, more women have died each year from COPD than men. To date, COPD remains a growing healthcare concern for women in many countries. See COPD in Women.
COPD predominantly occurs in those over 40 years of age. According to the American Lung Association, in 2002, 11.2 million adults in the United States were estimated to have COPD. However, approximately 24 million U.S. adults have evidence of impaired lung function, indicating that there is a high probability of under-diagnosis.
Types
COPD is a term that is often used to describe a group of lung diseases that includes:
It is possible (and quite common) for people with COPD to have a combination of these disorders at the same time. Many people also have an asthma component to their disease, an important factor when considering treatment.
COPD Pathophysiology
According to the American Academy of Family Physicians, what happens physiologically to your lungs when you have COPD is not completely understood. Playing a major role is that of chronic inflammation of the cells that line the bronchial tree in the lungs. Smoking and other airway irritants perpetuate an ongoing inflammatory response that leads to hyperactivity of the airways, whereby the smooth muscle of the airways constrict and narrow excessively.
This causes the airways to become swollen, excess mucus to be produced and the cilia to function poorly. As the disease progresses, COPD patients find it increasing difficulty to clear their secretions, developing a chronic, productive cough, wheezing and dyspnea, the hallmark symptoms of COPD. To further complicate matters, as excess mucus is produced, it begins to pool in the airways, providing a perfect breeding ground for bacteria to multiply. This leads to further inflammation, the formation of diverticuli (pouch-like sacs) in the bronchial tree and bacterial infections that occur frequently in COPD patients. Read more about COPD pathyophysiology.
The most significant risk factor for COPD is cigarette smoking. The American Lung Association estimates that 80% to 90% of people diagnosed are either chronic or former smokers; however, never-smokers also get COPD (read COPD in the Never-Smoker.)
Other common risk factors include:
- Secondhand smoke
- Indoor and outdoor air pollution
- Work-related exposure to coal mine dust, silica, cotton and grain dust
For a complete list of risk factors for COPD, visit Are You at Risk for COPD?
Alpha-1-Antitrypsin Deficiency
Alpha-1-antitrypsin (AAT) deficiency is a genetic form of COPD that occurs in a very small number of patients. It is passed on by one or both parents at birth. The onset of symptoms in people with AAT deficiency emphysema typically occurs much earlier in life, often between the ages of 32 and 41. If you fall into this age group and have been diagnosed, ask your doctor for a simple blood test to determine if your COPD is caused by AAT deficiency, as treatment options differ.
Hallmark symptoms of COPD include:
- Breathlessness with any type of activity
- Chronic cough
- Increase in sputum production
- Wheezing
- Fatigue
- Chest tightness
- Frequent chest infections
Additional signs and symptoms that may accompany the disease include swelling, weight gain and obesity (an unfortunate side effect of medication therapy), a round, barrel chest, hemoptysis and cyanosis.
For more information about signs and symptoms of chronic lung disease, visit About.com's Symptom Checker, an interactive and informative tool to help you learn more about signs and symptoms of COPD or any other illness.
To make a diagnosis of chronic obstructive pulmonary disease, a complete assessment must be taken, including family history, environmental and occupational exposure and smoking history. Additional tests may include:
- Blood tests (including arterial blood gases and a complete blood count, particularly hemoglobin and hematocrit levels)
- Chest X-ray
- Pulmonary function tests
- Bronchoscopy
- Pulse oximetry
The best treatment for the disease if you are a smoker is to quit as soon as possible. Other options include:
- Medications (bronchodilators, expectorants, antibiotics and corticosteroids)
- Oxygen therapy
- Pulmonary rehabilitation
- Flu shots (Learn more about which vaccines are recommended for adults).
- Pneumonia vaccine
- Surgical intervention
- Alternative therapy
- Airway clearance techniques
Although the disease is treatable, it must be emphasized that once you have COPD, the damage is irreversible and there is no known cure. However, it is important to take whatever steps you can to prevent the damage from worsening.
If you don't already have the disease, the following steps can help you prevent it from occurring:
- If you smoke, you should quit ASAP!
- If you live with someone who smokes, make sure they do not smoke around you. Additionally, no one should ever smoke when a child is present. Learn more about the dangers of secondhand smoke.
- If you work around hazardous chemicals, dust or other types of occupational hazards that may irritate your lungs, be sure to wear protective equipment including a mask and gloves.
- If you are at risk for developing the disease as determined by your doctor, get a yearly flu shot.
- Learn how to improve the air quality in your home.
- Obtain a spirometry test to improve your chances of early detection.
If you are still having trouble understanding the types and causes of this disease and how they affect your lungs, watch this informative COPD video.
If you are looking for more information on COPD, compare prices on COPD for Dummies by visiting Pricegrabber.com.
Sources:
Bare, Brenda G. & Smeltzer, Suzanne C. Brunner and Suddarth's Textbook of Medical-Surgical Nursing(8th Edition). Philidelphia, PA: Lippincott-Raven Publishers.
The Global Initiative for Obstructive Lung Disease. Global Strategy for the Diagnosis, Management and Prevention of Chronic Obstructive Pulmonary Disease. Updated 2010.
Taylor, Jill. "Underdiagnosis of COPD Observed in General Practice." Medscape Medical News, 2004.
COPD Fact Sheet. (2007). American Lung Association.
