Chronic Obstructive Pulmonary Disease (COPD)
 

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What is COPD?

Chronic Obstructive Pulmonary Disease (also called Chronic Obstructive Airway Disease and Chronic Obstructive Lung Disease) refers to a group of lung diseases in which the airways which carry air in and out of the lungs are obstructed. The disease typically involves loss of air sac elasticity, lung tissue destruction and airway inflammation. Emphysema and Chronic Bronchitis are the most common forms of COPD.

Causes

90% of COPD in the United States is caused by smoking. An estimated 15% - 20% of long-term smokers will develop COPD. Smoking causes the lungs to inflame and the delicate air sacs (alveoli) to be destroyed. This can eventually lead to inflammation and narrowing of the airways (chronic bronchitis), or enlargement of the air sacs, which causes reduced lung elasticity (emphysema). Other risk factors for COPD include passive smoking, or "second hand smoke" and working or living in heavy air pollution. Although more men have been diagnosed with COPD, the growth of the disease over the past 25 years has been much greater among women than among men. This increase tracks with the increase in smoking among women in the United States since the 1940s. A rare genetic disorder involving an enzyme deficiency called alpha-1 anti-trypsin deficiency (AAT) is also a known cause of COPD in non-smokers. This disorder is responsible for less than 1% of the disease in the United States .

Symptoms

  • Chronic cough, wheezing
  • Persistent and increasing shortness of breath (dyspnea), particularly with physical activity
  • Frequent respiratory infections

Chronic bronchitis sufferers will also often have sputum production with a chronic cough. Patients with advanced COPD may develop cyanosis, which is a bluish discoloration of the lips and nails due to a lack of oxygen in blood.

Diagnosis

Early diagnosis, treatment and changes in lifestyle can prevent the progression of COPD. Smokers, in particular, should be alert to symptoms like shortness of breath, morning cough and cough with mucous production when no other symptoms exist. At MPC we employ a number of tests, as well as take a full health history to determine whether a patient has COPD. Among the tools we use is a spirometer to determine a patient's breathing strength.

Prognosis

While not reversible, the progression of COPD can be significantly slowed by making lifestyle changes. The single most important factor in preventing the progression of the disease is to quit smoking. Patients are also encouraged to avoid second-hand smoke situations, as well as air pollution, dust, and certain cooking or heating fumes.

Left untreated, COPD will tend to progress and eventually cause death. COPD is the fourth leading cause of death in America , claiming the lives of 120,000 Americans in 2002.

Treatment

Besides quitting smoking and avoiding polluted air, there are a variety of medications that may help some COPD patients to improve their breathing capacity. At MPC, we sometimes use broncholdilators to relax the muscles around the airways. Most of these are inhaled, going directly into the patient's lungs. Inhaled steroids may also be used in cases of moderate to severe COPD. These work to reduce airway inflammation. Steroids are not typically recommended for long-term use.

Research shows that a comprehensive approach to treating COPD results in the most improved lung function and a better quality of life for patients. At MPC, we involve a team of health care professionals to develop individualized programs including medication, education, physical and breathing exercises, and patient support.

For a small number of patients, surgery may be an option. Lung volume reduction has been more successful over the past few years in removing diseased tissue from the lungs. And rarely, lung transplantation may be considered for patients in the most advanced stages of COPD. There are always risks with surgery, and these should be discussed with your doctor.

More Information

  • www.nlm.nih.gov is the U.S. National Library of Medicine and the National Institutes of Health combined web site. Click on "Health Information" in the left navigation, then choose "COPD" in the alphabetical listing of health topics.
  • The National Lung Health Education Program's site provides help for living with COPD. Go to www.nlhep.org and select "Your Lungs" on the home page navigation. Then choose "COPD" under "Your Lungs" on the next page.
  • The American Lung Association's web site at www.lungusa.org has a variety of information. Choose "Diseases A to Z" in the upper navigation bar, then go to COPD under the letter C. "COPD Around the Clock" is an online version of a brochure with helpful hints for daily living with COPD.