Chronic obstructive pulmonary disease (COPD) is a long-term lung condition. It gets worse over time, and a range of factors can affect how quickly it progresses.
Keep reading to learn more about COPD, including its symptoms, types, causes, and some treatment options.
What is COPD?
COPD is a progressive disease, which means that it gets worse over time.
The rate of progression varies considerably, depending on the individual and the type of disease involved. Treatments and lifestyle changes can significantly affect how quickly COPD progresses.
According to the American Lung Association, more than 15 million people in the United States have a COPD diagnosis, and many more likely have the disease without realizing it.
All forms of COPD adversely affect the lungs and cause breathing problems. However, the exact physiology and the type of lung damage can vary.
Chronic bronchitis and emphysema are commonly involved in COPD. Both tend to develop later in life, due to factors such as tobacco smoking. They generally involve a progressive decline that results in premature death.
Refractory asthma can also be a form of COPD. This type of asthma is severe and irreversible — it does not respond to medications that typically treat asthma.
All types of COPD cause similar signs and symptoms, but these can vary in severity. Symptoms of COPD commonly flare up, becoming more severe, from time to time.
Typical symptoms include:
- shortness of breath
- chest tightness
- increased mucus production
According to the National Heart, Lung, and Blood Institute, the primary cause of COPD in the U.S. is cigarette smoking. Exposure to other lung irritants, such as the following, can also contribute to the disease:
- secondhand smoke
- air pollution
In rare cases, a genetic condition called an alpha-1-antitrypsin deficiency can play a role in causing COPD. A person with this deficiency has a low level of the protein alpha-1-antitrypsin in their liver, making them more susceptible to lung damage.
A diagnosis of COPD begins with a physical exam and a review of the person's symptoms and medical history.
Additional tests can confirm a doctor's initial diagnosis. The doctor may request a chest X-ray and a pulmonary function test, which measures the amount of air that a person can exhale and how long a full exhalation takes.
Further tests can help determine the extent of the disease. For example, an arterial blood gas test can measure oxygen and carbon dioxide levels in the body.
Lung conditions that are forms of COPD include:
- Emphysema: This damages the air sacs, or alveoli, in the lungs.
- Chronic bronchitis: This involves inflammation of the bronchial tubes.
- Refractory asthma: This involves inflammation and narrowing of the airways that medication cannot reverse.
Other conditions linked to COPD include:
- Bronchiectasis: This involves inflammation and scarring of the airways that leads to extensive amounts of mucus.
- Pneumonia: People with COPD are more likely to develop pneumonia and other lung infections.
Determining the stage of COPD
Doctors use a staging system to classify the severity of COPD based on the results of spirometry testing.
A person takes a spirometry test in a doctor's office. It involves blowing into the mouthpiece of a device called a spirometer, which measures lung function.
The spirometer will record how much air the person can exhale when they try to empty their lungs completely. This measurement is called forced vital capacity.
Also, the device will record how much air the person can exhale in 1 second, which can indicate the severity of COPD.
The Global Initiative for Chronic Obstructive Lung Disease (GOLD) developed a COPD classification system based on spirometry results.
The GOLD classification also takes into account the person's symptoms, any hospitalization because of COPD, and how many times the disease has worsened.
The four grades of COPD include:
- grade 1: mild
- grade 2: moderate
- grade 3: severe
- grade 4: very severe
Treatment for COPD can help prevent flare-ups, slow the disease's progression, and improve the person's quality of life. A treatment plan may involve a combination of the following:
Inhaled medications, including bronchodilators and steroids, can ease symptoms.
Bronchodilators, such as albuterol, work by relaxing the muscles around the airways, opening them up.
Steroids, such as fluticasone, reduce inflammation in the lungs.
People with COPD may have decreased oxygen levels. Supplemental oxygen therapy may help improve these levels and ease shortness of breath.
Bilevel positive airway pressure (BIPAP) delivers pressure to the lungs, making breathing easier.
BIPAP may help relieve shortness of breath, boost oxygen levels, and remove carbon dioxide from the lungs.
Lifestyle changes may benefit people with COPD. For example, quitting smoking may slow the progression of the disease.
Changing the diet may also help. For example, overeating or eating foods that lead to gas can cause bloating, which can push against the diaphragm, increasing shortness of breath.
Some people with COPD may benefit from eating smaller meals and eating more frequently.
Also, it is important to keep immunizations up to date, such as those for the flu and pneumonia. This can reduce the risk of infections that can become severe in people with COPD.
Pulmonary rehabilitation classes combine education with a supervised exercise program.
Participants learn how to manage their lung disease. This may involve:
- tactics for identifying infection early
- strategies for conserving energy
- breathing exercises
The exercises involved can help relieve breathlessness and strengthen the heart and other muscles to improve daily functioning.
Also, a number of supplements may help with symptoms of COPD. Read about them here.
COPD is the third leading cause of disease-related death in the U.S. Research into a cure is ongoing.
According to the Centers for Disease Control and Protection, more females than males have died from COPD in the past 20 years.
The reason may be that females tend to receive a diagnosis later than males, when the disease has progressed further and treatments are less effective.
The CDC also report that females seem to be more susceptible to the negative effects of harmful substances, such as pollution, that can increase the risk of developing COPD.
The overall outlook for COPD depends on the stage of the disease and any other health issues the person has. People respond differently to treatment, and this can also significantly affect the outlook.
COPD is a progressive, long-term lung condition that restricts the ability to breathe. The severity of a person's symptoms depends on the stage of the disease.
Various treatments and other interventions can slow the disease's progression, control symptoms, and prevent complications.
Usually, a doctor will recommend medications and lifestyle changes, including stopping smoking.