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Chronic Obstructive Pulmonary Disease (COPD)

Definition and Overview

Chronic obstructive pulmonary disease or COPD is a term used to describe a number of respiratory disorders that make it difficult for patients to breathe. In COPD, lung tissue is stretched and broken down until it cannot bring enough oxygen to the lungs. The function of the lungs will slowly decline over a period of years.

Three main conditions that are covered by this term include chronic bronchitis, asthmatic bronchitis, and emphysema. Chronic bronchitis is defined as episodes over two or more years of a cough that produce phlegm and last three or more months. Asthmatic bronchitis produces lots of mucus, and when chronic this mucus leads to obstruction of the airways. Emphysema is a progressive destruction of the small sacs, or alveoli, in the lungs.

COPD continues to cause very serious health problems throughout the world. In many cases it is an easily preventable disorder. However, if uncared for COPD will cause life threatening damage to the respiratory system that requires a great deal of medical care and monitoring. The onset of the disease is very slow, taking years, and often hard to recognize until more advanced. It is something that affects millions of Americans. 

Causes and Symptoms

There are several causes of COPD, but smoking is responsible for at least 90% of cases in the US. Smoke, especially cigarette smoke, damages the lungs and causes lung tissue to break down. Inhalation of substances such as coal and silica dust can also damage the lungs and lead to COPD. The diseases that slowly damage the lung and lead to COPD include chronic bronchitis, asthma (a disease that constricts the airways), and emphysema. There also exists a genetic mutation, resulting in the lack of a substance called alpha-1 anti-trypsin, which will lead to COPD. In this case the body is not able to make enough of the substance that is necessary to prevent inflammatory cells from breaking down lung tissue.

Symptoms include shortness of breath on exertion, recurrent lung infections, and a chronic cough that produces phlegm. Also changes in altitude can be harmful to the patient, therefore when taking airplane trips or trips to high altitudes the patient must first consult with a physician. As the disease progresses these symptoms will become more severe, in the last stages of the disease the patient will experience wheezing and more coughing in addition to all of these symptoms. The patient will then suffer from respiratory failure and often die. 

Treatment and Prognosis

COPD is not curable; therefore treatment includes giving the patient inhaled drugs to try to keep the airways open and reduce some of the obstruction. As the disease becomes more severe inhaled oxygen is required for treatment. Oxygen is the only therapy that has been shown to prolong the life of someone suffering COPD. Patients are also shown how to strengthening and flexibility exercises for the lungs. As a last resort for treatment lung transplant surgery can be helpful.

Stopping smoking is one of the most important ways that one can slow the progress of COPD. Some things to help stop smoking include setting a definitive stop date, having a good network of support, getting advice on how to make healthy lifestyle changes, and a proper follow-up by a physician. Beyond stopping smoking there are other things available through a physician that can help with COPD. These include inhaled drugs, using a device to deliver oxygen, receiving a flu vaccine, surgery to reduce the size of diseased lung, and participating in a program to increase the strength and endurance of the chest and lungs.

The prognosis for COPD will depend in many ways on the efforts taken by the patient to avoid making it worse, stopping smoking, seeing a physician, as well as the age of the patient, and any other medical issues that may be present. Lung function will continue to decline regardless, so the goal of treatment is to try to prevent the lung disease from leading to respiratory failure.