Chronic Obstructive Pulmonary Disease

Chronic bronchitis and emphysema can both result in COPD. A COPD diagnosis means you may have one of these lung-damaging diseases or symptoms of both. COPD can progress gradually, making it harder to breathe over time.

Chronic bronchitis #

• Chronic bronchitis irritates your bronchial tubes, which carry air to and from your lungs.

• In response, the tubes swell and mucus (phlegm or snot) builds up along the lining.

• The buildup narrows the tube’s opening, making it hard to get air into and out of your lungs.

• Small, hair-like structures on the inside of your bronchial tubes (called cilia) normally move mucus out of your airways.

• But the irritation from chronic bronchitis and/or smoking damages them. The damaged cilia can’t help clear mucus.

Emphysema #

• Emphysema is the breakdown of the walls of the tiny air sacs (alveoli) at the end of the bronchial tubes, in the bottom of your lung.

• Your lung is like an upside-down tree. The trunk is the windpipe or trachea, the branches are the bronchi, and the leaves are the air sacs or alveoli.

• The air sacs play a crucial role in transferring oxygen into your blood and carbon dioxide out.

• The damage caused by emphysema destroys the walls of the air sacs, making it hard to get a full breath.

Causes #

• Alpha-1 antitrypsin (AAT) deficiency, a genetic disorder.

• Secondhand smoke.

• Air pollution. Workplace dust and fumes.

• Smoking Tobacco smoke irritates airways, triggering inflammation (irritation and swelling) that narrows the airways. Smoke also damages cilia so they can’t do their job of removing mucus and trapped particles from the airways.

• AAT deficiency AAT (alpha-1 antitrypsin deficiency) is an uncommon, inherited disorder that can lead to emphysema. Alpha-1 antitrypsin is an enzyme that helps protect your lungs from the damaging effects of inflammation.

When you have AAT deficiency, you don’t produce enough of alpha-1 antitrypsin. Your lungs are more likely to become damaged from exposure to irritating substances like smoke and dust.

Symptoms #

• Cough with mucus that persists for long periods of time.

• Difficulty taking a deep breath.

• Shortness of breath with mild exercise (like walking or using the stairs).

• Shortness of breath performing regular daily activities.

• Wheezing.

Diagnosis #

Lab tests #

• Pulse oximetry: This test measures the oxygen in your blood.

• Arterial blood gases (ABGs): These tests check your oxygen and carbon dioxide levels.

• Electrocardiogram (ECG or EKG): This test checks heart function and rules out heart disease as a cause of shortness of breath.

• Chest X-ray or chest CT scan: Imaging tests look for lung changes that COPD causes.

• Exercise testing: Your provider uses this to determine if the oxygen level in your blood drops when you exercise.

Stages #

Mild COPD (stage 1 or early stage) #

The first sign of COPD is often feeling out of breath with light exercises, like walking up stairs. Because it’s easy to blame this symptom on being out of shape or getting older, many people don’t realize they have COPD. Another sign is a phlegmy cough (a cough with mucus) that’s often particularly troublesome in the morning. These are early warning signs of COPD.

Moderate to severe COPD (stages 2 and 3) #

In general, shortness of breath is more evident with more advanced COPD. You may develop shortness of breath even during everyday activities. Also, exacerbations of COPD times when you experience increased phlegm, discoloration of phlegm, and more shortness of breath are generally more common in higher stages of COPD. You also become prone to lung infections like bronchitis and pneumonia.

Very severe COPD (stage 4) #

When COPD becomes severe, almost everything you do can cause shortness of breath. This limits your mobility. You may need supplemental oxygen from a portable tank.

Treatment #

• Bronchodilators: These medicines relax airways. You inhale a mist containing bronchodilators that help you breathe easier. Anti-inflammatory medications: You inhale steroids or take them as a pill to lower inflammation in the lungs.

• Supplemental oxygen: If blood oxygen is low (hypoxemia), you may need a portable oxygen tank to improve your oxygen levels.

• Antibiotics: COPD makes you prone to lung infections, which can further damage your weakened lungs. You may need to take antibiotics to stop a bacterial infection.

• Vaccinations: Respiratory infections are more dangerous when you have COPD. It’s especially important to get shots to prevent flu and pneumonia.

• Rehabilitation: Rehabilitation programs teach effective breathing strategies to lessen shortness of breath and on conditioning. When maintained, fitness can increase the amount you can do with the lungs you have.

• Anticholinergics: These drugs relax the muscle bands that tighten around the airways and help clear mucus from the lungs. Relaxed muscles let more air in and out. With the airways open, the mucus moves more freely and can therefore be coughed out more easily. Anticholinergics work differently and more slowly than fast-acting bronchodilators.

• Leukotriene modifiers: These medications affect leukotrienes, chemicals that occur naturally in the body that cause tightening of airway muscles and production of mucus and fluid. Leukotriene modifiers block the chemicals and decrease these reactions, helping improve airflow and reducing symptoms in some people.

• Expectorants: These products thin mucus in the airways so you can cough it out more easily. You should take these medications with about 8 ounces of water.

• Antihistamines: These medicines relieve stuffy heads, watery eyes, and sneezing. Although effective at relieving these symptoms, antihistamines can dry the air passages, making breathing difficult, as well as causing difficulty when coughing up excess mucus. Take these medications with food to reduce upset stomach.

• Antivirals: Your provider might prescribe these to treat or prevent illnesses caused by viruses, most frequently to treat or prevent influenza (the flu). Influenza is particularly dangerous for people who have COPD.