Chronic obstructive pulmonary disease (COPD) is an umbrella term for a group of lung diseases that includes emphysema and chronic bronchitis.
Having COPD makes it hard to breathe. Many smokers have COPD symptoms like coughing, wheezing, and shortness of breath.
There's no cure for COPD, but the doctors at UPMC can help you manage symptoms so you feel better.
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What Is Chronic Obstructive Pulmonary Disease (COPD)?
Doctors define COPD as a severe lung disease. It happens when your lungs become inflamed or damaged — often from smoking. The lungs can't move air easily in and out when you breathe, so you cough and feel short of breath.
According to the Centers for Disease Control and Prevention (CDC), 16 million Americans have been diagnosed with COPD. Millions more likely have it but don't know it yet or haven't been diagnosed.
COPD is a progressive disease that starts slowly and worsens over time, eventually affecting your ability to enjoy life.
COPD is also a leading cause of disability. In advanced stages of COPD, many people have trouble doing basic tasks like cooking or caring for themselves.
Most people get COPD because they smoke. Air pollution, second-hand smoke, and genetics can also cause COPD. Both men and women get COPD.
While there's no cure for COPD, doctors can help slow the disease's progression.
You can make lifestyle changes and try COPD treatment to improve your quality of life.
What are the types of COPD?
There are two forms of COPD — emphysema and chronic bronchitis.
- Chronic bronchitis — Happens when there's long-term irritation and inflammation in the lining of the airways. Thick mucus forms, making it hard for you to breathe. You may develop a characteristic "smoker's cough."
- Emphysema — Happens when the air sacs in the lungs get damaged. Healthy air sacs act like balloons, filling up with air and then deflating when you breathe out. Damaged air sacs can't move air out of your body easily.
Some people have both emphysema and chronic bronchitis. Others have asthma symptoms along with COPD.
What are the stages of COPD?
The four stages doctors use to diagnose and treat COPD are:
Stage 1: Mild
At this stage, you may not know you have COPD. You may experience more coughing or increased mucus production. If you’re concerned that you may be developing COPD, your doctor may order a spirometry test to measure your lung function.
If you smoke, you should quit immediately to slow the decline of lung function. Your doctor also may recommend breathing exercises or lifestyle changes to help manage symptoms.
Stage 2: Moderate
At this stage, most people have a cough, mucus, and shortness of breath. Some people pass these symptoms off as signs of aging or a cold. If you haven’t had a spirometry test, your doctor is likely to order one to determine if you need treatment.
Your doctor may recommend breathing exercises to help control your breathing. They may give you advice on how to avoid triggers that worsen your symptoms.
Stage 3: Severe
At this stage, lung function has seriously declined. Symptoms are more pronounced, and you may have flare-ups when they worsen. Your doctor will likely prescribe a long-acting bronchodilator and possibly steroids, expectorants, or oxygen therapy.
Stage 4: Very severe
At this stage, lung function is very low. You get winded with even small amounts of activity, and symptom flare-ups can be life-threatening.
If other treatments aren't helping, you may need surgery to remove damaged areas of the lungs. In severe cases — when all other treatment options have failed — a lung transplant may be necessary.
What causes COPD?
Smoking cigarettes is the main cause of COPD.
You may also get COPD after long-term exposure to:
- Air pollution.
- Chemical fumes.
- Second-hand smoke.
COPD risk factors
Several factors increase your risk of developing COPD.
Risk factors for COPD include:
- A genetic condition — If you inherit a condition known as alpha-1 antitrypsin (AAT) deficiency, you're more likely to get COPD. AAT makes you more vulnerable to smoke and chemical fumes. If you have AAT, you're also more likely to get COPD at a younger age.
- Age — Most people diagnosed with COPD are over 40 years of age.
- Asthma — People who already have asthma are more likely to develop COPD. Asthma is a lung disease that causes swelling of the airways.
- Environmental irritants — Air pollution or chemical fumes from your workplace may damage your lungs. Second-hand cigarette smoke in the workplace can also be a factor.
- Lung disease as a child — If you had lung problems as a child, you are more likely to get COPD as an adult.
- Other health issues — If you have a condition such as HIV, pneumonia, or tuberculosis, you're more likely to develop COPD.
- Smoking cigarettes — Most people who have COPD smoke or used to smoke.
Complications of COPD
COPD can lead to other physical, mental, and emotional complications.
If you have COPD, you're more likely to:
- Develop memory loss.
- Get chronic diseases like arthritis, heart failure, diabetes, and stroke.
- Have depression or anxiety.
- Have physical limitations, such as trouble walking or going up a set of stairs.
- Lose weight and muscle.
- Miss out on social events with family and friends.
- Need an oxygen tank to help you breathe.
- Quit working before you want to.
How can I prevent COPD?
The best way to prevent COPD is by not smoking. If you do smoke, try to quit as soon as possible.
Your PCP can talk to you about the best way to quit, including products, programs, and support groups.
You can also prevent complications from COPD by staying up to date on your vaccines. Getting routine flu and pneumonia shots helps prevent lung infections.
What Are the Signs and Symptoms of COPD?
Many people don't know they have COPD because symptoms are mild at first.
Here's what you should look out for.
- A cough — The cough in COPD is often the first symptom and produces a lot of mucus. Some people call it the "smoker's cough."
- A tight feeling in your chest.
- Shortness of breath, especially when you're exercising or even walking.
- Wheezing, whistling, or squeaking when you breathe.
There are times when symptoms flare up and get suddenly worse. Triggers include environmental substances or an infection in your body.
When should I see a doctor for my COPD?
If you have an increase in coughing or mucus, make an appointment with your doctor. The earlier you find out what’s causing your symptoms, the better your chances of slowing down the disease. You may be able to make some lifestyle changes, like quitting smoking, that can slow the progression of COPD.
How Do You Diagnose COPD?
Doctors diagnose COPD with a simple test called spirometry.
In spirometry, you blow as hard as possible into a tube connected to a machine. The machine measures how well your lungs are working.
How Do You Treat COPD?
Smoking cessation
The most crucial part of COPD treatment is to quit smoking. While there's no cure for COPD, not smoking can help slow its progression.
UPMC offers many resources to help you kick the smoking habit. Your provider can direct you to programs, support groups, and products that can help.
If you need to see a specialist, your PCP can direct you to a lung specialist. These doctors conduct cutting-edge research on lung diseases, including COPD.
Medicines
If you have moderate to severe COPD, you may need a bronchodilator. These inhaled medicines open the airways so you can take more oxygen into your lungs.
Your doctor may prescribe an inhaler containing a fast-acting medication such as albuterol. They may call this your "rescue inhaler." You should always carry your rescue inhaler with you to use when you feel short of breath.
Long-acting bronchodilators are another kind of medicine. You typically take them every day in the form of an inhaler.
Some common long-acting bronchodilators are:
- Arformoterol
- Formoterol
- Tioptropium
- Umeclidinium
Some inhalers are combination steroid-bronchodilators.
They include:
- Budesonide and formoterol (Symbicort, Breyna).
- Fluticasone and salmeterol (Advair Diskus, AirDuo Digihaler).
Oxygen therapy
COPD can prevent the proper amount of oxygen from reaching your blood supply, so your doctor may recommend oxygen therapy.
Supplemental oxygen gets delivered to the lungs through a portable oxygen tank that is easy to maneuver. Some people with COPD only need this treatment while they're active or sleeping. Others need its assistance at all times.
Surgery
Surgery may be a last-resort option for people with very severe COPD. At UPMC, we offer several types of lung surgery.
They include:
- Lung volume reduction surgery — An operation where surgeons remove small wedges of damaged lung tissue from the upper lungs. This approach provides extra space in the chest cavity, allowing the remaining healthy lung tissue to expand and helping the diaphragm work more efficiently.
- Bullectomy — A procedure in which surgeons remove bullae, or large air spaces, from the lung walls to improve airflow.
- Lung transplant — This is the last and most complex surgery option, as it requires a pair of donor lungs and the replacement of the damaged lungs. Transplant can be a lifesaving surgery, but you must take immune-suppressing medications to keep the body from fighting the donor lungs. Ultimately, your body may reject the donor lungs.
Other treatments to ease COPD symptoms
Other ways your doctor may suggest treating the symptoms of COPD are:
- Exercise therapy — Techniques to help you breathe better and conserve energy during physical activity.
- Nutrition therapy — Healthy diet advice to help make you stronger.
