Chronic Obstructive Pulmonary Disease (COPD)
Chronic Obstructive Pulmonary Disease (COPD) is a progressive chronic lung disease that makes it hard to breath. The two main types of COPD are chronic bronchitis and emphysema. It is a very common disease and the third leading cause of death in the United States.
COPD is mainly caused by long-term exposure to substances that irritate the lungs. Cigarette smoking is the leading cause of COPD. Other irritants include air pollution, chemical fumes, and dust.
At first COPD may have no signs or symptoms. As the disease gets worse, symptoms become more severe. Symptoms include:
- A cough that produces a lot of mucus
- Shortness of breath, especially with physical activity
- Chest tightness
The flu and pneumonia can cause severe problems for people with COPD. It is important to talk to your doctor or pharmacist about the flu shot and the pneumococcal vaccine. The flu shot can reduce your risk of getting the flu and lessen the symptoms. The pneumococcal vaccine lowers your risk of getting pneumonia and its complications. People with COPD have a greater risk for pneumonia than people without COPD.
How Normal Lungs Work
In normal lungs, your airways (bronchial tubes) fill with air as you breath. The airways branch into thousands of smaller, thinner tubes called bronchioles. These tubes end in tiny round air sacs called alveoli. Small blood vessels called capillaries run along the wall of the air sacs. When air reaches the air sacs, oxygen passes through the air sac walls into the blood in the capillaries. At the same time, carbon dioxide (CO2) gas moves from the capillaries into the air sacs. This process (gas exchange) bring oxygen in the body and removes the CO2. The airways and air sacs are elastic or stretchy. When you breath in, the air sac fills with air. When you breath out, it deflates and the air leaves your body.
How COPD Hinders The Lungs
In COPD, less air flows in and out of the airways because of one or more of the following:
- The airways and air sacs lose their elastic quality
- The walls between many of the air sacs are destroyed
- The walls of the airways become thick and inflamed
- The airways make more mucus than usual and can become clogged
There is no cure for COPD. However, lifestyle changes and treatments can help with symptoms and slow the progress of the disease.
The goals of COPD treatments include:
- Relieving your symptoms
- Slowing the progress of the disease
- Improving your exercise tolerance or your ability to stay active
- Preventing and treating complications
- Improving your overall health
Quit smoking and avoid lung irritants
Quitting smoking is the most important step you can take to beat COPD. Talk to your doctor about programs and products that can help you quit. Try to avoid secondhand smoke and places with dusts, fumes, or other toxic substances that you may inhale and irritate your lungs.
COPD, especially severe forms, may cause you to have trouble eating because of shortness of breath and fatigue. This may cause you to not get enough calories and nutrients, which can worsen your symptoms and raise your risk of infection. Talk to your doctor about an eating plan that will meet your nutritional needs. Your doctor may suggest smaller, more frequent meals and resting before eating.
People with COPD may find it hard to stay physically active. Talk with you doctor about what types of activity is safe for you. Physical activity strengthens the muscles that help you breathe and improve your overall wellness.
There are a few different types of medication doctors can prescribe someone with COPD. Depending on the severity of your symptoms, your doctor may have you use a combination of medications.
Bronchodilators relax the muscles in your airways to help open your airways and make it easier to breathe. There are two types of bronchodilators: short-acting and long-acting bronchodilators. The short-acting last about 4-6 hours and should be used only when needed. Long-acting bronchodilators last about 12 hours or more and are used daily.
Most bronchodilators are taken using an inhaler. This allows the medicine to go straight to your lungs. Not all inhalers are used the same, so make sure you ask your doctor or pharmacist to show you the correct way to use your inhaler. If your COPD is mild, you may only be prescribed the short-acting bronchodilator to use when symptoms occur. If you have moderate to severe COPD, you may be prescribed a regular treatment of both short-acting and long-acting bronchodilators.
Combination Bronchodilators plus inhaled Glucocorticosteroids (steroids)
Steroids help reduce airway inflammations. Typically using inhaled steroids alone is not the preferred treatment. If your COPD is severe or if you symptoms flare up often, you may be prescribed a combination of bronchodilator and an inhaled steroid.
If you have severe COPD and low levels of oxygen in your blood, oxygen therapy can help you breathe better. Oxygen is delivered through nasal prongs or a mask. You may only need extra oxygen at certain times or all the time. Oxygen can help people with severe COPD do tasks or activities while experiencing fewer symptoms, protect their heart and organs from damage, sleep better, and live longer.
Some people with COPD may benefit from surgery. This is usually a last resort for people whose symptoms are not improving with medications. Surgeries for people with COPD mainly relate to emphysema. A lung transplant might be an option for people who have very severe COPD.
Types of Surgery
Bullectomy: When the walls of the air sacs are destroyed, larger air spaces called bullae form. These air spaces can become so large they interfere with breathing. In a bullectomy, one or more very large bullae from the lungs are removed.
Lung Volume Reduction Surgery (LVRS): To help the lungs work better, surgeons remove damaged tissue from the lungs. In carefully selected patients, LVRS can improve breathing and quality of life.
Lung Transplant: A lung transplant can improve lung function and quality of life in people with very severe COPD. Surgeons remove the damaged lung and replace it with a healthy lung from a donor. Lung transplants have many risks, including infections and rejection of the transplanted lung.
Source: American Lung Association
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