Healthtips

Many of the patients who are referred to a pulmonologist, a physician who specializes in diseases of the lungs, suffer from chronic obstructive pulmonary disease (COPD). COPD refers to a group of long-term, irreversible diseases that cause a disruption of the air flow from the lungs resulting in difficulty breathing. If not diagnosed and treated properly, COPD worsens and may lead to severe shortness of breath, heart problems, and even death.

COPD is most often caused by smoking. Nearly everyone with COPD has been a long-term smoker, and research indicates that smoking cigarettes increases the risk of developing COPD. At least 10% to 15% of long-term smokers develop COPD with symptoms while some studies indicate up to 50% of long-term smokers older than age 45 develop COPD.

COPD is often a mix of two diseases -- chronic bronchitis and emphysema. In chronic bronchitis, inflammation occurs in the tubes that carry air to the lungs (bronchial tubes), narrowing the bronchial tubes and making it hard to breathe. The main symptom of chronic bronchitis is a cough that brings up mucus. In emphysema, lung tissue and the tiny air sacs (alveoli) at the end of the bronchial tubes are damaged, trapping air in the lungs. This leads to shortness of breath which is the main symptom of emphysema. Other lung irritants that are inhaled over a long period of time—such as secondhand smoke, air pollution, industrial dust, and chemical fumes—are believed to contribute to COPD.

A number of medical organizations have classified COPD according to symptoms and lung function. Lung function is based on spirometry tests that measure how much air those with COPD can breathe out compared to a person without COPD.

Symptoms of mild COPD may include a chronic cough that often brings up mucus from the lungs. Patients with mild COPD have impaired lung function but may not have shortness of breath. Patients with moderate COPD may have some of these symptoms and a worsening chronic cough that brings up a large amount of mucus from the lungs. They may also experience a shortness of breath and fatigue with exercise and strenuous daily activities. Occasionally they may suffer from a COPD exacerbation which is a sudden increase in shortness of breath and wheezing, and possibly an increased cough with or without mucus. A COPD exacerbation can be life-threatening, and hospitalization may be necessary.

In severe COPD, patients may have some of these symptoms and shortness of breath with even simple daily activities, such as getting dressed and eating. They may experience weight loss and repeated and sometimes severe COPD exacerbations. People with severe COPD have greatly reduced lung function. In very severe COPD, patients have some of the symptoms the earlier stages, plus may have blue skin color especially in the lips, fingers, and toes, fluid buildup in the legs and feet, bloated abdomen, and confusion because of too little oxygen and too much carbon dioxide in the blood. They may also experience life-threatening COPD exacerbations.

Screening is often recommended for adults who are at increased risk of developing COPD. These patients include smokers and ex-smokers, people with chronic asthma, people with a strong family history of emphysema, and those with significant on-the-job exposure to lung irritants, such as chemicals.

It is recommended that you call your primary care physician if you have not been diagnosed with COPD but are experiencing relevant symptoms. A history of smoking (even in the past) greatly increases the likelihood that symptoms are due to COPD.

COPD cannot be cured, but it can be managed. The only reliable way to slow the disease is to stop smoking. Medications may reduce or relieve symptoms. Lifestyle changes, such as exercising, doing breathing exercises, and taking rest breaks, may help reduce symptoms.