Chronic Obstructive Pulmonary Disease

COPD is a term used to denote a number of progressive lung disorders. Emphysema and chronic bronchitis can potentially lead to COPD. A COPD diagnosis means you may have one of these lung-damaging diseases or symptoms of both. When COPD worsens over time, breathing becomes more difficult.

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 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.

Difference between asthma and COPD

Asthma and COPD are similar in many ways, including similar symptoms like shortness of breath and blocked airflow. However, COPD is chronic and progressive. Asthma is often set off by allergens. COPD’s main cause is smoking.

People with asthma don’t always  develop COPD. People with COPD don’t always have asthma. However, it’s possible to have both of these respiratory conditions. If you do have both, you need to treat both.


  • This the main risk factor. Up to 75% of people who have COPD ,smoke or used to smoke.
  • Long-term exposure to other lung irritants, such as second-hand smoke, air pollution, and chemical fumes and dusts from the environment or workplace
  • Most people who have COPD are at least 40 years old when their symptoms begin.
  • This includes alpha-1 antitrypsin deficiency, which is a genetic condition. Also, smokers who get COPD are more likely to get it if they have a family history of COPD.
  • Other causes include poorly ventilated homes, which force families to breathe fumes from burning fuel used for cooking and heating.


At first, you may have no symptoms or only mild symptoms. As the disease gets worse, your symptoms usually become more severe. They can include:

  • Frequent coughingor a cough that produces a lot mucus.
  • Wheezing
  • A whistling or squeaky sound when you breathe.
  • Shortness of breath, especially with physical activity
  • Tightness in your chest

Some people with COPD get frequent respiratory infections such as colds and the flu. In severe cases, COPD can cause weight loss, weakness in your lower muscles, and swelling in your ankles, feet, or legs.

There may be a genetic predisposition to developing COPD. Some people with COPD have a deficiency in a protein called alpha-1-antitrypsin.

This deficiency causes the lungs to deteriorate and also can affect the liver. There may be other associated genetic factors at play as well.


A person with COPD can experience a period when their symptoms are much worse than usual. This is known as an acute exacerbation.  Acute exacerbation of COPD is associated with increased frequency and severity of coughing. It is often accompanied by worsened chest congestion and discomfort. Shortness of breath and wheezing are present in many cases.

COPD exacerbations can be harmful because they can cause further damage to the lungs.

COPD – Measures to practice

COPD requires lifelong disease management. That means following the advice of your healthcare team and maintaining healthy lifestyle habits like :

  • Avoid smoking.If you’re having trouble quitting, talk to your doctor about smoking cessation programs. Try to avoid second-hand smoke, chemical fumes, air pollution, and dust.
  • A little exercise each day can help you stay strong.
  • Eat a diet of nutritious foods.Avoid highly processed foods that are loaded with calories and salt but lack nutrients.
  • Treating other conditions.If you have other chronic diseases along with COPD, it’s important to manage those as well, particularly diabetes mellitus and heart disease.
  • Be prepared for flare-ups.Carry your emergency contact information with you and post it on your refrigerator. Include information about what medications you take, as well as the doses. Program emergency numbers into your phone.


To  diagnose your condition, your doctor will review your signs and symptoms, discuss your family and medical history. Your healthcare provider may order several tests to diagnose your condition.

Tests may include:

  • Lung (pulmonary) function tests.These tests measure the amount of air you can inhale and exhale, and whether your lungs deliver enough oxygen to your blood.
  • Chest X-ray.
  • CT scan
  • Arterial blood gas analysis.This blood test measures how well your lungs are bringing oxygen into your blood and removing carbon dioxide.
  • Laboratory tests.Lab tests aren’t used to diagnose COPD, but they may be used to determine the cause of your symptoms or rule out other conditions. For example, lab tests may be used to determine if you have the genetic disorder alpha-1-antitrypsin deficiency, which may be the cause of COPD in some people. This test may be done if you have a family history of COPD and develop COPD at a young age.


Many people with COPD have mild forms of the disease for which little therapy is needed other than smoking cessation. Even for more advanced stages of disease, effective therapy is available that can control symptoms, slow progression, reduce your risk of complications and exacerbations, and improve your ability to lead an active life.

Quitting smoking

The most essential step in any treatment plan for COPD is to quit smoking. Stopping smoking can keep COPD from getting worse and reducing your ability to breathe. But quitting smoking isn’t easy. And this task may seem particularly challenging if you’ve tried to quit and have been unsuccessful.

Talk to your doctor about nicotine replacement products and medications that might help, as well as how to handle relapses. Your doctor may also recommend a support group for people who want to quit smoking. Also, avoid second-hand smoke exposure whenever possible.


Several kinds of medications are used to treat the symptoms and complications of COPD. You may take some medications on a regular basis and others as needed.


Bronchodilators are medications that usually come in inhalers they help to  relieve coughing and shortness of breath and make breathing easier. Depending on the severity of your disease, you may need a short-acting bronchodilator before activities, a long-acting bronchodilator that you use every day or both.

Inhaled steroids

Inhaled corticosteroid medications can reduce airway inflammation and help prevent exacerbations. Side effects may include bruising, oral infections and hoarseness. These medications are useful for people with frequent exacerbations of COPD. Examples of inhaled steroids include:

  • Fluticasone
  • Budesonide

Combination inhalers

Some medications combine bronchodilators and inhaled steroids. Examples of these combination inhalers include:

  • Fluticasone and vilanterol
  • Formoterol and budesonide (Symbicort)
  • Salmeterol and fluticasone

Oral steroids

These medications are used in case of acute exacerbation of copd.

Short courses (for example, five days) of oral corticosteroids may prevent further worsening of COPD. However, long-term use of these medications can have serious side effects, such as weight gain, diabetes, osteoporosis, cataracts, and an increased risk of infection.


This is a less expensive medication, may help improve breathing and prevent episodes of worsening COPD. Side effects are dose related and may include nausea, headache, fast heartbeat, and tremor, so tests are used to monitor blood levels of the medication.


Respiratory infections, such as acute bronchitis, pneumonia, and influenza, can aggravate COPD symptoms. Antibiotics help treat episodes of worsening COPD, but they aren’t generally recommended for prevention.

Lung therapies

Additional therapies for people with moderate or severe COPD include :

  • Oxygen therapy. Oxygen therapy can improve quality of life and is the only COPD therapy proved to extend life. Talk to your doctor about your needs and options.
  • Pulmonary rehabilitation program.These programs generally combine education, exercise training, nutrition advice and counselling.

Pulmonary rehabilitation after episodes of worsening COPD may reduce readmission to the hospital, increase your ability to participate in everyday activities and improve your quality of life.

In-home non-invasive ventilation therapy

  • Evidence supports in-hospital use of breathing devices such as bilevel positive airway pressure (BiPAP), but some research now supports the benefit of its use at home.
  • A non-invasive ventilation therapy machine with a mask helps to improve breathing and decrease retention of carbon dioxide (hypercapnia) that may lead to acute respiratory failure and hospitalization.

Managing exacerbations

Even with ongoing treatment, you may experience times when symptoms become worse for days or weeks. It may lead to lung failure if you don’t receive prompt treatment.

Exacerbations may be caused by a respiratory infection, air pollution or other triggers of inflammation.

When exacerbations occur, you may need additional medications (such as antibiotics, steroids or both), supplemental oxygen or other  treatments that mentioned above and treated   in the hospital.

Once symptoms improve, your  health care  provider can talk with you about measures to prevent future exacerbations, such as quitting smoking; taking inhaled steroids, long-acting bronchodilators or other medications; getting your annual flu vaccine; and avoiding air pollution whenever possible.


Surgery is an option for some people with some forms of severe emphysema who aren’t helped sufficiently by medications alone. Surgical options include:

  • Lung volume reduction surgery.In this surgery, your surgeon removes small wedges of damaged lung tissue from the upper lungs. This creates extra space in your chest cavity so that the remaining healthier lung tissue can expand and the diaphragm can work more efficiently
  • Endoscopic lung volume reduction  a minimally invasive procedure
  • Lung transplant.Lung transplantation may be an option for certain people who meet specific criteria. Transplantation can improve your ability to breathe and to be active. However, it’s a major operation that has significant risks, such as organ rejection, and you’ll need to take lifelong immune-suppressing medications.
  • Large air spaces (bullae) form in the lungs when the walls of the air sacs (alveoli) are destroyed. It can become very large and cause breathing problems. In a bullectomy, doctors remove bullae from the lungs to help improve air flow.


Once you’ve been diagnosed, you’ll need to see your healthcare provider on a regular basis. You’ll also have to take steps to manage your condition and make the appropriate changes to your daily life.

If you’ve been diagnosed with COPD, preventing an exacerbation from occurring can help you live a healthier life and reduce the risk of severe illness.

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