AN INTRODUCTION TO COPD
What Is COPD?
COPD stands for "chronic obstructive pulmonary disease":
- "Chronic" means long-term.
- "Obstructive" refers to the fact that breathing is
partially blocked.
- "Pulmonary" indicates that the disease affects the lungs.
If you have COPD, you're not alone. It's even more common than asthma.
The term COPD refers to a disease that generally includes both chronic
bronchitis and emphysema. Usually it occurs in people who are heavy smokers and
have been smoking for a long time.
Most people don't realize they have a problem until they're 40 or older.
Then they start noticing that they're short of breath. They may also have a
morning cough that produces sputum (mucus or phlegm). It might be mistaken for
smoker's cough. Many people don't find out that they have COPD until they have
a serious attack of bronchitis.
If you have any of the following symptoms regularly (especially if you are
or were a smoker), you may have some form of COPD:
- A severe cough that persists between colds.
- Spitting up mucus.
- Difficulty breathing.
- Frequent bad colds.
- Shortness of breath on exertion.
The doctor's overall goal in treating COPD is to relieve symptoms with the
fewest side effects possible. New drugs have made the lives of patients with
COPD much better.
The single most important step you can take to keep your lungs healthier is
to stop smoking. Even if you're under 35 years old, with mild COPD, your lungs
will probably return to normal after you stop smoking. Even if you're older,
stopping smoking can keep your lungs working better for longer -- and prolong
your life.
COPD can vary from day to day and from season to season. Infections,
pollution, and other factors may make your symptoms more severe for certain
periods. Physicians call these times "exacerbations."
COPD doesn't go away, but it can be treated. And the sooner you get
treatment, the better. To learn more about COPD, talk to your doctor. There are
medications, breathing techniques, and lifestyle changes that can help you
breathe easier.
Chronic Bronchitis
Chronic bronchitis is one of two major lung diseases that underlie COPD. The
other is emphysema (see the section below). Chronic bronchitis and emphysema
frequently, but not always, occur together in COPD. Both chronic bronchitis and
emphysema are long-term conditions. Both make it hard to breathe. Both cause
shortness of breath, tiredness, and coughing.
Many people experience short-term bronchitis when they have a very bad cold.
Other people may have a different cause, but experience the same symptoms:
severe cough, raspy throat, difficulty breathing, and a need to cough up a
great deal of mucus from the lungs. In chronic bronchitis, this condition lasts
for months at a time, and each year it lasts longer.
Chronic bronchitis often develops in people over age 40 who are or who used
to be moderate to heavy smokers. The total amount of smoking over a lifetime is
measured in "pack-years." (For example, 10 pack-years can mean a pack
a day for 10 years, or two packs a day for five years, or half a pack a day for
20 years.) Typically, people who develop chronic bronchitis have a smoking
history of over 10 pack-years.
Chronic bronchitis involves the bronchial tubes: the main airways that
branch into the lungs. In chronic bronchitis, they have been constantly
irritated by inhaled cigarette smoke, air pollution, or other harmful
substances.
When the bronchial tubes have been irritated for years, their walls thicken
or swell. They produce more mucus, so less air flows through. The mucus is
brought up by coughing, every day for months. The irritated airways become an
ideal breeding place for infections that can endanger the lungs.
Emphysema
Emphysema is one of two major lung diseases that underlie COPD. The other is
chronic bronchitis.
Emphysema is usually diagnosed in smokers or ex-smokers (usually 50 to 75
years of age) with shortness of breath both at rest and during physical
exertion. People with emphysema may cough, but their coughing isn't usually
severe and does not produce much mucus. Breathing, on the other hand, may be
hard.
Like chronic bronchitis, emphysema, in most cases, is believed to be the
result of long-term irritation or infection of the bronchial tubes. The
inflammation gradually blocks the airways.
In emphysema, this blockage traps air in the tiny air sacs found at the end
of the bronchial tubes. These air sacs (called alveoli) are where carbon
dioxide and other waste gases in the blood are exchanged for oxygen taken in by
the lungs from the air.
Eventually, the walls of these air sacs stretch out, become stiff instead of
elastic, and break down. The lungs themselves become larger and don't exchange
oxygen for carbon dioxide as well. In severe emphysema, even very simple
activities can bring on shortness of breath.
A small number of people with emphysema are born without a lung-protecting
enzyme called alpha1-antitrypsin. This makes them more likely to develop
emphysema at an earlier age.
Smoking, however, is the main problem for most patients with emphysema. It
must be stopped if the patient is to be helped.
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