Chronic Obstructive Pulmonary Disease (COPD)
Chronic obstructive pulmonary disease (COPD) is a term that refers to two lung diseases, chronic bronchitis and emphysema. Both of these often occur in the same person so doctors may use the term COPD. It does not include other airway diseases such as asthma.
Risk Factors
- Smoking is the main risk factor for COPD. About 80 to 90% of COPD deaths are caused by smoking. Female smokers are nearly 13 times more likely to die from COPD as women who have never smoked. Male smokers are nearly 12 times more likely to die from COPD as men who have never smoked.
- Smog
- Second-hand smoke
- History of lung infections as a child
- Genes
- Job exposure to pollutants
Chronic Bronchitis
This is the inflammation and scarring of the lining of the breathing tubes. When these are inflamed or infected, less air is able to flow to and from the lung and heavy mucus is coughed up. It is defined as a cough with mucus most days of the month, three months out of a year, for two years in a row without having other disease that explains the cough.
The breathing tubes become a breeding place for infection in the airways which will then limit the airflow to the lungs.
Chronic bronchitis affects people of all ages, but occurs more in those over 45 years old. Females are more than twice as likely to have this as males.
Symptoms include:
- chronic cough
- increased mucus
- frequent clearing of the throat
- shortness of breath
Emphysema
Emphysema begins with damage to the air sacs in the lungs. This results in ‘holes’ in the tissues of the lower lungs. As air sacs are destroyed, the lungs are able to get less and less oxygen to the bloodstream, causing shortness of breath. The lungs also lose the “stretch” which is needed to keep the airways open. The patient will have great trouble breathing out.
Emphysema does not start quickly. It comes on very slowly. Years of smoking often come before the start of emphysema. It is found mostly in people who are over 45 years of age.
Symptoms include cough, shortness of breath, and trouble with exercise. Doctors can test for this with breathing tests, history, exam, and other tests.
AAT (Alpha Anti-trypsin Deficiency-Related) Emphysema
AAT emphysema is caused by the lack of a protein called alpha1-antitrypsin (AAT) or alpha1-protease inhibitor. This protein is produced by the liver and protects the lungs. Without AAT, emphysema will set in. It affects 5% or less of the people with emphysema. About 100,000 Americans, mostly of northern European descent, have AAT deficiency emphysema. Another 25 million Americans carry a single gene that causes AAT and may pass the gene to their children.
Symptoms of this type of emphysema may begin between 32 and 41 years of age and include shortness of breath and trouble with exercise. Smoking makes this type of emphysema worse. A blood test is used to see if a person has this gene. If children are found to have this gene, they may need a liver transplant. Also, a cheek swab test is being used to test for the lack of AAT.
COPD Treatment
The quality of life for a person that suffers from COPD gets worse as the disease goes on. At first, there is some shortness of breath. People with COPD may later need extra oxygen and may have to rely on breathing machines.
Half of all COPD patients say their COPD limits their work. It also limits them in daily routines, chores, social activities, sleeping, and family activities. None of the current medicines for COPD has been shown to change the long term decline in lung function. The goal of treatment is to provide relief of symptoms and prevent problems, and slow the progress of the disease with as few side effects as possible.
Drugs that relax and open airways in the lungs are key to easing symptoms. They can be inhaled or taken by mouth. Other treatment includes antibiotics, oxygen, and steroids. Long-term treatment with oral steroids involves the risk of severe side effects. These are used mainly when the disease gets worse.
Patients with COPD should receive pneumonia and influenza vaccines. Those with COPD should live a health lifestyle by
- Staying as active as you can
- Not smoking
- Avoiding smog
- Eating well
Your health care team has a program to help people cope with COPD. Lung transplants are being done more often, and may be an option for some people. Also, lung volume reduction surgery has shown promise and is being done more often, but may be too risky in some severe cases.
Treatments for AAT deficiency emphysema, including AAT replacement therapy (a life-long process) and gene therapy are being tested.
Questions?
If you have any questions or concerns please call UWHC Pulmonary Clinic, Monday-Friday 8:00am-4:30pm at (608)263-7203.
Toll free: 1-800-323-8942, please ask for Pulmonary Clinic.
For help to quit smoking, ask your doctor or call 1-800-QUIT NOW (1-800-784-8669) for free help.
For more information, see the American Lung Association website, www.lungusa.org or call them at 1-800-LUNG-USA (1-800-586-4872).
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 02/01/2010
Copyright © 02/01/2010 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#6501
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