Chronic obstructive pulmonary disease (COPD)
COPD; Chronic obstructive airways disease; Chronic obstructive lung disease; Chronic bronchitis; Emphysema; Bronchitis - chronicChronic obstructive pulmonary disease (COPD) is a common lung disease. Having COPD makes it hard to breathe.
There are two main forms of COPD:
- Chronic bronchitis, which involves a long-term cough with mucus
- Emphysema, which involves damage to the lungs over time
Most people with COPD have a combination of both conditions.
Causes
Smoking is the main cause of COPD. The more a person smokes, the more likely that person will develop COPD. But some people smoke for years and never get COPD.
If a person has a rare condition in which they lack a protein called alpha-1 antitrypsin, they can develop emphysema even without smoking.
Alpha-1 antitrypsin
Alpha-1 antitrypsin (AAT) deficiency is a condition in which the body does not make enough of AAT, a protein that protects the lungs and liver from d...
Other risk factors for COPD are:
- Exposure to certain gases or fumes in the workplace
- Exposure to heavy amounts of secondhand smoke and pollution
- Frequent use of a cooking fire without proper ventilation
Symptoms
Symptoms may include any of the following:
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Cough, with or without mucus
Cough
Coughing is an important way to keep your throat and airways clear. But too much coughing may mean you have a disease or disorder. Some coughs are d...
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Fatigue
Fatigue
Fatigue is a feeling of weariness, tiredness, or lack of energy.
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- Shortness of breath (dyspnea) that gets worse with mild activity
Dyspnea
Breathing difficulty may involve:Difficult breathing Uncomfortable breathingFeeling like you are not getting enough air
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Wheezing
Wheezing
Wheezing is a high-pitched whistling sound during breathing. It occurs when air moves through narrowed breathing tubes in the lungs.
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Because the symptoms develop slowly, many people may not know that they have COPD.
Exams and Tests
The best test for COPD is a lung function test called spirometry. This involves blowing out as hard as possible into a small machine that tests air movement and lung capacity. The results can be checked right away.
Spirometry
Pulmonary function tests are a group of tests that measure breathing and how well the lungs are functioning.
Using a stethoscope to listen to the lungs can also be helpful, showing prolonged expiratory time or wheezing. But sometimes, the lungs sound normal, even when a person has COPD.
Imaging tests of the lungs, such as x-rays and CT scans may be ordered. With an x-ray, the lungs may look normal, even when a person has COPD. A CT scan will almost always show signs of COPD if it is present.
x-rays
A chest x-ray is an x-ray of the chest, lungs, heart, large arteries, ribs, and diaphragm.
CT scans
A chest CT (computed tomography) scan is an imaging method that uses x-rays to create cross-sectional pictures of the chest and upper abdomen....
Sometimes, a blood test called arterial blood gas may be done to measure the amounts of oxygen and carbon dioxide in the blood.
Arterial blood gas
Blood gases are a measurement of how much oxygen and carbon dioxide are in your blood. They also determine the acidity (pH) of your blood.
If your health care provider suspects you have alpha-1 antitrypsin deficiency, a blood test will likely be ordered to detect this condition.
Blood test
Alpha-1 antitrypsin (AAT) is a laboratory test to measure the amount of AAT in your blood. The test is also done to check for abnormal forms of AAT....
Treatment
There is no cure for COPD. But there are many things you can do to relieve symptoms and keep the disease from getting worse.
If you smoke, now is the time to quit. This is the best way to slow lung damage.
Now is the time to quit
Smoking is the leading cause of chronic obstructive pulmonary disease (COPD). Smoking is also a trigger for COPD flare-ups. Smoking damages the air...
Medicines used to treat COPD include:
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Quick-relief drugs to help open the airways
Quick-relief drugs
Quick-relief medicines for chronic obstructive pulmonary disease (COPD) work quickly to help you breathe better. You take them when you are coughing...
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Control drugs to reduce lung inflammation
Control drugs
Control medicines for chronic obstructive pulmonary disease (COPD) are medicines you take to control or prevent symptoms of COPD. You must use these...
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- Certain long-term antibiotics
In severe cases or during flare-ups, you may need to receive:
- Steroids by mouth or through a vein (intravenously)
- Bronchodilators through a nebulizer
- Oxygen therapy
- Assistance from a machine to help breathing by using a mask or through the use of an endotracheal tube
Machine
Positive airway pressure (PAP) treatment uses a machine to pump air under pressure into the airway of the lungs. This helps keep the windpipe open d...
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Your provider may prescribe antibiotics during symptom flare-ups, because an infection can make COPD worse.
Flare-ups
Chronic obstructive pulmonary disease (COPD) symptoms can worsen rapidly. You may find it hard to breathe. You may cough or wheeze more or produce ...
You may need oxygen therapy at home if you have a low level of oxygen in your blood.
Oxygen therapy
Because of your medical problem, you may need to use oxygen to help you breathe. You will need to know how to use and store your oxygen.
Pulmonary rehabilitation does not cure COPD. But it can teach you more about the disease, train you to breathe in a different way so you can stay active and feel better, and keep you functioning at the highest level possible.
LIVING WITH COPD
You can do things every day to keep COPD from getting worse, protect your lungs, and stay healthy.
Can do things every day
Your health care provider gave you the news: you have chronic obstructive pulmonary disease (COPD). There is no cure, but there are things you can d...
Walk to build up strength:
- Ask the provider or respiratory therapist how far to walk.
- Slowly increase how far you walk.
- Avoid talking if you get short of breath when you walk.
- Use pursed lip breathing when you breathe out, to empty your lungs before the next breath.
Things you can do to make it easier for yourself around the home include:
- Avoid very cold air or very hot weather
- Make sure no one smokes in your home
- Reduce air pollution by not using the fireplace and getting rid of other irritants
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Manage stress and your mood
Manage stress and your mood
People with chronic obstructive pulmonary disease (COPD) have a greater risk for depression, stress, and anxiety. Being stressed or depressed can ma...
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Eat healthy foods, including fish, poultry, and lean meat, as well as fruits and vegetables. If it is hard to keep your weight up, talk to a provider or dietitian about eating foods with more calories, by eating small frequent meals.
Surgery or other interventions may be used to treat COPD. Only a few people benefit from these surgical treatments:
- One-way valves can be inserted with a bronchoscopy to help deflate parts of the lung that are hyperinflated (overinflated) in select patients.
- Surgery to remove parts of the diseased lung, which can help less-diseased parts work better in some people with emphysema (lung volume reduction surgery).
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Lung transplant for a small number of very severe cases.
Lung transplant
Lung transplant is surgery to replace one or both diseased lungs with healthy lungs from a human donor.
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Support Groups
You can ease the stress of illness by joining a support group. Sharing with others who have common experiences and problems can help you not feel alone.
Support group
The following organizations are good resources for information on lung disease:American Lung Association -- www. lung. orgNational Heart, Lung, and B...
Outlook (Prognosis)
COPD is a long-term (chronic) illness. The disease will get worse more quickly if you do not stop smoking.
If you have severe COPD, you will be short of breath with most activities. You may be admitted to the hospital more often.
Talk with your provider about breathing machines and end-of-life care as the disease progresses.
Possible Complications
With COPD, you may have other health problems such as:
Other health problems
If you have chronic obstructive pulmonary disease (COPD), you are more likely to have other health problems, too. These are called comorbidities. P...
- Irregular heartbeat (arrhythmia)
Arrhythmia
An arrhythmia is a disorder of the heart rate (pulse) or heart rhythm. The heart can beat too fast (tachycardia), too slow (bradycardia), or irregul...
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- Right-sided heart failure or cor pulmonale (heart swelling and heart failure due to chronic lung disease)
Cor pulmonale
Cor pulmonale is a condition that causes the right side of the heart to fail. Long-term high blood pressure in the pulmonary arteries of the lung an...
ImageRead Article Now Book Mark ArticleHeart failure
Heart failure is a condition in which the heart is no longer able to pump oxygen-rich blood to the rest of the body efficiently. This causes symptom...
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Pneumonia
Pneumonia
Pneumonia is a breathing (respiratory) condition in which there is an infection of the lung. This article covers community-acquired pneumonia (CAP). ...
ImageRead Article Now Book Mark Article - Collapsed lung (pneumothorax)
Pneumothorax
A collapsed lung occurs when air escapes from the lung. The air then fills the space outside of the lung between the lung and chest wall. This buil...
ImageRead Article Now Book Mark Article - Severe weight loss and malnutrition
Malnutrition
Malnutrition is the condition that occurs when your body does not get enough nutrients.
ImageRead Article Now Book Mark Article - Thinning of the bones (osteoporosis)
Osteoporosis
Osteoporosis is a disease in which bones become fragile and more likely to break (fracture).
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- Increased anxiety
When to Contact a Medical Professional
Go to the emergency room or call 911 or the local emergency number if you have a rapid increase in shortness of breath.
Prevention
Not smoking prevents most cases of COPD. Ask your provider about quit-smoking programs. Medicines are also available to help you stop smoking.
Quit-smoking
Smoking is the leading cause of chronic obstructive pulmonary disease (COPD). Smoking is also a trigger for COPD flare-ups. Smoking damages the air...
References
Global Initiative for Chronic Obstructive Lung Disease (GOLD) website. Global Initiative for Chronic Obstructive Lung Disease: 2023 Report. goldcopd.org/2023-gold-report-2/. Accessed June 2, 2023.
Han MK, Lazarus SC. COPD: diagnosis and management. In: Broaddus VC, Ernst JD, King TE, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 7th ed. Philadelphia, PA: Elsevier; 2022:chap 64.
National Institutes of Health, National Heart, Lung, and Blood Institute website. COPD national action plan. www.nhlbi.nih.gov/health-topics/education-and-awareness/COPD-national-action-plan. Updated February 9, 2021. Accessed June 2, 2023.
Rochester CL, Nici L. Pulmonary rehabilitation. In: Broaddus VC, Ernst JD, King TE, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 7th ed. Philadelphia, PA: Elsevier; 2022:chap 139.
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Spirometry - illustration
Spirometry is a painless study of air volume and flow rate within the lungs. Spirometry is frequently used to evaluate lung function in people with obstructive or restrictive lung diseases such as asthma or cystic fibrosis.
Spirometry
illustration
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Emphysema - illustration
Emphysema is a lung disease involving damage to the air sacs (alveoli). There is progressive destruction of alveoli and the surrounding tissue that supports the alveoli. With more advanced disease, large air cysts develop where normal lung tissue used to be. Air is trapped in the lungs due to lack of supportive tissue which decreases oxygenation.
Emphysema
illustration
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Bronchitis - illustration
Bronchitis is the inflammation of the bronchi, the main air passages to the lungs. It often results from a respiratory infection caused by a virus or bacteria. Symptoms include coughing, shortness of breath, wheezing and fatigue.
Bronchitis
illustration
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Quitting smoking - illustration
The many methods of quitting smoking include counseling and support groups, nicotine replacement therapy, prescription medications, and incremental reduction.
Quitting smoking
illustration
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COPD (chronic obstructive pulmonary disorder) - illustration
Chronic obstructive pulmonary disease (COPD) refers to chronic lung disorders that result in blocked air flow in the lungs. The two main COPD disorders are emphysema and chronic bronchitis, the most common causes of respiratory failure. Emphysema occurs when the walls between the lung's air sacs become weakened and collapse. Damage from COPD is usually permanent and irreversible.
COPD (chronic obstructive pulmonary disorder)
illustration
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Respiratory system - illustration
Air is breathed in through the nasal passageways, travels through the trachea and bronchi to the lungs.
Respiratory system
illustration
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Spirometry - illustration
Spirometry is a painless study of air volume and flow rate within the lungs. Spirometry is frequently used to evaluate lung function in people with obstructive or restrictive lung diseases such as asthma or cystic fibrosis.
Spirometry
illustration
-
Emphysema - illustration
Emphysema is a lung disease involving damage to the air sacs (alveoli). There is progressive destruction of alveoli and the surrounding tissue that supports the alveoli. With more advanced disease, large air cysts develop where normal lung tissue used to be. Air is trapped in the lungs due to lack of supportive tissue which decreases oxygenation.
Emphysema
illustration
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Bronchitis - illustration
Bronchitis is the inflammation of the bronchi, the main air passages to the lungs. It often results from a respiratory infection caused by a virus or bacteria. Symptoms include coughing, shortness of breath, wheezing and fatigue.
Bronchitis
illustration
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Quitting smoking - illustration
The many methods of quitting smoking include counseling and support groups, nicotine replacement therapy, prescription medications, and incremental reduction.
Quitting smoking
illustration
-
COPD (chronic obstructive pulmonary disorder) - illustration
Chronic obstructive pulmonary disease (COPD) refers to chronic lung disorders that result in blocked air flow in the lungs. The two main COPD disorders are emphysema and chronic bronchitis, the most common causes of respiratory failure. Emphysema occurs when the walls between the lung's air sacs become weakened and collapse. Damage from COPD is usually permanent and irreversible.
COPD (chronic obstructive pulmonary disorder)
illustration
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Respiratory system - illustration
Air is breathed in through the nasal passageways, travels through the trachea and bronchi to the lungs.
Respiratory system
illustration
- Chronic obstructive pulmonary disease
- Chronic obstructive pulmonary disease - InDepth
- Pulmonary hypertension
- Gastroesophageal reflux disease
- Obstructive sleep apnea - InDepth
- Bronchitis
- Pneumonia - InDepth
- Gastroesophageal reflux disease and heartburn - InDepth
- Rheumatoid arthritis - InDepth
- Heart failure - InDepth
Review Date: 5/3/2023
Reviewed By: Denis Hadjiliadis, MD, MHS, Paul F. Harron, Jr. Professor of Medicine, Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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