Chronic Obstructive Pulmonary Disease (COPD)

Last updated April 13, 2017

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What are the other Names for this Condition? (Also known as/Synonyms)

  • CAFL (Chronic Airflow Limitation)
  • CAO (Chronic Airflow Obstruction)
  • Chronic Airflow Limitation (COPD)

What is Chronic Obstructive Pulmonary Disease? (Definition/Background Information)

  • Chronic Obstructive Pulmonary Disease (COPD) causes severe damage to the lungs affecting airflow, mainly expiration. COPD includes the following main conditions:
    • Emphysema
    • Chronic bronchitis
    • Small airways disease         
  • Emphysema occurs when the air sacs in the lungs fill up with air and become abnormally large because of the collapse of their walls. This results in an abnormal presence of air sacs in the lung tissues
  • Chronic bronchitis ensues when the walls of the airways and air sacs get inflamed and secrete a lot of mucus. The mucus obstructs free flow of air and gaseous exchange
  • Small airways disease is a group of infectious and non-infectious conditions of the tiny branches of the lung airways
  • Patients suffering from COPD have shortness of breath and cough with sputum/phlegm. The condition is diagnosed by various methods, including physical check-up, with emphasis on lung function
  • The severity of COPD determines treatment options that may include lifestyle changes, the use of inhalers, oxygen therapy, and medication.
  • Chronic Obstructive Pulmonary Disease is a chronic and progressive disease that may be managed through lifestyle modifications and the use of medications

Who gets Chronic Obstructive Pulmonary Disease? (Age and Sex Distribution)

  • Chronic Obstructive Pulmonary Disease is normally seen in chronic smokers. COPD is more commonly seen among the elderly population, but could be observed in younger individuals, if they start smoking early or if there is a genetic risk for COPD
  • It can affect both genders equally
  • The occurrence of COPD may be influenced by race, ethnicity, and environmental factors

What are the Risk Factors for Chronic Obstructive Pulmonary Disease? (Predisposing Factors)

The following are generally considered to be the leading risk factors for developing Chronic Obstructive Pulmonary Disease:

  • Smoking, both tobacco and marijuana smokers; primary and secondary smoke inhalers
  • Smoking with pre-existing conditions, such as asthma or other respiratory disorders
  • Environmental factors or bad quality of air, like exposure to toxic fumes, dust
  • Occupational exposure: Certain jobs related to smoke and dust exposure, such as fire fighters and workers exposed to asbestos and construction dusts
  • Age: Since the condition takes years to progress into a chronic stage, COPD is prevalent in older adults
  • Genetics: Alpha-1 antitrypsin deficiency (AATD) in descendants of Northern European and other populations 

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Chronic Obstructive Pulmonary Disease? (Etiology)

The following are some of the known/suspected causes of Chronic Obstructive Pulmonary Disease:

  • Smoking, both tobacco and marijuana
  • Excessive secondhand smoke inhalation
  • Smoke inhalation while cooking with burning fuels in poorly-ventilated homes
  • Toxic fumes and dust inhalation in factories and other work environments
  • Existing lung damage
  • Deficiency in alpha-1 antitrypsin, which is secreted in the liver and renders a protective effect on the lungs

What are the Signs and Symptoms of Chronic Obstructive Pulmonary Disease?

A person with Chronic Obstructive Pulmonary Disease may present with one or more of the following signs and symptoms:

  • Wheezing
  • Difficulty breathing, initially on walking or exertion
  • Chronic cough
  • Productive cough with sputum
  • Fatigue
  • Cyanosis or blue hue along the lips and nails
  • Recurring respiratory infections
  • Loss of weight in later stages of the disease

How is Chronic Obstructive Pulmonary Disease Diagnosed?

A physician may employ the methods below to help diagnose Chronic Obstructive Pulmonary Disease:

  • Learn about the medical history of the individual
  • Smoking history
  • Family history of COPD, lung transplant or liver transplant
  • A thorough physical examination
  • Test for lung function called ‘spirometry’ or PFTs (pulmonary function testing)
  • Chest x-ray
  • Less commonly, computerized axial tomography scan (CAT scan) to check for emphysema and other abnormalities arising from COPD
  • Arterial blood gas analysis to check for oxygenated blood and carbon dioxide; a measure of gas exchange

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Chronic Obstructive Pulmonary Disease?

Chronic Obstructive Pulmonary Disease could potentially lead to the following complications:

  • Worsening breathing
  • Depression and anxiety
  • Poor quality of life; This may develop due to many factors, such as for example, an inability to perform small tasks like getting dressed or enjoying activities
  • Frequent respiratory infections and increased susceptibility to common cold and influenza
  • Risk for developing pneumonia
  • Acute exacerbations, which are worsening symptoms for a few days/weeks, brought on by exposure to inflammatory or infectious triggers
  • Heart problems such as hypertension and coronary artery disease
  • Pulmonary hypertension, which is increased pressure in the blood vessels of the lungs
  • Higher risk of developing lung cancer, in comparison to people without COPD
  • Thinning of the bones (osteopenia or osteoporosis) due to repeated steroid use
  • Malnutrition with advanced COPD

How is Chronic Obstructive Pulmonary Disease Treated?

A diagnosis of Chronic Obstructive Pulmonary Disease may need lifestyle changes, as well as devices and medications to improve the quality of the patient’s life, as stated below:

  • Smoking cessation is the most effective way of slowing COPD progression
  • Vaccinations: Pneumococcal vaccine and annual flu shots are recommended, if the individual is not allergic to the same
  • Use of bronchodilators to ease breathing and coughing (short-term like albuterol and ipratropium; long-acting ones like salmeterol, formoterol, and tiotropium)
  • Use of steroids (which are anti-inflammatory in nature) in either oral or inhaler forms
  • A combination of inhaled bronchodilators and steroids
  • Antibiotics during exacerbations
  • Phosphodiesterase -4 (PDE-4) inhibitors in tablet form
  • Oxygen therapy in case of low levels of oxygen in blood
  • Pulmonary rehabilitation involving therapists for diet, exercise, and counseling for depression and anxiety
  • Surgery to remove damaged lung tissue (big air sacs in the lungs)
  • In extremely severe cases, a lung transplantation may be required

How can Chronic Obstructive Pulmonary Disease be Prevented?

The symptoms of Chronic Obstructive Pulmonary Disease may be managed by doing the following:

  • Refraining from smoking, as this is an established cause of COPD
  • Avoiding polluted environments or wearing personal protective gear when such environment is unavoidable (like occupation-related, or if it is an occupational hazard))
  • Exercising regularly
  • Eating nutritious food
  • Maintaining a healthy body weight
  • Breathing exercises
  • Drinking plenty of water
  • Taking an active role in disease management by keeping appointments, following medications, and therapy regimens

What is the Prognosis of Chronic Obstructive Pulmonary Disease? (Outcomes/Resolutions)

It is not possible to reverse the damage to the lungs in Chronic Obstructive Pulmonary Disease. However, the symptoms can be managed and further damage to the lungs slowed through treatment, preventing exacerbations of COPD.

  • For mild cases of COPD, the prognosis is good; the symptoms may be manageable with lifestyle changes and medication use, to slow progression of the disease
  • Severe cases of COPD may require life-long medications and treatment
  • Individuals suffering from severe COPD especially on home oxygen therapy may be advised to look into end-of-life care decisions
  • Home nebulizer machine, pulse oximeter device, home oxygen therapy, and non-invasive ventilation machine for night-time use, may be beneficial depending on the severity of the COPD. It is recommended to discuss these options with a pulmonologist

Additional and Relevant Useful Information for Chronic Obstructive Pulmonary Disease:

Please check back for periodic updates to our ‘physician approved content’.

What are some Useful Resources for Additional Information?

American Lung Association
55 W. Wacker Drive, Suite 1150, Chicago, IL 60601
Phone: (312) 801-7630
Toll-Free: 1-800-LUNGUSA
American Lung Association Lung Helpline, to speak with a lung health professional: 1 (800) 548-8252
Fax: (202) 452-1805
Website: http://www.lung.org

World Lung Foundation (Americas, Africa, Europe, Eastern Mediterranean, Southeast Asia and Western Pacific)
61 Broadway, Suite 2800, New York, New York 10006
Phone: (212) 542-8870
Email: info@worldlungfoundation.org
Website: http://www.worldlungfoundation.org

References and Information Sources used for the Article:

http://www.nhlbi.nih.gov/health/health-topics/topics/copd (accessed on 04/14/2015)

http://www.copdgene.org/copd-genetics (accessed on 04/14/2015)

http://www.mayoclinic.org/diseases-conditions/copd/basics/definition/con-20032017 (accessed on 04/14/2015)

http://www.who.int/respiratory/copd/management/en/index.html (accessed on 04/14/2015)

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001153/ (accessed on 04/14/2015)

http://www.nlm.nih.gov/medlineplus/ency/article/000091.htm (accessed on 04/14/2015)

Helpful Peer-Reviewed Medical Articles:

Hogg, J., Chu, F., Utokaparch, S., Woods, R., Elliott, W., Buzatu, L., . . . Paré, P. (2004). The Nature Of Small-Airway Obstruction In Chronic Obstructive Pulmonary Disease. New England Journal of Medicine, 350, 2645-2653.

Ford, E., Croft, J., Mannino, D., Wheaton, A., Zhang, X., & Giles, W. (2013). COPD Surveillance—United States, 1999-2011. Chest Journal, 144(1), 284-305

Hawkins, N. M., Petrie, M. C., Jhund, P. S., Chalmers, G. W., Dunn, F. G., & McMurray, J. J. V. (2009). Heart failure and chronic obstructive pulmonary disease: diagnostic pitfalls and epidemiology. European Journal of Heart Failure, 11(2), 130–139. doi:10.1093/eurjhf/hfn013

Chee, A., & Sin, D. D. (2008). Treatment of mild chronic obstructive pulmonary disease. International Journal of Chronic Obstructive Pulmonary Disease, 3(4), 563–573.

Balkissoon, R., Lommatzsch, S., Carolan, B., & Make, B. (2011). Chronic Obstructive Pulmonary Disease: A Concise Review. Medical Clinics of North America, 1125-1141.

Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: April 27, 2015
Last updated: April 13, 2017

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