Chronic Obstructive Pulmonary Disease (COPD) – Conditions 

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Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory lung disease that causes obstructed airflow from the lungs. Symptoms include breathing difficulty, cough, mucus (sputum) production, and wheezing. It’s typically caused by long-term exposure to irritating gases or particulate matter, most often from cigarette smoke. People with COPD are at increased risk of developing heart disease, lung cancer, and a variety of other conditions.

Emphysema and chronic bronchitis are the two most common conditions that contribute to COPD. These two conditions usually occur together and can vary in severity among individuals with COPD.

Causes

Most people with COPD are at least 40 years old and have at least some history of smoking. The longer and more tobacco products you smoke, the greater your risk of COPD is. In addition to cigarette smoke, cigar smoke, pipe smoke, and secondhand smoke can cause COPD. Your risk of COPD is even greater if you have asthma and smoke. You can also develop COPD if you’re exposed to chemicals and fumes in the workplace. Long-term exposure to air pollution and inhaling dust can also cause COPD. In developing countries, along with tobacco smoke, homes are often poorly ventilated, forcing families to breathe fumes from burning fuel used for cooking and heating.

There may be a genetic predisposition to developing COPD. Up to an estimated 5 percent of 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.

Symptoms

At first, you might not have any symptoms. But as the disease gets worse, you might notice these common signs of COPD:

  • A cough that doesn’t go away
  • Coughing up lots of mucus
  • Shortness of breath, especially when you’re physically active
  • Wheezing or squeaking when you breathe
  • Tightness in your chest
  • Frequent colds or flu
  • Blue fingernails
  • Low energy
  • Losing weight without trying (in later stages)
  • Swollen ankles, feet, or legs

Diagnosis

Your doctor will ask about your symptoms, your medical history, and whether you smoke or have been exposed to chemicals, dust, or smoke at work. They’ll also do a physical exam and breathing tests. Let them know if you have an ongoing cough.

The most common test is called spirometry. You’ll breathe into a large, flexible tube that’s connected to a machine called a spirometer. It’ll measure how much air your lungs can hold and how fast you can blow air out of them. Your doctor may order other tests to rule out other lung problems, such as asthma or heart failure. These might include:

  • More lung function tests.
  • Chest X-rays that can help rule out emphysema, other lung problems, or heart failure
  • CT scan, which uses several X-rays to create a detailed picture of your lungs and can tell the doctor if you need surgery or if you have lung cancer.
  • Arterial blood gas test, which measures how well your lungs are bringing in oxygen and taking out carbon dioxide.
  • Laboratory tests to determine the cause of your symptoms or rule out other conditions, like the genetic disorder alpha-1-antitrypsin (AAT) deficiency.

Treatment

There’s no cure, so the goal of treatment is to ease your symptoms and slow the disease. Your doctor will also want to prevent or treat any complications and improve your overall quality of life. One of the best things you can do to stop your COPD from getting worse is to stop smoking. Talk to your doctor about different things you can try. Your plan may include:

  • Bronchodilators: You inhale these medicines. They help open your airways.
  • Combination inhalers: These inhalers pair steroids with a bronchodilator.
  • Antibiotics: Your doctor might prescribe these to fight bacterial infections.
  • Flu or pneumonia vaccines: These vaccines lower your risk for these illnesses.
  • Pulmonary rehabilitation: This program includes exercise, disease management, and counseling to help you stay as healthy and active as possible.
  • Oxygen therapy: You may need this to reduce shortness of breath, protect your organs, and enhance your quality of life.

When to See a Doctor?

Talk to your doctor if your symptoms are not improving with treatment or getting worse, or if you notice symptoms of an infection, such as fever or a change in sputum. Seek immediate medical care if you can’t catch your breath, if you experience severe blueness of your lips or fingernail beds (cyanosis) or a rapid heartbeat, or if you feel foggy and have trouble concentrating.


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