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Alternative Names Return to topCOPD; Chronic obstructive airways disease; Chronic obstructive lung disease; Chronic bronchitis; Emphysema; Bronchitis - chronic
Definition Return to top
Chronic obstructive pulmonary disease (COPD) is lung disease that makes it difficult to breathe. There are two main forms of COPD:
Most people with COPD have symptoms of both.
Causes Return to top
Smoking is the leading cause of COPD. The more a person smokes, the more likely that person will develop severe bronchitis. Secondhand smoke may also cause chronic bronchitis. Air pollution, infection, and allergies make chronic bronchitis worse.
In rare cases, nonsmokers who lack a protein called alpha-1 antitrypsin can develop emphysema.
Other risk factors for COPD are:
Symptoms Return to top
Some people may have few or no symptoms.
Exams and Tests Return to top
The health care provider make hear wheezing or abnormal breathing sounds when listening to the chest and lungs with a stethoscope. However, lung sounds can be normal during the exam.
In severe cases, a person with COPD can seem anxious and may breathe through pursed lips (the shape lips make when you whistle).
During a flare up, the muscles between the ribs contract while the person is breathing in. This is called intercostal retractions. The person will use other muscles to breathe. The number of breaths per minute (respiratory rate) may be high.
The best test for COPD is lung function testing.
A chest x-ray may show that the lung is expanding too much. A chest CT scan may reveal emphysema.
A sample of blood taken from an artery (arterial blood gas) can show low levels of oxygen and high levels of carbon dioxide (respiratory acidosis).
Treatment Return to top
There is no cure for COPD. However, there are many things you can do to relieve symptoms and keep the disease from getting worse.
Persons with COPD must stop smoking. This is the only way to prevent the lung damage from getting worse.
Medications used to treat COPD include:
In severe cases or during flare-ups, you may need to receive steroids by mouth or through a vein (intravenously).
Antibiotics are prescribed during symptom flare ups, because infections can make COPD worse.
Other treatments for COPD include:
Lung rehabilitation does not cure the lung disease, but it teaches a patient to breathe in a different way so they can stay active.
Lung rehabilitation does not cure the lung disease, but it can teach you to breathe in a different way so you can stay active. Many hospitals offer these programs. They can also help you learn more about COPD. Exercise is very important, and helps keep you strong.
Things you can do to make it easier for yourself around the home include:
Lung transplant is sometimes performed for severe cases.
Support Groups Return to top
People often can help ease the stress of illness by joining a support group in which members share common experiences and problems.
See also: Lung disease - support group
Outlook (Prognosis) Return to top
This condition is a long-term (chronic) illness. The disease will get worse if you continue to smoke or use tobacco.
Possible Complications Return to top
When to Contact a Medical Professional Return to top
Go to the emergency room or call the local emergency number (such as 911) if you have a rapid increase in shortness of breath.
Prevention Return to top
Not smoking prevents most COPD. Diagnosing and treating small airways disease and taking part in stop-smoking programs may prevent the disease from getting worse in persons who smoke.
References Return to top
Anthonisen N. Chronic Obstructive Pulmonary Disease. In: Goldman L, Auseillo D. Goldman: Cecil Medicine. Philadelphia, PA: Saunders Elsevier; 2007:chap 88.
Qaseem A. Diagnosis and management of stable chronic obstructive pulmonary disease: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2007;147:633-638.
Rabe KF, Hurd S, Anzueto A, Barnes PJ, Buist SA, Calverley P, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med. 2007;176:532-555.Update Date: 9/24/2008 Updated by: Benjamin Medoff, MD, Assistant Professor of Medicine, Harvard Medical School, Pulmonary and Critical Care Unit, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.