Q & A: What is COPD?

12/15/2016 by Dr. Elliot J. Bruhl

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Q: What is COPD?

A: COPD stands for chronic obstructive pulmonary disease. With this disease, people have difficulty emptying the air out of their lungs. It's also called "emphysema" and "chronic bronchitis." COPD is a chronic and progressive condition; once people develop it, they will have it for life. In most cases, it develops in older adults and is preventable and treatable. The Center for Disease Control estimates that COPD affects 30 million Americans. 

Q: What is emphysema?

A: Emphysema is a form of COPD where the small air sacks within the lungs (alveoli) are destroyed, causing airways to collapse when the person exhales. Air becomes "trapped" in the lungs, and the patient must work harder to blow the air out with each breath. This poor air movement can lead to lower oxygen levels. 

Q: What is chronic bronchitis? 

A: Chronic bronchitis is a form of COPD with increased mucus production and swelling in the small airways of the lungs. This narrowing of the airways reduces air movement, contributes to air being "trapped" in the lungs and leads to chronic coughing and sputum (mixture of saliva and mucus) production. The mucus also can cause infections to develop. 

Q: Is COPD the same as asthma?

A: No. Asthma is a disease caused by spasms of the small airways, which can reduce airflow out of the lungs. Unlike COPD, most asthma starts early in life, and symptoms vary - often getting better or worse, depending on the season; at different times of the day; or with exposure to irritants. 

Q: What causes COPD?

A: Most of the time, COPD is caused by long-term exposure to tobacco smoke, either directly or as second-hand smoke. Exposures to particulates in the workplace, such as dust and chemicals, also can contribute to the disease. It's less common, but a genetically based deficiency in Alpha-I Antitrypsin (AATD) protein can cause or contribute to the development of COPD. Approximately one in 30 people who develop COPD may have undetected AATD. 

Q: What are the symptoms of COPD?

A: Early in its development, there aren't any symptoms. As it progresses the patient may experience frequent coughing or sputum, wheezing and shortness of breath. Often, the disease remains undiagnosed until it's quite advanced, and patients experience breathlessness. With time, the patient may develop low oxygen levels and weight loss due to the added effort of breathing. 

Q: How can I tell if I have COPD?

A: If you have a cough, sputum or shortness of breath that won't go away, you should discuss these symptoms with your health care provider. These symptoms raise particular concerns if you have a history of smoking, second-hand smoke or have been exposed to dust or fumes at work. 

Q: How is COPD diagnosed? 

A: Your health care provider can diagnose COPD based on symptoms, combined with a simple test called "spirometry." Spirometry measures the flow of air in and out of the lungs and is the most reliable test for the disease. 

Q: How is COPD treated?

A: The first step in treating COPD is to remove exposure to smoke, dust and fumes. Smokers should stop smoking, and second-hand smoke should be eliminated. Health care providers may prescribe bronchodilators, which open airways, and inhaled corticosteroids, which reduce secretions and inflammation. Infections are treated with antibiotics and low oxygen levels are treated with supplemental oxygen. For some patients, lung reduction surgeries or lung transplant is possible. 

COPD is a chronic condition, and once it develops, a patient will have it for life. However, many patients who quit smoking and take proper medications can control the symptoms of COPD and continue to live productive lives. 

Dr. Elliot Bruhl is a family physician practicing primary care medicine in Employee and Community Health's (ECH) Department of Family Medicine at Mayo Family Clinic Northwest, where he also serves as the clinic's medical director.