Chronic Obstructive Pulmonary Disease (COPD)

What Is COPD?

Chronic obstructive pulmonary disease (COPD) refers to a group of diseases that cause airflow blockage and breathing-related problems. COPD includes emphysema; chronic bronchitis; and in some cases, asthma.¹

With COPD, less air flows through the airways—the tubes that carry air in and out of your lungs—because of one or more of the following:^2,3

• The airways and tiny air sacs in the lungs lose their ability to stretch and shrink back.
• The walls between many of the air sacs are destroyed.
• The walls of the airways become thick and inflamed (irritated and swollen).
• The airways make more mucus than usual, which can clog them and block air flow.

In the early stages of COPD, there may be no symptoms, or you may only have mild symptoms, such as:⁴

• A nagging cough (often called "smoker's cough")
• Shortness of breath, especially with physical activity
• Wheezing (a whistling sound when you breathe)
• Tightness in the chest

As the disease gets worse, symptoms may include:⁴

• Having trouble catching your breath or talking
• Blue or gray lips and/or fingernails (a sign of low oxygen levels in your blood)
• Trouble with mental alertness
• A very fast heartbeat
• Swelling in the feet and ankles
• Weight loss

How severe your COPD symptoms are depends on how damaged your lungs are. If you keep smoking, the damage will get worse faster than if you stop smoking.⁴ Among 15 million U.S. adults with COPD, 39% continue to smoke.⁵

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How Is Smoking Related to COPD?

COPD is usually caused by smoking.³   Smoking accounts for as many as 8 out of 10 COPD-related deaths.⁶ However, as many as 1 out of 4 Americans with COPD never smoked cigarettes.⁵

Smoking during childhood and teenage years can slow how lungs grow and develop. This can increase the risk of developing COPD in adulthood.⁷

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How Can COPD Be Prevented?

The best way to prevent COPD is to never start smoking, and if you smoke, quit.⁸ Talk with your doctor about programs and products that can help you quit. Also, stay away from secondhand smoke, which is smoke from burning tobacco products, such as cigarettes, cigars, or pipes.^6,9,10  Secondhand smoke also is smoke that has been exhaled, or breathed out, by a person smoking.^9,10

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How Is COPD Treated?

Treatment of COPD requires a careful and thorough exam by a doctor.¹ Quitting smoking is the most important first step you can take to treat COPD. Avoiding secondhand smoke is also critical. Other lifestyle changes and treatments include one or more of the following:

• For people with COPD who have trouble eating because of shortness of breath or being tired:¹¹
  • Following a special meal plan with smaller, more frequent meals
  • Resting before eating
  • Taking vitamins and nutritional supplements
• A broad program that helps improve the well-being of people who have chronic (ongoing) breathing problems and includes the following:¹²
  • Exercise training
  • Nutritional counseling
  • Education on your lung disease or condition and how to manage it
  • Energy-conserving techniques
  • Breathing strategies
  • Psychological counseling and/or group support
• Medicines such as:
  • A bronchodilator to relax the muscles around the airways. This helps open airways and makes breathing easier. Most bronchodilators are taken with a device called an inhaler.¹¹
  • A steroid drug you inhale to reduce swelling in the airways.¹¹
  • Antibiotics to treat respiratory infections, if appropriate¹
  • A vaccination during flu season¹
• Oxygen therapy, which can help people who have severe COPD and low levels of oxygen in their blood to breathe better¹¹
• Surgery for people who have severe symptoms that have not improved with other treatments¹¹
  • Lung volume reduction surgery (LVRS): Surgery to remove diseased parts of the lung so healthier lung tissue can work better. LVRS is not a cure for COPD.
  • A lung transplant: Surgery in which one or two healthy lungs from a donor are put in the patient’s body to replace diseased lungs. A lung transplant is a last resort.

Even though there is no cure for COPD, these lifestyle changes and treatments can help you breathe easier, stay more active, and slow the progress of the disease.¹¹

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Additional Resources

The following resources provide information and support to people with COPD and their caregivers:

• To learn more about COPD, visit the National Heart, Lung, and Blood Institute’s COPD Learn More Breathe Better Web page.
• To find peer support, an online community, and events in your area, visit the COPD Foundation Web site and 360Social.
• To join a network of patients affected by COPD, visit the COPD Patient-Powered Research Network, which is a lung health research registry.
• To learn more about lung health and diseases, visit the American Lung Association’s COPD Web page.
• To find peer support and resources for patients and caregivers, contact the C.O.P.D. Information Line at 1-866-316-2673.

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References

1. Centers for Disease Control and Prevention. What Is COPD? [last updated 2015 Mar 12; accessed 2015 Nov 11].
2. National Heart, Lung, and Blood Institute. How Does COPD Affect Breathing? [accessed 2015 Nov 11].
3. National Heart, Lung, and Blood Institute. What Is COPD? [last updated 2013 July 31; accessed 2015 Nov 11].
4. National Heart, Lung, and Blood Institute. What Are the Signs and Symptoms of COPD? [last updated 2013 July 31; accessed 2015 Nov 11].
5. Centers for Disease Control and Prevention. Chronic Obstructive Pulmonary Disease Among Adults—United States, 2011. Morbidity and Mortality Weekly Report 2012;61(46):938–43 [accessed 2015 Nov 11].
6. U.S. Department of Health and Human Services. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014 [accessed 2015 Nov 11].
7. U.S. Department of Health and Human Services. A Report of the Surgeon General. Preventing Tobacco Use Among Youth and Young Adults: We CAN Make the Next Generation Tobacco-Free. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health [accessed 2015 Nov 11].
8. National Heart, Lung, and Blood Institute. How Can COPD Be Prevented? [last updated 2013 July 31; accessed 2015 Nov 11].
9. Institute of Medicine. Secondhand Smoke Exposure and Cardiovascular Effects: Making Sense of the Evidence. Washington: National Academy of Sciences, Institute of Medicine, 2009 [accessed 2015 Nov 11].
10. National Toxicology Program. Report on Carcinogens, Thirteenth Edition. Research Triangle Park (NC): U.S. Department of Health and Human Services, Public Health Service, 2014 [accessed 2015 Nov 11].
11. National Heart, Lung, and Blood Institute. How Is COPD Treated? [last updated 2013 July 31; accessed 2015 Nov 11].
12. National Heart, Lung, and Blood Institute. What Is Pulmonary Rehabilitation? [last updated 2010 Aug 1; accessed 2015 Nov 11].