Chronic Obstructive Pulmonary Disease (COPD)

Chronic pulmonary obstructive disease, or COPD, is persistent airway obstruction caused by emphysema or chronic bronchitis that interferes with breathing. More than 12 million Americans are known to suffer from COPD, according to the American Lung Association. It is the fourth leading cause of death in the United States, and the number of deaths from COPD is growing.

Risk Factors

• Genetics appear to play a role in some cases of COPD, but the number one cause of COPD is believed to be smoking. In fact, more than 85 percent of the cases of COPD in the United States are due to smoking tobacco, according to the National Lung Health Education Program. Smokers also have higher death rates from the disease than non-smokers do. Other factors include air pollution, allergens and occupational exposure to toxic substances, such as workers who make abrasive soaps, miners, potters, sandstone and granite cutters, sandblasters, asbestos workers and welders.

Types

• There are two main types of COPD, emphysema and chronic bronchitis. In emphysema, damage to the walls of the small airways causes them to lose their structural support and collapse when air is exhaled. This airway obstruction is structural and permanent. In chronic bronchitis, air flow obstruction is caused by inflammation of the airways that involves scarring of their walls, swelling of their lining, smooth muscle spasms and partial obstruction of their passages by mucus. This airway obstruction is partially reversible.

Symptoms

• The earliest symptom of COPD is usually a cough and the raising of mucus, that most often occurs upon arising. This cough may appear after as little as 5 to 10 years of smoking, is generally mild and often dismissed as a "normal" smoker's cough. There may also be a tendency for head colds to migrate into the chest. Over time, these chest colds occur more frequently and may produce yellow or green sputum accompanied by wheezing.

Effects

• As the disease progresses, there may be a slowly worsening shortness of breath on effort. Ultimately, the person experiences shortness of breath during regular daily activities, such as bathing, dressing and cooking, at which point many people experience severe weight loss. Swelling of the legs, possibly due to heart failure, develops in some cases. In the end stage, a chest cold that might have been easily tolerated at an earlier time may cause severe shortness of breath at rest, an indication of acute respiratory failure.

Treatment

• The first step of treatment for COPD for most people is quitting smoking, which will provide some extent of benefits at any stage--but the earlier, the better. Avoidance of other airborne irritants is also important. The reversible elements of the disease include the muscle spasms, inflammation and increasing secretions. Bronchodilator medications, either in oral or inhaler form, may be prescribed to reduce muscle spasms and corticosteroids may be prescribed to reduce inflammation. Long-term oxygen therapy is usually beneficial for prolonging life and reducing some symptoms in those with severe COPD.