A Guide to Chronic Obstructive Pulmonary Disease (COPD)

Chronic obstructive pulmonary disease (COPD) refers to certain conditions that cause breathing difficulties, including emphysema and chronic bronchitis. While COPD is long-term and progressive, it can be prevented or improved with treatment. COPD is a long-term, progressive lung condition that can make it difficult to breathe and causes other changes to the respiratory system. It typically develops due to long-term irritation and inflammation that causes permanent damage to the airways and lungs.

There are many treatment options that may help alleviate symptoms, slow COPD progression, and improve your quality of life.

This article explains COPD, including its types, symptoms, and causes. It also discusses treatment options, outlook, and support for COPD.

COPD refers to a group of specific conditions that cause difficulty breathing.

According to the National Institutes of Health (NIH), the United States includes two main conditions under COPD:

• Emphysema: Emphysema is when air sacs, known as alveoli, and the walls between them become damaged. These alveoli are elastic and stretch. When you breathe in, they fill with air, and when you breathe out, they deflate and push air outward. However, emphysema can make these tissues less elastic, making it harder for air to move out of the body and for you to breathe out.
• Chronic bronchitis: Chronic bronchitis is when the lining of the airways experiences repeated or constant irritation and inflammation. This can lead to the airways swelling and mucus forming in the airways. Due to this, the airways can become obstructed, making it harder to breathe.

Most often, COPD is caused by long-term exposure to irritants that damage the lungs. In fact, the National Health Service (NHS) suggests that smoking may contribute to around 9 in 10 cases of COPD.

However, both environmental and genetic factors can play a role in its development.

In the United States, the most common cause of COPD is smoking cigarettes. However, other types of smoke exposure can also contribute to COPD, such as long-term or high-level exposure to:

• secondhand smoke
• pipe, cigar, and other forms of tobacco smoke
• smoke from other substances, such as wood, coal, or industrial materials

Learn more about COPD causes.

Other possible COPD causes include:

• alpha-1 antitrypsin deficiency (AATD), a genetic susceptibility resulting in low levels of a protective protein
• exposure to other harmful chemicals, such as from:
  • indoor and outdoor pollution
  • exposure to irritants at work, known as occupational exposure
  • fumes and vapors
  • gases
  • particles in the air

Read more about AATD, including its symptoms, treatment, and effects.

Smoking is considered the main risk factor and cause of COPD.

However, other factors may also increase the risk of developing COPD, such as:

• being age 40 or older
• having a family history of COPD
• having a history of respiratory infections in childhood
• having a history of asthma
• having differences in lung structure and development
• experiencing Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source other exposure to smoke, such as secondhand smoke or smoke exposure in the womb
• being exposed to irritants at work
• living in rural areas
• having reduced access to healthcare
• experiencing socioeconomic disparities that affect health
• having a lower weight at birth
• being born preterm

Learn more about COPD risk factors and prevention.

Each person with COPD may have slightly different symptoms.

Many people’s COPD symptoms develop gradually, starting off mild and then becoming more noticeable or severe as the condition progresses. Some people may experience COPD flares, whereby symptoms become aggravated and may worsen.

Symptoms of COPD include:

• shortness of breath
• difficulty taking deep breaths
• a whistling or squeaky sound when breathing
• frequent coughing or wheezing
• feeling out of breath or hunger for air
• other feelings of difficulty breathing
• chest tightness
• producing excess phlegm or sputum, or producing mucus when coughing
• frequent respiratory infections, such as a cold or the flu
• difficulty carrying out your daily activities

Severe COPD may also cause:

• weight loss
• weakness in the lower muscles
• swelling in the legs, ankles, or feet

Doctors categorize COPD into four grades or stages, based on how much airflow is obstructed.

These stages include:

• mild airflow obstruction
• moderate airflow obstruction
• severe airflow obstruction
• very severe airflow obstruction

Learn more about the stages of COPD and what they mean.

To diagnose your condition, your doctor will ask you about:

• your symptoms
• your medical history
• your family medical history

It can be helpful to note down your symptoms and find out whether any close biological family members have had COPD.

Your doctor may also conduct a physical exam.

If your doctor suspects COPD, they may also order the following exams:

• lung function tests, such as a spirometry test
• imaging scans, such as X-ray or CT scans
• genetic testing for AATD with a blood test

There is currently no cure for COPD. However, treatment can be effective at alleviating symptoms, reducing complications and progression, and improving quality of life.

One key treatment approach is to quit smoking if you smoke. It is also helpful to avoid any other risk factors where possible, such as:

• avoiding indoor and outdoor pollution
• avoiding other harmful particles in the air, such as secondhand smoke or workplace chemicals
• staying up to date with your vaccinations

If you have COPD, your doctor may recommend Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source further vaccinations in addition to the standard recommended courses, such as:

• annual flu vaccinations
• the 13-valent pneumococcal conjugate vaccine
• COVID-19 vaccinations

Ask your doctor for personal advice about vaccination.

Other treatment options include:

• Medications: Bronchodilators and glucocorticoids can reduce inflammation and improve breathing.
• Antibiotics: These treat any bacterial infections and lower the risk of complications.
• Supplemental oxygen: This improves your oxygen levels.
• Pulmonary rehabilitation: This can include nutrition advice and exercise training.
• Lung surgery:
  • bullectomy or lung volume reduction surgery to remove areas of damaged lung
  • lung transplantation to replace a damaged lung with a healthy, donated lung

Complementary therapies, such as counseling or occupational therapy, may also help improve your quality of life.

Finding the right medication and treatment plan for you can take some trial and error. Talk with your doctor if you have questions or concerns about your treatment.

Read more about medications for COPD.

COPD is a progressive condition, and lung damage linked to COPD can be permanent.

This can impact quality of life in different ways, such as socially, personally, and professionally. COPD may also cause other complications, such as:

• requiring hospitalization for difficulty breathing
• COPD flare-ups
• infections
• respiratory failure
• pulmonary hypertension
• other cardiovascular conditions, such as cor pulmonale
• weight loss
• side effects and adverse reactions to medications

In some cases, COPD does affect life expectancy, as some complications and severe COPD can be life threatening. However, this can vary per person and depend on factors such as:

• treatment effectiveness
• whether you quit smoking if you smoke
• whether you have other underlying conditions or experience complications

Also, COPD may not be fatal for everyone with the condition. Treatment can be effective at improving your outlook and quality of life.

If you have questions about your outlook, talk with your medical team.

The following resources are available for people affected by COPD:

• The American Lung Association provides resources and support, including action plans and online and in-person social support.
• The COPD Foundation offers information, education resources, and community events.
• NeedyMeds provides information on low cost healthcare programs and discounts on medications. It also offers explanations for navigating government health initiatives.
• Medicaid aims to help people with lower incomes to cover health costs. You can find out whether you qualify for help and also explore lower-cost health insurance options.
• The Medicare website offers information about pharmaceutical assistance programs by state, which may help with medication costs. You may also be able to sign up for Medicare coverage based on your age or health.

If you are having trouble affording medical treatment for COPD, let your medical team know. They can work with you to factor cost into their recommendations. Also, talk with a healthcare professional for any other personal advice or more information about local services.

COPD refers to two conditions, emphysema and chronic bronchitis, that cause difficulty breathing. COPD usually develops due to long-term irritation in the lungs and airways, which leads to permanent damage.

The most significant cause of COPD in the United States is smoking. However, other factors, such as genetic susceptibilities and breathing in other harmful chemicals, can also contribute to COPD.

Treatment such as medication, pulmonary rehabilitation, and surgery can help manage symptoms and improve the effects of COPD.

Contact your doctor if you have questions or experience any symptoms of COPD, such as wheezing or frequent coughing.