Chronic Obstructive Pulmonary Disease, or COPD, is a group of conditions that includes emphysema, chronic bronchitis, and asthmatic bronchitis. Because these conditions often overlap each other, they are lumped together under the diagnosis of COPD. COPD has been diagnosed in sixteen million Americans but, many believe the true number with COPD is twice as high.

COPD is caused primarily by smoking. Long-term exposure to tobacco smoke damages the airways causing swelling, excess mucus production, injury to structures that clear mucus from the airways, and contraction of airway muscle; all of which cause the airways to be narrower. This makes it more difficult to breathe and results in symptoms such as shortness of breath, chest tightness, and cough. These changes to the airway reflect the chronic bronchitis part of COPD.

Smoking also leads to the destruction of many of the small air sacs in the lungs, called alveoli. Their purpose is to get oxygen into the bloodstream and when they are damaged, you may have difficulty getting enough oxygen nto your blood to supply the body. The destruction of these air sacs is the emphysema component of COPD.

The early symptoms of COPD include a morning cough and shortness of breath duringactivity. Because these symptoms occur gradually over a long period of time, many patients dismiss them as a part of “just getting older.” When symptoms occur, especially in those with a history of smoking, the doctor may order a test called spirometry. By simply having the patient blow into a mouthpiece, lung function is measured in an accurate, sensitive, and reliable manner. Spirometry will detect changes in the airways years before they would appear on a chest x-ray and even before symptoms occur.

Although the damage from COPD cannot be reversed (unless the patient quits smoking early), there is treatment available to help relieve or reduce symptoms and help the patient lead a more active lifestyle.

Smoking Cessation – The most important step in managing COPD is to stop smoking. Even in patients that have smoked for many years, quitting smoking still helps to slow the rate at which COPD will worsen.

Bronchodilator Therapy – These medications, which are usually taken by inhaling the medication using an inhaler or nebulizer, act by opening the airways, reducing the amount of mucus, and assisting with clearing mucus from the airways. Wheezing, coughing, tight chest, and shortness of breath are all symptoms that can be reduced or alleviated with proper bronchodilator therapy.

Most patients respond best when utilizing two different types of bronchodilators:

One type of bronchodilator is called an anticholinergic (e.g., Ipratropium), and works in the larger airways by preventing the airways from contracting while reducing the amount of mucus being produced.

The second type of bronchodilator is called a beta-agonist (e.g., Albuterol, Xopenex), and acts by relaxing the airways so they are more open and improving the clearance of mucus.

Studies have shown that in COPD patients, using these two medications together results in better breathing than using either one alone and even reduces the overall cost of treatment by reducing hospitalizations. It is important to take these medications exactly as ordered by your physician.

Corticosteroids – The addition of an inhaled corticosteroid may be beneficial. These medications are helpful in reducing the swelling of the airways, makes bronchodilators more effective, and has been shown to reduce the need for hospitalizations.

Oxygen Therapy – In patients whose blood oxygen level is too low, using supplemental oxygen is very important. Many patients may only need oxygen during activity or during sleep, the two times when oxygen levels are most likely to be low. Oxygen therapy has been shown to increase life expectancy and improve quality of life when used appropriately. Many people avoid oxygen use for fear of becoming physically addicted to it. There is no truth to this old myth.

Pulmonary Rehab – This program teaches patients how to self-manage their disease and start an activity program that will recondition their weakened muscles. Pulmonary rehab is designed to minimize the effects of COPD so that the patient can lead a more active lifestyle.

NPPV – Noninvasive Positive Pressure Ventilation or NPPV is a therapy which assists some patients in adequately ventilating their lungs. It may be especially beneficial for those who under-ventilate at night.

If you have questions concerning any of these treatments, talk to your doctor who will gladly provide you with more information.