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Am Fam Physician. 2004;69(10):2439-2440

What is chronic obstructive pulmonary disease?

Chronic obstructive pulmonary disease (or COPD) is a lung disease. It blocks the large and small airways of your lungs. COPD includes two main illnesses, chronic bronchitis and emphysema (say: em-fi-see-ma). There is no cure for COPD.

Your lungs have two main parts: (1) air sacs and (2) airways that are called bronchial tubes. When you breathe in through your windpipe, the air moves through your bronchial tubes into your air sacs. From these sacs, oxygen goes into your blood, and carbon dioxide moves out of your blood.

If you have chronic bronchitis, the lining of your bronchial tubes gets irritated and makes a lot of mucus. This mucus blocks your tubes. If you have blocked airways, it is hard to breathe.

If you have emphysema, your air sacs are damaged, and the smallest bronchial tubes collapse. This makes it hard for you to get oxygen into your blood and carbon dioxide out of your blood.

Who gets COPD?

About 14 million people in the United States have COPD. The disease develops over many years. It usually is caused by cigarette smoking. The best way to keep COPD from getting worse is to quit smoking.

How do I know I have COPD?

The most common signs of COPD are chronic coughing and shortness of breath. If you are a smoker who coughs and you are short of breath on most days, you might have COPD.

Your doctor might give you a test to see how well your lungs are working. In this test, you take deep breaths, then blow into a machine. The machine measures how deeply you can breathe and how fast you can move air in and out of your lungs. You also might have a chest x-ray. The x-ray can show if you have signs of COPD.

How is COPD treated?

If you have COPD, the most important thing you can do is stop smoking. Quitting can stop or at least slow the damage to your lungs. Talk to your doctor about how to stop smoking. If you quit smoking soon, you have a better chance of living longer and having a good quality of life.

Your doctor also might want you to take some medicines to make you feel better and breathe more easily. Some of these medicines are the kind that you breathe in with an inhaler. You also might need to take a kind of steroid and antibiotics if you get a lung infection.

Some people with advanced COPD need to use oxygen therapy. The oxygen is breathed in through tubes that you put in your nose or through a mask that goes over your mouth and nose.

Patients with very bad COPD might have to have surgery. They might have a lung reduction operation or a lung transplant. These surgeries are usually done only in people who have not gotten better with the other treatments.

How do I take inhaled medicines?

To take inhaled medicines, you can use a small handheld canister called an inhaler, or you can use a machine called a nebulizer. You can carry the handheld inhaler along with you. Some people call this kind of inhaler a “puffer.” You might use the inhaler several times a day.

A nebulizer machine turns liquid medicine into a vapor that you breathe. This machine often is used to treat people with very bad COPD. It also helps people who have trouble using handheld inhalers.

What else can help?

If you have COPD, you might be more likely to get colds and the flu. Because your heart can be strained, it will get bigger. You might have high pressure in the vessels that bring blood to your lungs.

You should get a flu shot every year. You also should get a pneumonia shot. You are less likely to get sick with the flu or pneumonia if you have these shots. Lung rehabilitation and exercise programs also may be helpful.

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