Chronic Obstructive Pulmonary Disease (COPD) is a respiratory condition with limited airflow in the lungs, making it hard to breathe out. The disease develops and worsens over time.




What is COPD?

The two major diseases in this category are emphysema and chronic bronchitis. Some patients may have both. A less common underlying disease is obstructive bronchiolitis. Although asthma shares many of the same symptoms and findings, it is generally considered a different disease. They can co-exist, however.

Emphysema is where the alveoli, the grape-like clusters of air sacs at the ends of the smallest airways (the bronchioles), are destroyed.

Chronic Bronchitis, on the other hand, is defined by symptoms– chronic cough with production of mucus for at least 3 months total during at least 2 consecutive years.

Common symptoms of COPD include:

  • shortness of breath, especially with exertion earlly on
  • chronic cough (often with production of mucus)
  • wheezing

What causes COPD?

Cigarette smoke accounts for 80% or more of all cases of COPD. The longer and heavier one smokes, the greater the risk for COPD. Only 15-20% of all smokers develop emphysema, however, suggesting  a role by genetics. About 1 out of every 5,000 to 7,000 people have an inherited condition called alpha 1-antitrypsin deficiency (A1AD), which can cause emphysema, even in a non-smoker.

Other causes of COPD include occupational dusts and chemicals, such as silica and industrial smoke, and air pollution. For unknown reasons, patients with HIV/AIDS are at increased risk for COPD.

What are the complications or risks of COPD?

About 12 million adults in the U.S. have been diagnosed with COPD. In the US, COPD is the 4th leading cause of death. Worldwide, by 2020 it is estimated COPD will be the 3rd most common cause of death.Death usually results from respiratory failure.

Although this used to be a man’s disease, with the increase of smoking amongst women beginning decades ago, many women are afflicted with this condition. Unfortunately, women tend to fare worse than men. The good news is that women who stop smoking benefit more rapidly than men.

Known complications of COPD include:

  • acute exacerbations
  • reduced quality of life
  • malnourishment
  • heart disease

COPD is associated with a number of health concerns, including:

  • lung cancer
  • osteoporosis
  • GERD (reflux disease)
  • sleep disturbances

How is COPD diagnosed?

After performing a complete examination, your doctor will typically ask you to perform breathing tests. This might be a simple test in the office in which you are asked to take a deep breath in and exhale rapidly for at least 6 seconds (spirometry) or more sophisticated testing (usually done at the hospital or specialist’s office).  With COPD, you are usually able to inhale a normal size breath, but your rapid exhalation is limited. Your overall lung size might increase substantially. Additionally, you might also undergo x-ray testing, blood testing and assessment of blood oxygen levels.

How is COPD treated?

There is no medical cure for COPD. Treatment is aimed at relief of symptoms and trying to slow progression. Commonly employed modalities include:

  • medications
  • respiratory training/rehabilitation
  • smoking cessation
  • supplemental oxygen (when room air levels are abnormally low)
  • disease education
  • vaccinations (including pneumococcal and influenzal)
  • treatment of acute exacerbations and infections
  • nutritional advice
  • exercise
  • surgery (bullectomy; lung volume reduction; lung transplantation)

Where can I learn more?

American Lung Association

Global Initiative for Obstructive Lung Disease (GOLD)

National Institutes of Health (NIH)

COPD International (support group)

American Thoracic Society