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Lost breath: COPD and your lungs

Chronic obstructive pulmonary disease is the third leading cause of death by disease among Americans. But finding and treating the disease early can slow it down.

Smoking is a well-known risk factor for lung cancer. It's also the biggest cause of a lesser-known lung problem—chronic obstructive pulmonary disease (COPD).

So just what is COPD—and how can you tell if you have it?

Double trouble

COPD includes two major diseases that affect the lungs and make breathing difficult:

Chronic bronchitis occurs when the airways are frequently inflamed and become scarred.

Emphysema occurs when the lungs are damaged over a long period of time. The tiny air sacs in the lungs eventually can no longer stretch and retract. The lungs themselves also lose elasticity and cannot expand and contract. Air is trapped in the air sacs, making oxygen exchange difficult and increasing the effort needed to take each breath.

Most people who have COPD have both of these conditions.

Irreversible damage

Everyone's lung function gradually declines with age. For people who smoke, the rate of decline is much more rapid. Quitting smoking can slow that decline, even for people already diagnosed with COPD. But the damage that has already been done cannot be reversed, and lung function itself will not return to normal.

Although COPD is irreversible, early detection and treatment can help alleviate symptoms. Eventually, however, COPD will gradually worsen. The disease can interfere with your ability to work, do chores and sleep. It can also affect your heart, making it work harder to try to pump enough blood through the lungs.

Risk factors

As many as 8 out of 10 COPD-related deaths are caused by smoking. In fact, COPD is almost always caused by smoking, says the Centers for Disease Control and Prevention (CDC). Other risk factors for COPD include:

  • Heredity. Although rare, emphysema cases can be caused by a genetic abnormality.
  • Exposure to secondhand smoke.
  • Exposure to indoor or outdoor air pollution or industrial pollutants.
  • Frequent respiratory infections during childhood.

Know the signs

The early signs of COPD may be very subtle. Chronic bronchitis begins with increased mucus in the airways, which causes a cough that brings up mucus. An early sign of emphysema is shortness of breath. Other common COPD symptoms may include frequent throat clearing and tightness in the chest.

Because the early signs are so mild, many people may ignore them. They think their coughing is just a smoker's cough. Or they may assume they are having trouble breathing just because they are getting older or out of shape. That's why so many people don't get medical help until the disease is fairly advanced, says Norman H. Edelman, MD, senior scientific advisor to the ALA.

People who have COPD may occasionally suffer flare-ups, where symptoms become worse. Flare-ups are often caused by respiratory infections or colds. During a flare-up, the lungs become irritated and may produce extra mucus or the muscles around the airways may tighten, making breathing even more difficult than usual.

Dealing with COPD

According to Dr. Edelman and CDC, to help prevent or manage COPD you should:

  • Quit smoking. Not smoking almost always prevents the development of COPD. If you have COPD, quitting smoking will help slow the advancement of the disease.
  • Consider moving to an area with less air pollution.
  • Change jobs if you have a job that exposes you to fumes or other substances that irritate your lungs.

There are also a variety of treatments available for people who have COPD:

Inhaled bronchodilators relax the muscles around the airways when COPD flares up.

Antibiotics fight respiratory infections that irritate the airways and cause COPD to flare up.

Corticosteroids may be used for short periods to decrease inflammation.

Supplemental oxygen is given when COPD progresses to the point where a person can't get enough oxygen.

Surgery may be used to remove damaged lung tissue.

A lung transplant may be an option for people in the most advanced stages of COPD.

Early detection is important in treating COPD, says Dr. Edelman. Steps—such as smoking cessation—can be taken to help slow progression of the disease. And a doctor can create a respiratory care program to help you avoid flare-ups.

Dr. Edelman recommends that smokers ask their doctors for a simple breathing test called spirometry to measure their lung function and check periodically for COPD.

Reviewed 8/16/2022

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