What is COPD? Disease & Treatment Overview

Chronic obstructive pulmonary disease (COPD) is a significant public health concern in the U.S. Population data from the Centers for Disease Control and Prevention show that 16 million Americans are living with diagnosed COPD, with potentially millions more living with the condition without a formal diagnosis.(1) COPD is the fourth leading cause of death in the U.S. and can significantly affect the quality of life among those living with the condition.

The general thinking is that COPD is mostly a concern for people who smoke cigarettes, and while smoking is a primary risk factor, the disease state overall is more complex than that. As many as one-quarter of all COPD patients have never smoked.(2) Smoking habits notwithstanding, there are additional considerations to keep in mind when evaluating personal risk for COPD or when learning more about how to support a loved one who may be living with COPD.

Below you will find more information about COPD symptoms, risk factors, treatments and other critical information:

What is COPD?

COPD is a long-term, progressive lung disease that impedes your ability to breathe easily and general lung function. COPD is an umbrella term that covers emphysema and chronic bronchitis. The condition is diagnosed using a simple device called a spirometer, which measures your lung capacity.(1) The spirometer measures the amount of air you’re able to breathe in and out, as well as how long it takes you to exhale completely after taking a deep breath. Results of this test alongside a review of your health history are normally all a doctor needs to make a COPD diagnosis.

COPD is typically preventable. Smoking cigarettes is the leading cause of COPD – most patients are current or former smokers. But, as mentioned previously, up to 25% of people diagnosed with COPD have never smoked. Other factors, including long-term exposure to lung irritants other than tobacco like air pollution, dust or chemical fumes, and family history, can also increase the risk of COPD. In rare cases, a genetic defect called alpha-1 antitrypsin deficiency can also be behind the disease.(2)

What Are the Symptoms of COPD?

In the early stages of COPD, there may be mild symptoms or no symptoms at all. As COPD progresses, symptoms tend to worsen. The severity of symptoms depends on how much lung damage you have.

The most common signs and symptoms of COPD include2:

• A persistent cough, particularly a cough that produces a large amount of mucus. Sometimes referred to as “smoker’s cough”
• Shortness of breath, particularly when exercising or generally be active
• Wheezing, whistling or squeaking sounds while breathing
• Tightness in the chest
• Concurrent cold or respiratory infections such as cold or flu

This list of symptoms is not exhaustive, and it is important to note these symptoms are similar to those of other respiratory conditions. As such, it is important to speak with your doctor if you are experiencing symptoms so the underlying cause can be properly identified.

Beyond the common symptoms, there is a subset of serious COPD symptoms that could signal a medical emergency. Serious symptoms that require immediate medical attention include2:

• Great difficulty catching your breath or holding a conversation
• Sustained rapid heartbeat
• Blue- or grey-tinted lips or fingernails, which may indicate dangerously low levels of blood oxygen
• Unexplainable mental fogginess

What Types of Medications Are Used to Treat COPD?

There are several classes and types of medications available to help treat and manage COPD symptoms. Options include*(3)*:

• Inhaled bronchodilators. These medications, usually taken through an inhaler or nebulizer, help loosen the muscles in the airway so air can pass through more easily. Inhaled bronchodilators can come in short-acting forms, meaning you only use it when you need it, or long-acting formulations, which are used each day and produce effects for up to 12 hours
• Corticosteroids. Corticosteroids help to reduce inflammation in the airways while lowering mucus production levels. Reduced inflammation can help open airways. Corticosteroids are often prescribed in conjunction with inhaled bronchodilators
• Phosphodiesterase-4 inhibitors. Like corticosteroids, this class of medications works to lower inflammation in the airways. Phosphodieterase-4 inhibitors are normally prescribed for severe cases of COPD with chronic bronchitis
• Theophylline. This drug works to lower chest tightness and alleviate shortness of breath to help avoid flare-ups. Theophylline is an older drug and is typically not a first-line option in COPD
• Antibiotics and antiviral medications. These medications can be prescribed to treat certain respiratory infections that may arise alongside COPD
• Vaccines. Your doctor will likely recommend certain vaccines to help avoid preventable lung infections like the flu or pneumonia. Lung infections can pose serious problems in people with COPD

There is no one optimal medication regimen for COPD management. Your doctor will work with you to find the ideal medication and dosage levels for your individual case.

Are Non-pharmacologic Treatment Options Available for COPD?

Non-medication treatment options are available for COPD, and these can help support improved quality of life in a significant way. Recommendations your doctor might consider include*(1)*:

• Smoking cessation. Quitting smoking is an extremely important aspect of COPD treatment in patients who smoke cigarettes
• Avoiding lung irritants. Tobacco smoke and other air pollutants should be avoided as much as possible
• Personalized lung rehabilitation. An individualized breathing treatment program can be designed to improve COPD symptoms and overall quality of life. Rehabilitation activities can include learning to breathe more effectively, energy conservation strategies and food and exercise recommendations for improved lung health
• Oxygen. Supplemental oxygen from a portable tank may be recommended if your oxygen levels in the blood are low

Beyond addressing COPD directly, there are several treatments aimed at managing the stressors that often accompany life with COPD. Complementary therapies and palliative care both fall into this category.(4) Complementary therapies like yoga, massage or acupuncture are sometimes used to treat symptoms and quality of life issues, while palliative care focuses on helping patients and their families access the support they need to cope with a COPD diagnosis and any resulting life changes.

Outlook: Moving Forward in Life With COPD

Unfortunately, there is no cure for COPD – but the good news is the condition can be managed. Although COPD generally reduces overall life expectancy, the specific outlook can vary greatly from person to person. For smokers, smoking cessation plays a large role in outlook, but other factors including how well you respond to your treatment and whether you can avoid serious complications can also affect outcomes.

Improving one’s overall outlook and prognosis for COPD requires a daily commitment to managing the condition and making appropriate lifestyle changes in support of a healthier life. Your doctor is best placed to help you work through the challenges that come with managing COPD and your overall health, so it is important to maintain a close and communicative relationship. Support groups can also help with any emotional distress you may experience as a result of COPD.