CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD; Emphysema)

General Information

DEFINITION--A term used to describe chronic airway obstruction that results from emphysema, chronic bronchitis, asthma, or any combination of these disorders. The combina-tion often involves bronchitis and emphysema.

BODY PARTS INVOLVED--Lungs.

SEX OR AGE MOST AFFECTED--More men than women are affected (until recently, men were more likely to be the heavy smokers).

SIGNS & SYMPTOMS

Symptoms may not appear until middle-age even though COPD is thought to begin early in adult life. Bronchitis:

• Frequent cough or coughing spasms usually with sputum.
• Shortness of breath.
• Sputum that is thick and difficult to cough up.

Emphysema:

• No symptoms in the early stages (often).
• Increasing shortness of breath over several years.
• Occasional recurrent infections of the lungs or bronchial tubes.
• Weight loss.
• Minimal wheezing or coughing; scant sputum.

CAUSES--

Damage to the lung from bronchial irritation and inflammation and caused by:

• Cigarette smoking; air pollution.
• Antitrypsin deficiency (an inherited form of emphysema).
• Occupational exposure to irritants (e.g., firefighters).
• Infection, possibly (viral).

RISK INCREASES WITH

• Smoking; passive smoke (especially adults whose parents smoked).
• Severe viral pneumonia early in life.
• Aging.
• Family history of allergies, respiratory or lung disorders.

HOW TO PREVENT

Don't smoke. Also avoid secondary (or passive) smoke.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and exam by a doctor.
• Laboratory blood studies, pulmonary functions studies, CT scan, bronchogram (See Glossary for both) and chest x-ray.

APPROPRIATE HEALTH CARE

• Doctor's treatment.
• Overall goals of treatment are to relieve symptoms, slow the progression of the disorder and prevent complications.
• Home treatment is usually adequate, but hospitalization may be required.
• Lung transplantation is currently being evaluated.

POSSIBLE COMPLICATIONS

• Frequent infections; anxiety; depression.
• Other complications include pulmonary hyper-tension, cor pulmonale, secondary polycythemia, bullous lung disease and respiratory failure.

PROBABLE OUTCOME--

• Gradual decline in lung function. However, treatment can reduce symptoms, help prevent infections and permit a more active life.
• Younger patients may have a fairly good prog-nosis; older patients have a poorer prognosis.

How To Treat

GENERAL MEASURES--

• Installing air conditioning with air filters in the home may be helpful.
• Bronchial hygiene may be improved with inhalation of mist, postural drainage and chest physical therapy.
• Get pneumovax vaccine and yearly influenza vaccines.
• Join a support group.
• See Resources for Additional Information.

MEDICATION--Your doctor may prescribe:

• Bronchodilators.
• Antibiotics for infections.
• Corticosteroids may be beneficial for some.
• Drugs for anxiety or depression, but must be used with caution.
• Replacement therapy for antitrypsin deficiency.
• Supplemental oxygen for continuous use, only at night or with exercise.

ACTIVITY--

• Prolonged inactivity leads to increased disability. If there is no severe heart disease, it is important to maintain regular exercise.
• Occupational therapy, vocational rehabilitation and physical therapy may be recommended.

DIET--No special diet, but good nutrition is vital to help maintain your well-being. Drink at least 8 to 10 glasses of fluid each day.

Call Your Doctor If

• You have symptoms of COPD.
• A fever develops or chest pain increases.
• Blood appears in the sputum or sputum thickens; vomiting occurs.
• Shortness of breath occurs even when you are resting or not coughing.