Chronic obstructive pulmonary disease, or COPD, is a group of lung conditions or diseases that block airflow and make breathing difficult.
COPD generally starts off mild, but progressively gets worse over time.
In 2011, approximately 13.7 million people in the United States reported having COPD, according to a 2013 report in the journal Chest.
However, the National Heart, Lung, and Blood Institute (NHLBI) notes that at least 12 million people likely have COPD without knowing it.
Chronic lower respiratory disease of which COPD is the biggest component is the third leading cause of death in the United States, according to the Centers for Disease Control and Prevention (CDC).
In 2010, COPD killed about 133,575 people in the United States, according to the Chest report.
There are two main types of COPD: Emphysema and chronic bronchitis.
In emphysema, the alveoli (air sacs in the lungs) become damaged, causing them to lose their elasticity.
The walls of the alveoli can also rupture, reducing the overall surface area of the lungs.
This in turn reduces the amount of oxygen that can enter the bloodstream and the amount of carbon dioxide that can be exhaled.
Additionally, emphysema makes it difficult for people to fully exhale because the alveolar walls are no longer able to hold open the breathing tubes when you breathe out.
With chronic bronchitis, the lining of the breathing tubes becomes irritated and inflamed. This causes the airway lining to thicken and produce a lot of mucus (phlegm), which interferers with normal breathing.
Most people with COPD suffer from both emphysema and chronic bronchitis, according to the NHLBI.
Refractory asthma, which is non-reversible, is also considered part of COPD, as are some forms of bronchiectasis, an abnormal scarring of the airways.
Chronic obstructive pulmonary disease most often develops in people who are over 40 years old and have a history of smoking (currently smoke or have in the past), according to the CDC.
In fact, smoking contributes to up to 90 percent of COPD-related deaths. However, up to one out of six people who develop COPD have never smoked.
Other important causes of COPD include:
In rare cases, emphysema is caused by an inherited disorder called alpha-1 antitrypsin deficiency, in which the body doesn't produce enough of a certain protein (alpha-1 antitrypsin) that normally protects the lungs from damage.
Symptoms of COPD develop slowly and often include:
People with COPD may also experience exacerbations, or periods in which their symptoms are worse than normal.
Doctors diagnose COPD based on symptoms, medical history, and lab tests.
The main test for COPD is a lung function test called spirometry, which involves blowing into a tube connected to a spirometer, a machine that measures how much air you breathe out and how quickly you do it.
Other tests include chest x-rays or computerized tomography (CT) scans and an arterial blood gas test, which measures the amount of oxygen and carbon dioxide in the blood taken from the artery.
There is no cure for COPD. Treatment of COPD focuses on relieving symptoms, improving quality of life, and correcting lifestyle habits that may worsen the condition. This can include:
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Emphysema is one of the two main types of chronic obstructive pulmonary disease, or COPD, a group of progressive respiratory diseases that cause airflow blockage and breathing difficulties.
Most people with COPD suffer from both emphysema and chronic bronchitis, the other main form of COPD, according to the National Heart, Lung, and Blood Institute (NHBLI).
In 2012, 4.1 million people were living with emphysema in the United States, and about 93 percent of them were 45 years old or older, according to the Centers for Disease Control and Prevention (CDC).
As had been the case in years past, more men than women were living with emphysema that year with men totaling about 2.3 million cases, compared to about 1.8 million cases in women.
In 2011, emphysema killed 9,352 Americans, the CDC notes.
Emphysema occurs when the air sacs of the lungs (alveoli) become damaged and enlarged, causing breathlessness.
Each lung has an average of 480 million alveoli, according to a report in the American Journal of Respiratory and Critical Care Medicine.
When you breathe in, the alveoli expand and stretch, taking in oxygen and transporting it to the blood in the small capillary vessels within their thin walls.
At the same time, carbon dioxide waste moves into the air sacs from the capillaries, a process called gas exchange.
When you breathe out, the alveoli easily deflate, expelling the carbon dioxide out of the body through the airways.
However, for people with emphysema, the alveolar walls are damaged and the air sacs lose their normal elasticity, causing the airways to the lungs (bronchioles) to collapse.
The inelasticity of the alveoli and the narrowed bronchioles make it difficult for people with emphysema to fully expel all of the air out of their lungs.
Additionally, emphysema can cause some of the alveoli to rupture or burst, resulting in fewer, larger alveoli and ultimately reducing the surface area available for gas exchange.
Emphysema is considered one of the most preventable respiratory diseases because cigarette smoking is its leading cause.
The smoking habit contributes to 80 to 90 percent of all COPD-related deaths, according to the CDC.
Other risk factors for emphysema include frequent childhood respiratory infections, asthma, and chronic exposure to air pollution, secondhand smoke, and workplace dust and smoke.
In rare cases, emphysema is caused by the heredity disorder alpha-1 antitrypsin (A1AT) deficiency.
People with A1AT deficiency don't produce enough A1AT, a protein that protects the lungs from a potentially destructive enzyme called neutrophil elastase.
Hard numbers are difficult to come by, but small studies suggest that up to 5 percent of people with COPD have this genetic disorder, according to a 2012 report in the Canadian Respiratory Journal.
Symptoms of emphysema include:
Emphysema is generally diagnosed via tests, including:
There are no treatments that can cure or reverse COPD, but quitting smoking and undergoing treatment can reduce the progress of the disease and improve your quality of life.
For emphysema, these treatments generally include:
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Chronic obstructive pulmonary disease (COPD) is an umbrella term to describe a group of long-term diseases that make it difficult to breathe.
Chronic bronchitis and emphysema are the two main forms of COPD, with the former being the most common.
Between 2011 and 2012, some 8.7 million people in the United States were diagnosed with chronic bronchitis, according to the Centers for Disease Control and Prevention (CDC).
Over 60 percent of the people diagnosed with chronic bronchitis were women, and over 40 percent of them were between 45 and 64 years of age.
In 2010, COPD killed almost 134,000 people in the United States, according to a 2013 report in the journal Chest.
Bronchitis is an inflammation of the bronchial tubes (airways), which bring air to and from your lungs.
When the bronchial tubes are inflamed, the lining, or mucus membrane, of the airways swells and grows thicker. It also produces an excess amount of mucus.
The narrowing and increased blockage of the bronchial tubes from the mucus causes airflow to decrease and a phlegmy cough to develop.
Bronchitis can be either acute or chronic.
Acute bronchitis typically results from temporary infections and lung irritants, and is commonly caused by the same viruses that cause colds and the flu, according to the National Heart, Lung and Blood Institute (NHLBI).
Most cases of acute bronchitis clear up within a few days, though the phlegmy cough may persist for weeks.
In cases of chronic bronchitis, however, the bronchial tubes are constantly irritated and inflamed.
For a person to be diagnosed with chronic (rather than acute) bronchitis their mucus-filled cough must last three months of the year for two years in a row, according to the American Lung Association.
Long-term smoking of cigarettes or other forms of tobacco is, by far, the most common cause of COPD, chronic bronchitis included.
However, one out of six smokers never develops COPD, according to the CDC.
Other causes of chronic bronchitis include:
Unlike some cases of emphysema, chronic bronchitis is not caused by the genetic disorder alpha-1 antitrypsin (A1AT) deficiency.
Aside from the mucus-laden cough (often called "smoker's cough"), people with chronic bronchitis experience:
Symptoms often worsen during periods of increased air pollution.
Diagnosis of chronic bronchitis begins by looking at a person's medical history, specifically how long the phlegmy cough has persisted. Other health conditions must also be ruled out.
A definitive diagnosis of the lung disease generally requires additional tests, including lung function, blood, and imaging tests.
Chronic bronchitis is an incurable disease and treatment focuses on symptom relief and slowing the progression of the disease.
Treatment options generally include medications (bronchodilators, steroids, antibiotics), oxygen therapy, and a kind of educational physical therapy called pulmonary rehabilitation.
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Chronic obstructive pulmonary disease, or COPD, is an umbrella term to describe a group of diseases that cause airflow obstruction and difficulty breathing.
Emphysema and chronic bronchitis are the two main forms of COPD, but it also includes an irreversible form of asthma (refractory asthma) and some forms of bronchiectasis, an abnormal scarring of the airways.
When you inhale, air travels into the lungs through breathing tubes or airways called bronchi, which branch off into smaller airways called bronchioles.
At the end of each bronchiole is a grape-like cluster of air sacs called alveoli, which transport oxygen to, and carbon dioxide from, the bloodstream through its thin walls in a process called gas exchange.
In people with COPD, several factors can cause a decrease in airflow, including:
This obstruction can cause various symptoms.
The symptoms of COPD include:
People with COPD often experience exacerbations, or periods of time when symptoms worsen, which usually occurs when environmental air pollution increases.
To determine whether you have COPD, your doctor will begin by asking you questions regarding your:
After getting your medical history, your doctor will do a physical examination to inspect the strength and function of your lungs and heart, and look for other visible signs of COPD, such as cyanosis (blueness of the lips and fingernail beds).
Your doctor will likely order one or more lung function tests to fully diagnose COPD and rule out other possible causes of your symptoms. These tests may include:
Your doctor might also order blood tests and imaging scans, such as:
Other diagnostic tests may also be necessary, such as a heart test called electrocardiogram (EKG), bronchoscopy (where a thin tube with a camera is inserted into the airways to examine the lungs), and a lung or bronchial biopsy.
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An abbreviation for chronic obstructive pulmonary disease, COPD refers to a group of diseases that cause difficulty breathing from airflow obstruction.
The two most common types of COPD are emphysema and chronic bronchitis, which progressively get worse over time.
There is no cure for COPD. However, experts consider it one of the most preventable respiratory issues.
The most common cause of COPD is cigarette smoking. One of the best ways to prevent getting COPD is to never start smoking, or to quit smoking if you already do.
If you have trouble quitting smoking, there are numerous options to help you, including gums, patches, and prescription medications.
Additionally, support groups and classes to help you quit smoking can often be found through hospitals, workplaces, and community associations.
Enlisting the support of family and friends may also help you in your smoking cessation efforts.
Heavy and long-term exposure to various lung irritants, including air pollution, dust and chemical fumes in the workplace, and secondhand smoke, can also cause COPD.
Here are some tips to reduce your exposure to COPD-causing irritants:
Determining the long-term health and life expectancy of a person with COPD depends on two complicated tests.
During diagnosis, the severity of COPD is typically based on the GOLD (Global Initiative for Chronic Obstructive Lung Disease) system.
The GOLD system takes into account multiple factors, including your FEV1 score (the amount of air you can forcibly expel from your lungs in one second), frequency of exacerbations (periods of worsened symptoms), hospitalizations, and functional dyspnea (degree of breathlessness associated with varying physical activity).
The GOLD system is designed to help gauge the severity of a person's COPD and predict the risk of the condition getting worse, helping physicians determine the best treatment plan. It doesn't predict how long a person has to live.
Based on the GOLD system, COPD prognosis is as follows:
In 2004, researchers came up with another COPD prognosis tool called the BODE (Body mass index, Obstruction, Dyspnea, and Exercise) Index, which they outlined in a report in the New England Journal of Medicine.
The BODE index helps health care professions predict COPD mortality, or how long people have to live after being diagnosed with the disease.
The index takes into account four factors to determine a person's risk of death within a 52-month period:
The BODE Index is also a good predictor of the number and severity of COPD exacerbations, according to a 2009 in the journal Respiratory Medicine.
The goal of COPD treatment is to relieve symptoms, slow the decline of lung function, decrease exacerbations, and improve overall quality of life.
To slow the progression of the disease, it's important to stop smoking and avoid exposure to lung irritants.
Pulmonary rehabilitation can improve your well-being and may include:
Various medicines may also be necessary, including:
If you have severe COPD and low levels of oxygen in your blood, you may require oxygen therapy, or oxygen from a tank that's provided through nasal prongs or a mask.
This can help protect your organs from damage, improve your sleep, and help you be more active with fewer symptoms.
In severe cases, a lung transplant or surgery may be recommended to help improve lung function.
There are three basic types of surgical options for COPD treatment:
Lung volume reduction surgery (LVRS): Many people with COPD cannot fully empty their lungs, leaving an area in the lungs that's sometimes referred to as "dead space."
It's the increased effort required to empty the lungs that creates feelings of shortness of breath and chest tightness.
LVRS is seen as a possible solution to the problem of having more lung space than you are able to use.
In this surgery, a surgeon will take out some of the damaged tissue in your lungs, thereby reducing the amount of "dead space" available.
Bullectomy: People with a specific type of emphysema (bullous emphysema) develop "air bubbles" called bullae due to the destruction of the walls between the air sacs in their lungs.
In a bullectomy, the surgeon removes these bubbles. Surgery is typically done for people struggling with symptoms, or who have large areas of involvement in the lungs.
Lung transplant: For younger patients (under age 60) with severe COPD, getting a new lung or set of lungs is a good option.
More than half of single-lung transplants (58 percent) are in people with idiopathic emphysema (where the cause is not known) or those with the inherited form of emphysema, which strikes at earlier ages than most forms of COPD.
The five-year survival for lung transplants is about 50 percent.
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Chronic obstructive pulmonary disease (COPD) refers to a group of irreversible diseases most notably emphysema and chronic bronchitis that cause long-term breathing issues by obstructing airflow.
COPD is a fairly common disease, and is often deadly.
In 2011, there were approximately 13.7 million people in the United States with COPD, according to a 2013 report in the journal Chest.
However, at least 12 million more people likely have the condition without knowing it, because symptoms develop slowly and are similar to those of other diseases.
In 2010, COPD killed almost 134,000 people in the United States, according to the Chest report.
Emphysema develops when the air sacs in the lungs (alveoli) become damaged, while chronic bronchitis develops from long-term inflammation of the bronchial tubes, or airways.
In most cases, both conditions stem from airborne irritants that are inhaled.
Cigarette smoking is the most common cause of COPD (both emphysema and chronic bronchitis), because the multitude of chemicals in cigarette smoke causes a cascade of biological reactions that both inflame the airways and damage alveoli.
Other causes of COPD include:
Emphysema can also be caused by an inherited disorder called alpha-1 antitrypsin (A1AT) deficiency, in which a normally beneficial enzyme called neutrophil elastase damages alveoli tissue.
The majority of people who develop COPD are current or former smokers who are at least 40 years old, according to the Centers for Disease Control and Prevention (CDC).
Additionally, the CDC notes that the people who are most likely to report being diagnosed with COPD are those who:
Abnormal lung development in the womb and HIV infection may also be risk factors for COPD.
Studies suggest that up to 5 percent of people with COPD have alpha-1 antitrypsin (A1AT) deficiency, according to a 2012 report in the Canadian Respiratory Journal.
You can develop the disorder if you have a certain type of mutation to the SERPINA1 gene, which is responsible for encoding the A1AT protein.
However, other genes may also make you more or less likely to get COPD.
For instance, while smoking is the biggest cause of COPD, only about 20 percent of smokers develop COPD, suggesting that genetic factors may make some people more susceptible to the chemicals of cigarette smoke (and possibly other inhaled irritants), according to a 2014 report in the journal PLoS ONE.
The study found that, compared with non-smokers, certain airway cells in smokers abnormally express a number of genes, including four genes (NFKBIB, LTBP4, EGLN2, and TGFB1) that have been previously linked to COPD.
Numerous other genes may also be involved in the development of COPD, such as MMP12, according to a 2012 report in the journal EMBO Molecular Medicine.
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Cigarette smoking is the number one cause of chronic obstructive pulmonary disease, or COPD.
The Centers for Disease Control and Prevention (CDC) notes that smoking accounts for up to 90 percent of all deaths related to COPD, a term that actually refers to a group of diseases that cause progressive breathing problems by obstructing airflow.
The two main types of COPD are chronic bronchitis and emphysema, both of which are caused by smoking.
Chronic bronchitis occurs when the bronchial tubes airways that bring air to and from your lungs are constantly irritated and inflamed.
When inflammation of the bronchial tubes occurs, the lining of the airways swells and produces an excess amount of mucus. Both of these issues obstruct airflow and make breathing more difficult.
Cigarette smoke contains thousands of chemical components. When you breathe in cigarette smoke, the chemicals irritate and activate certain white blood cells (macrophages) and cells that make up the lining of the airways (epithelial cells).
This causes the cells to release multiple types of cytokines, which are small signaling proteins that cause the airway lining to thicken and airways to become inflamed.
The persistent airway inflammation caused by cigarette smoke can cause a cycle of injury and repair that changes the structure of the airways and makes them narrower.
Cigarette smoke also induces a cascading effect that results in certain cells producing more mucus than normal.
What's more, the irritants decrease the number and length of cilia hair-like appendages that beat rapidly to move particles, fluid, and mucus through your airways.
With the cilia unable to do their jobs, mucus blankets the lining of the airways, providing a home for bacteria, which release toxins that promote mucus production and further damage cilia.
Emphysema occurs when alveoli air sacs located at the end of the bronchial tubes in grape-like clusters become damaged.
During normal breathing, the elastic alveoli repeatedly swell and deflate. When you breathe in, the alveoli fill up with oxygen, which is passed to the capillaries (small blood vessels) in the thin walls of the air sacs.
When you breathe out, carbon dioxide waste is transported from the capillaries to the alveoli (a process called gas exchange), and exhaled out of the body.
In emphysema, the alveoli lose their normal elasticity and are no longer able to adequately hold open the airways, causing labored breathing.
Some of the alveoli may also rupture or burst, producing fewer, larger alveoli with a reduced surface area available for gas exchange.
Cigarette smoke-induced inflammation is also thought to be an underlying cause of emphysema, but the processes involved are unclear.
Some research suggests that certain inflammatory cells release enzymes that break down the proteins responsible for alveolar elasticity. Cigarette smoke may also somehow induce programmed cell death (apoptosis) in alveolar cells.
There is even some evidence that cigarette smoke causes an autoimmune response in which the immune system attacks alveoli tissue, according to a report in the journal Physiological Reviews.
Airway inflammation might continue after you quit smoking, even after one year of abstinence, according to a 2009 report in the International Journal of Environmental Research and Public Health.
Despite this, it's important to stop smoking if you have COPD because this can prevent the continued loss of lung function.
Quitting smoking can also reduce the rate of COPD development and the risk of developing high blood pressure (hypertension), stroke, coronary heart disease, and cancer.
There are numerous ways to quit smoking, including:
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Chronic obstructive pulmonary disease, or COPD, refers to a group of diseases that cause long-term breathing problems.
COPD includes emphysema and chronic bronchitis, as well as refractory (irreversible) asthma and some forms of bronchiectasis (abnormal scarring of the airways).
Most people with COPD have both emphysema and chronic bronchitis, which develop from damage to the air sacs of the lungs and inflammation of the lungs' airways, respectively.
The progressive lung condition commonly causes various symptoms, including coughing, wheezing, and shortness of breath. But it can also cause numerous complications to develop over time.
People with COPD have trouble taking in enough oxygen to meet their bodies' demands and expelling the carbon dioxide waste their bodies produce.
In severe cases, people may develop low levels of oxygen in the blood (hypoxia) and high levels of carbon dioxide (hypercapnia).
Long-term and severe hypoxia and hypercapnia can result in acute respiratory failure, which may cause arrhythmia (irregular heart beat).
Additionally, COPD, through inflammation, can cause coronary artery disease, in which the blood vessels that supply the heart with nutrients, oxygen, and blood become hardened and narrowed.
Hypoxia also affects the blood vessels inside the lungs (the pulmonary arteries), causing them to narrow and increase blood pressure.
This can cause pulmonary hypertension, or high blood pressure in the lungs.
Because the hearts right ventricle pumps blood into the lungs through the pulmonary arteries, pulmonary hypertension causes the right ventricle to strain, enlarge, and eventually fail, a condition called cor pulmonale (right-sided heart failure).
About 28.7 percent of people with COPD develop heart failure, compared with only 13 percent of people without the lung disease, according to a study presented at the 2014 American Thoracic Society International Conference.
Severe heart issues are not the only complications of COPD; the disease is also associated with:
Lung cancer and COPD often go hand-in-hand, but COPD may not directly cause the cancer, according to a 2013 report in the Journal of Thoracic Oncology.
Instead, lung cancer in COPD patients may be more attributable to smoking, the study found.
However, in a subsequent letter to the editor of the journal, other researchers argued that COPD is, in fact, an independent risk factor for lung cancer. More research is needed to understand the relationship between COPD and lung cancer.
Many people with COPD are also diagnosed with GERD, which can worsen COPD symptoms. According to a large Korean study in the journal BMC Pulmonary Medicine, at least 28 percent of people with COPD have GERD.
But the connection between the two health issues is unclear, and they may just be linked by common risk factors, such as smoking.
Osteoporosis and COPD have a number of common risk factors, including age and smoking. But issues related to COPD, including inactivity, inflammation, vitamin D deficiency, and corticosteroid use, may also put people at risk for bone density loss and osteoporosis.
In a study in the journal Respiratory Medicine, researchers found that about 68 percent of participants with COPD had osteoporosis or osteopenia (reduced bone mass of lesser severity than osteoporosis).
People with COPD often have weight issues and poor nutrition, which is often associated with the increased energy (calories) and effort required to breathe.
According to a 2014 article in the Journal of Parenteral and Enteral Nutrition, 11 percent of people with COPD suffer from malnutrition, a higher rate than other devastating diseases, including depression, coronary heart disease, and dementia.
People with COPD, particularly those in the later stages of the disease, often have difficulty with normal daily activities, such as carrying heavy objects and walking up stairs.
What's more, nearly 30 percent of them may also suffer from insomnia, a 2012 study in the journal Sleep found.
These issues can affect mood and put people with COPD at an increased risk for psychiatric conditions, including:
In fact, it's estimated that about 40 percent of people with COPD suffer from severe depressive symptoms or clinical depression, according to a report in the International Journal of Chronic Obstructive Pulmonary Disease.
And a study in the journal Respiratory Medicine found that 55 percent of COPD patients have been diagnosed with a mental disorder.
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