What is chronic obstructive pulmonary disease?
Chronic obstructive pulmonary disease (also called COPD) is a lung disease that makes it hard for you to breathe. COPD includes two main illnesses: chronic bronchitis and emphysema (say: “em-fa-see-ma”). Most people who have COPD have both of these conditions.
Your lungs have 2 main parts: bronchial tubes (also called airways) and alveoli (also called air sacs). When you breathe, the air moves down your trachea (or wind pipe) through your bronchial tubes and into your alveoli. From the alveoli, oxygen goes into your blood while carbon dioxide moves out of your blood.
If you have chronic bronchitis, the lining in your bronchial tubes gets red, swollen, and full of mucus. This mucus blocks your tubes and makes it hard to breathe.
If you have emphysema, you lose alveoli. This makes it hard for you to get oxygen into and carbon dioxide out of your blood. It also makes it harder to exhale (breathe out).
What are the symptoms of COPD?
COPD can cause a variety of symptoms, including:
- Chronic (long-lasting) cough
- A cough that produces mucus
- An increase in respiratory infections (such as flu and colds)
- Shortness of breath, especially during physical activity
- A tight feeling in the chest
At first, you may have no symptoms or only mild symptoms. But COPD is a progressive disease, meaning the symptoms start slowly and get worse over time. COPD symptoms develop over the course of many years. Eventually, the symptoms begin to affect your activity levels and quality of life.
Causes & Risk Factors
What causes COPD?
COPD is caused by damage to the lungs. This type of damage typically occurs when you regularly breathe in irritants over a long period of time. Common irritants include:
- Air pollution
- Chemical fumes, gases, vapors, or mists
- Cigarette smoke (including second-hand smoke)
What are the risk factors for COPD?
The primary risk factor for COPD is smoking. Approximately 80% to 90% of COPD cases are caused by long-term smoking. The best way to prevent or keep COPD from getting worse is to quit smoking.
Workers who are regularly exposed to chemicals or dust while at work also are at risk of developing COPD. Workers who smoke and have exposure to other irritants are at even greater risk of developing COPD.
Diagnosis & Tests
How can I find out if I have COPD?
Talk to your doctor if you experience any symptoms of COPD. Your doctor will ask you if you smoke or if you have been exposed to excessive amounts of dust, fumes, smoke, gases, vapors, or mists over a long period of time.
Your doctor might give you a spirometry test. This is a special test to see how well your lungs are working. You might also have a chest X-ray. The X-ray can show signs of COPD. Your doctor may also suggest a blood test or a special test that analyzes your mucus.
Is there a cure for COPD?
No. There is no cure for COPD.
How is COPD treated?
Treatment for COPD aims to help you feel better, control your symptoms, and reduce your risk of complications. Your treatment options include:
If you are a smoker who has COPD, the most important thing you can do is stop smoking. This will help to stop or slow the damage to your lungs and is the only way to keep your symptoms from getting worse. Talk to your doctor about how to stop smoking. The sooner you stop smoking, the better chance you have of living longer and being healthier.
Medicines: Your doctor may prescribe one or more medicines to make you feel better and help you breathe. These medicines may include:
- Antibiotics: These medicines help treat bacterial respiratory infections, which can make your symptoms worse.
- Bronchodilators: These medicines help relax the muscles around your airways and may make it easier for you to breathe.
- Steroids: These medicines may help make it easier for you to breathe, but usually are only used in people who have more severe COPD.
Vaccines: Vaccines can help prevent certain respiratory infections, such as influenza and pneumonia. These infections can make your symptoms worse or cause more lung damage. Talk to your doctor about when and how often you should receive vaccines.
Oxygen therapy: Some people who have more advanced COPD need to use oxygen. You breathe the oxygen through tubes that you put in your nose or through a mask that goes over your mouth and nose.
Pulmonary rehabilitation: Rehabilitation programs help you manage your disease by creating a team of health professionals to help you learn about your disease, receive counseling, and create exercise and eating plans tailored to your needs.
Surgery: Rarely, patients who have very serious COPD may benefit from surgery. They might have a lung reduction operation or a lung transplant. These surgeries are usually done only in people who have not done well with other treatments.
How do I take inhaled medicines?
To take inhaled medicines, you might use a small handheld canister, or you might use a nebulizer machine to deliver a specific amount of medication to your lungs. A nebulizer machine turns liquid medicine into a vapor (like a cloud) that you can breathe. This machine is often used to treat people who have more serious COPD. It also helps people who have trouble using handheld inhalers.
Your doctor will tell you how to take your medicine. It is important to follow your doctor’s instructions carefully so that your lungs receive the right amount of medicine.
What are the complications of COPD?
If you have COPD, you are at risk for complications, including:
- Heart problems: COPD can cause an irregular heartbeat (called arrhythmia) and heart failure.
- High blood pressure: COPD can cause high pressure in the vessels that bring blood to your lungs. This is called pulmonary hypertension.
- Respiratory infections: You are more likely to have frequent colds, the flu, or even pneumonia. These infections can make your symptoms worse or cause more lung damage. You should have a flu shot every year and talk to your doctor about whether you need a pneumonia shot. You are less likely to get flu or pneumonia if you have these shots.
Questions to Ask Your Doctor
- I’m not a smoker or ex-smoker. How could I have COPD?
- I smoke. Will quitting really make a difference? How do I start?
- What lifestyle changes can I make at home to help reduce my symptoms?
- What treatment options are best for me? Will I need oxygen?
- What are the health risks associated with COPD?
- Do I need any vaccines?
- Is it safe for me to exercise? What kind of exercise can I do?
- Will my symptoms get worse?
National Heart Lung and Blood Institute. COPD. Accessed October 17, 2012
U.S. National Library of Medicine. Chronic obstructive pulmonary disease. Accessed October 17, 2012
COPD: Management of Acute Exacerbations and Chronic Stable Disease by MH Hunter, MD; DE King, MD, August 15, 2012,