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How Can Chronic Obstructive Pulmonary Disease (COPD) Be Managed?

Erin Russell

My name is Gail Weinmann and I am deputy director of the Division of Lung Diseases at NHLBI. People can live a long time with COPD, many decades actually, so it’s important to understand that there are options to allow those with COPD to live their lives fully. Even though there’s no cure for COPD, these options may slow its progression and manage symptoms. You and your health care provider are in the best position to decide what you need and what is the best course of action for you in particular. Some of the options that are available include medication, physical training or rehabilitation, and of course, general healthy living.

Let’s start with healthy living. If you still smoke, the most important step you can take towards healthy living is to quit. Studies have shown that it’s never too late to quit. This is a good step for you and anyone you know, whether they have COPD or not. It’s not easy to quit and there is no magic bullet. But there are many programs available at the national and local levels to help. Usually, a multi-faceted approach works best. Nicotine replacement therapy or a support group or both may be helpful. If you have COPD, it’s best to avoid lung irritants, like second-hand smoke, dusty environments, and fumes.

It’s probably a good idea to stay indoors on bad pollution days. A healthy, balanced diet helps everyone. Eating the wrong food or too much food or not enough food can all potentially worsen symptoms. Another important step towards healthy living is adequate exercise and strength training. While it can be very hard to remain active, physical activity provides overall conditioning of your heart and muscles and improves your overall endurance. Many report it helps them sleep at night. Another part of healthy living is staying up to date with your vaccinations. You should check with your health care provider what vaccinations are appropriate for you. If you have symptoms of being short of breath, there are some medications that may help. The most commonly used one is lung bronchodilators. These are medications that relax the muscles in your airways and help the air to move in and out of your lungs.

Some patients with COPD may respond well to corticosteroids. These are drugs which work to decrease the inflammation in the airways. For those with very low levels of blood oxygen, a health care provider may prescribe oxygen therapy. A very select group of patients with a certain pattern of COPD may benefit from surgery of the lung. Beyond regular exercise, a coordinated pulmonary rehabilitation program may help. Pulmonary rehabilitation is a prescribed regime that includes an exercise program, disease management, and nutritional and psychological counseling. A team of health care professionals that may include doctors, nurses, physical therapists, respiratory therapists, exercise specialists, and dietitians, work together to create a program that meets your needs. Sometimes a cold, flu, or a lung infection may cause your symptoms to worsen suddenly and you may have a much harder time breathing, feel chest tightness, have more coughing, there could be changes in the color or amount of your sputum or spit, you could even have a fever.

If this happens to you, it’s important to contact a health care provider right away. For more information about COPD, visit COPD.nhlbi.nih.gov. .

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The Basics of Chronic Obstructive Pulmonary Disease (COPD)

Erin Russell

My name is Lisa Postow and I am a program officer in the Division of Lung Diseases at NHLBI, the National Heart, Lung, and Blood Institute.

COPD, short for Chronic Obstructive Pulmonary Disease, affects millions of Americans. Approximately 16 million people over the age of 18 are diagnosed and it is estimated that millions more have COPD without even realizing it. Most – but not all – people with COPD either smoke or used to smoke. But 25% of COPD cases are due to other factors, such as genetics or environmental exposure. Annually, about 150 thousand Americans die from the disease. At NHLBI, we are committed to raising awareness of COPD so that people who are at risk for COPD or are in the early stages can get help earlier and get back to doing the things they love. COPD puts a tremendous burden on people with the disease and their loved ones. It can affect quality of life, causing people to not be able to do everyday tasks and stop socializing. It also costs the health care system billions of dollars.

But not everyone is aware of COPD, and there is a lot about COPD that people don’t know. As the name suggests, COPD is a chronic obstruction of the lungs. Lung obstruction means you have trouble breathing. In healthy lungs, airways and air sacs are elastic or stretchy. When breathing in, each air sac fills up with air like a small balloon. When breathing out, the air sacs deflate and the air goes out. For people with COPD, less air flows in and out of the airways because of one or more of the following: Either the airways and air sacs lose their elastic quality; or the walls between many of the air sacs are destroyed; or the walls of the airways become thick and inflamed; or the airways make more mucus than usual, which can clog them.

The easiest way to understand how a person with COPD feels is to try breathing through a straw. COPD is sometimes also called Emphysema or Chronic Bronchitis. Both of these obstruct the lungs, but they do it differently. In emphysema, the walls between the air sacs are destroyed, and the air sacs lose their shape. This means the lungs don’t work like they should. In chronic bronchitis, the airway lining becomes swollen and inflamed, and a lot of mucus is produced. Most people have a combination of both emphysema and chronic bronchitis. COPD is a slowly progressing disease and often people don’t realize they have it until it’s already severe. As the disease gets worse, symptoms usually become more severe. And when symptoms are mild, they may not be noticed right away and people may adjust their lifestyle to make breathing easier.

For example, taking the elevator instead of the stairs or resting more often. Symptoms of COPD include shortness of breath or breathlessness, excess mucus production, wheezing, and a constant cough, which is sometimes called a smoker’s cough. Often people think these are signs of aging or being out of shape. However, extreme shortness of breath is not usually a sign of typical aging. If COPD is left untreated, it can lead to severe limitations to quality of life.

But COPD is highly treatable and when managed properly, symptoms can be greatly relieved and those with COPD can enjoy an improved quality of life. That’s why it is important to learn about the signs and symptoms so we can recognize them early and talk to a health care professional to find ways to manage it.  You can learn more about COPD on our website at COPD.nhlbi.nih.gov.

What is COPD/KOL?

Erin Russell

Hello, in this HealthSketch we want to talk to you about COPD. COPD stands for Chronic Obstructive Pulmonary Disease. It’s a bit of a mouthful, but it makes sense when you break it down. ‘Chronic’ describes how it doesn’t go away ‘Obstructive’ describes the way it makes breathing difficult, and ‘Pulmonary disease’ means it affects the lungs. Around the world, COPD is becoming more common it’s now the third highest cause of all deaths. The true number of people with COPD is likely to be much higher, as many people don’t know they have the condition.

An early diagnosis is important, so that treatment can be started to slow down the damage to the lungs. Most of the time, smoking is the cause of COPD, as particles from tobacco smoke inflame and irritate the lungs. So stopping smoking is the best thing smokers can do. However, COPD does occur in non­smokers too. Polluted environments and rare genetic diseases can also lead to the disease. But what exactly is COPD? First let’s see how the lungs work. The lungs are a spongy network of airways and air­sacs. When we breathe in, air travels down branching airways, which become smaller and smaller, ending up in tiny air­sacs.

In these air­sacs, oxygen from the air moves into the blood, and carbon dioxide moves out. In COPD, inflammation over time causes permanent damage to the airways and air­sacs of the lungs. The airways become inflamed, swollen and filled with mucus, obstructing the flow of air The air­sacs lose their structure and sponginess, so they can’t fill and empty as easily, making the exchange of oxygen and carbon dioxide difficult. These lung changes cause the key symptoms of COPD: breathlessness, wheeze, cough and phlegm. The symptoms worsen gradually over time, making daily activities harder. You should see your doctor if you have these symptoms, as early treatment of COPD/KOL can make a big difference. So how is COPD diagnosed and treated? After checking your symptoms, doctors can arrange breathing tests to see how hard and how fast you can blow out air from your lungs.

If you are found to have COPD, doctors will recommend the most appropriate treatment to help with symptoms and control the disease. For smokers, stopping smoking is the single most effective thing to do. Inhalers (which come in many forms) will be started, and contain medicines which help expand the airways and reduce inflammation. Using an inhaler can be tricky, but correct technique is essential for the medicine to be effective. Nurses, doctors and pharmacists can all help to teach the right way to use an inhaler. Also, people with COPD should get vaccinations to help prevent chest infections, and regular check ups to see how overall treatment is working. Treatment may be ‘stepped up’ according to your needs, and other medications may be prescribed as well.

Sometimes, people with COPD have episodes of severe breathlessness called ‘exacerbations’. Exacerbations can be triggered by infections, cold weather or other irritants. It’s important to recognise these ‘flare ups’ as the earlier treatment is given, the less likely symptoms will get worse. Antibiotics and steroids are often used, and sometimes oxygen therapy is needed. In severe cases, a stay in hospital may be required, but in milder cases, treatment can but in milder cases, treatment can be given effectively at home. Besides medication, there are many other ways to improve COPD symptoms. A ‘Pulmonary Rehabilitation Programme’ is a great way to get education and support, tailored to your needs, and it has been proven to be one of the best ways of improving quality of life. A programme may include: Chest physiotherapy to help overcome breathlessness and manage phlegm.

Regular light exercise. Nutritional advice, as weight loss is common in COPD. Counselling – to help stay motivated when feeling low or anxious. Support groups – to connect with others with the same experiences, questions and feelings Remember, stopping smoking will make the biggest difference, and it’s never too late to quit. This can be challenging, but local stop smoking services are available, and smokers are much more likely to quit with their support.

Nicotine replacement and other medications can reduce the urge to smoke, and have been proven to be effective. In this HealthSketch, we’ve talked about what COPD is and its causes; its key symptoms and treatments; and the lifestyles changes that can make a big difference. We hope this HealthSketch about COPD has been helpful for you and those around you. HealthSketch ­ ‘Health for all to see’ .