COPD 101: What Is COPD?

COPD is an acronym for Chronic Obstructive Pulmonary Disease. It’s an umbrella term for lung diseases that cause persistent airflow limitation. Symptoms include coughing, sputum production, chest tightness, and shortness of breath. So, what is COPD? Here’s what to know.¹

The 2018 GOLD COPD Guidelines define COPD this way:

“COPD is a common, preventable and treatable disease that is characterized by persistent respiratory symptoms and airflow limitation that is due to airway and/or alveolar abnormalities usually caused by significant exposure to noxious particles or gases.”²

Allow me to dissect this definition, although not in the same order as they are noted in the above paragraph.

What causes COPD?

“...usually caused by significant exposure to noxious particles or gases.”

It’s usually caused by exposure to noxious substances in the air. In about 85-90% of cases the noxious substance inhaled is cigarette smoke. This includes both first and second hand smoke.³

Yet there are sometimes other causes. This includes air pollution in outdoor air. It also includes fumes, chemicals, and dusts in the air at your work.²

A rare genetic form of COPD is called alpha-1 antitrypsin deficiency. This is caused by a genetic defect on the alpha-1 gene. This affects 5% of people diagnosed with COPD.⁴

What is it?

“...airflow limitation due to airway and/or alveolar abnormalities…”

This basically describes chronic bronchitis and emphysema.

Chronic bronchitis affects airways. They become chronically inflamed. Over time, this can lead to airway scarring. This makes airway walls thicker than normal and increasingly narrow. This obstructs the flow of air through airways. Increased sputum, and loss of mechanisms for removing it, may further obstruct airways.^1-2

Emphysema affects air exchange units called alveoli. Like balloons, they expand when you inhale. But, they have a hard time closing when you exhale. This is because their walls become chronically inflamed and stiff. When they don’t close all the way, airway walls lose their support, so they collapse. So, this makes airway walls leading to them abnormally narrow. And this also acts to obstruct the flow of air through airways.^1-2

Obstructed airways cause airflow limitation. I define this in my post, “What is airflow limitation.” It is this that causes your symptom of shortness of breath.

What are characteristics?

“...characterized by persistent respiratory symptoms…”

The most common symptoms experienced are coughing, throat clearing, chest tightness, shortness of breath, and wheezing. One or more of these symptoms seem to always be there. Coughing is the earliest symptom experienced. Although most people with COPD experience some degree of shortness of breath even on good COPD days.

COPD is a gradually progressive disease. In the early stages, some people feel no symptoms at all. Others may experience throat clearing, coughing, and increased sputum production. This may explain COPD often goes undiagnosed in these early stages. In the later stages, it may progresses to increasing chest tightness, and shortness of breath.

Shortness of breath is usually what causes people to seek medical attention. It may increase so gradually that it’s brushed off to aging or being out of shape. It may occur only when you are exerting yourself, such when walking from room to room. Symptoms are also experienced differently from one person to the next.

What else to know?

“COPD is a common, preventable and treatable disease…”

• It’s common. It affects 12 million Americans. That comes to 6.7% of our population. It’s now the 3rd leading cause of death. Efforts to treat it are estimated to cost over $32 billion. Worldwide, 251 million people are diagnosed with COPD.^{2, 5-7}
• It’s preventable. Educational campaigns teach about the dangers of cigarette smoke, both first and second hand exposure. People who smoke are encouraged to quit. Efforts are ongoing to reduce outdoor air pollution. Efforts are also ongoing to reduce exposure to air pollution in work environments.
• It’s treatable. There are more proven treatments for COPD today than ever before. Learning what treatments are best for you begins by talking talking with your doctor.

What to make of this?

COPD is a gradually progressive disease. It causes symptoms that can impact the quality of your life. The good news is that this progression can be slowed and symptoms controlled. You can live a long life full of quality. This can only be accomplished by talking to a doctor and getting a proper diagnosis.