What Exactly is COPD?
COPD stands for Chronic Obstructive Pulmonary Disease. It is a disease of the lungs that causes obstructed airflow. Common symptoms of COPD are a cough, wheezing, shortness of breath, chest tightness and excess mucus production to name a few. COPD is an umbrella term for Chronic Bronchitis and Emphysema which are the two most common types of COPD. It is not uncommon for people with a COPD diagnosis to have a combination of both chronic bronchitis and emphysema. But what exactly are they?
Chronic bronchitis occurs when there is increased inflammation and mucus production in the lungs. It causes a chronic productive cough and difficulty breathing along with wheezing. The difference between acute and chronic bronchitis is that the chronic form keeps coming back or never fully goes away completely. Smoking is the leading cause of chronic bronchitis, however other exposures to environmental fumes, pollution, dust or harsh chemicals can also lead to the diagnosis. Chronic bronchitis is diagnosed via physical exam and medical history, pulmonary function testing (PFT’s) and chest X-ray. A high-resolution chest CT scan can also be done to more accurately get a picture of your lungs and any possible damage.
Emphysema is a gradually progressive disease which causes shortness of breath. In emphysema, the tiny air sacs, called alveoli in the lungs (where oxygenation occurs) become damaged. The linings of these air sacs weaken and can burst, which can lead to air pockets where air can get trapped, making it difficult to breathe. The tissue (known as bronchioles) that holds these smaller airways open allowing you to exhale, however when the bronchioles are damaged it causes them to collapse causing air trapping. A good way to imagine what emphysema does is to think of a kitchen sponge. At first, when the sponge is new, the holes are small and the sponge is firm but squishy and elastic. This is what a healthy person’s alveoli are like. With emphysema, imagine the sponge after it has been used for a very long time, the holes are large and the sponge is no longer “spongy” and has lost its elasticity. To diagnose emphysema, your doctor will perform a physical exam, go over your medical history along with a few tests. A chest x-ray will show if your lungs are hyper inflated, and a high resolution chest CT scan will show if the alveoli are damaged. In some cases, an arterial blood gas (blood test with blood from an artery-usually the wrist) is done to see how well your lungs exchange oxygen and expel carbon dioxide. A PFT is also often times done to measure your lung volumes as well as well as airflow.
The treatment for both chronic bronchitis and emphysema are treated with medications (bronchodilators and steroids), oxygen when indicated, Pulmonary rehab, and self-care. While COPD is an incurable progressive disease, with the proper treatment the progression can be slowed. Having an aggressive medical team is also important to help you stay on top of things so you can lead the best life possible.
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