Chronic obstructive pulmonary disease, or COPD, is a chronic, progressive lung disease that is characterized by shortness of breath and can be associated with coughing and wheezing and chest tightness or discomfort. While these symptoms are seen in other lung conditions, identifying COPD as the cause and starting treatment can help prevent disease progression and maintain quality of life.
COPD is a major cause of disability in the United States, and the third-leading cause of death. Twelve million American’s have been diagnosed with COPD and experts estimate that just as many are living with symptoms but are undiagnosed.
Asthma vs. COPD
“The majority of patients with COPD are active or former smokers. These patients usually have chronic bronchitis or emphysema. Many patients with emphysema require supplemental oxygen. Many asthmatics who have never smoked can also have chronic airflow obstruction on breathing tests and be classified as having COPD,” explained Dr. Kimberly McCrea of Novant Health Pulmonary and Critical Care. While this can be confusing, there are some key differences between asthma and COPD:
When it starts. Asthma is a common disease in childhood but can be diagnosed at any age. COPD due to tobacco smoking usually doesn’t usually affect patients younger than age 40. “Many children will outgrow the worst of their asthma symptoms by the time they reach adulthood. COPD is caused by chronic exposure to noxious gases and particles (usually tobacco smoke), leading to slowly progressive and abnormal inflammation in the lungs, and symptoms are often not noticed until later in life” said McCrea. “Very rarely, a genetic condition, Alpha-1 Antitrypsin Deficiency, can cause emphysema in younger patients.”
Pattern of symptoms. With asthma, symptoms are often intermittent. Patients often feel fine for long periods of time until they encounter a trigger that sets off an attack. COPD patients often experience symptoms continually. “Many of our patients have shortness of breath with everyday activities or find that they cannot exercise. Fortunately, we have many treatments that can help reduce symptoms and improve quality of life,” said McCrea.
How the lungs are affected. Both asthma and COPD are caused by inflammation in the lungs but the inflammation in asthma tends to affect just the airways and can be reversible. In COPD, the airways are remodeled by inflammation and lung tissue is destroyed, causing irreversible damage and placing patients with COPD at increased risk for lung cancer.
Treatment for COPD
Currently, there is no cure for COPD, but lifestyle changes and medications can help lessen symptoms and slow the progression of the disease.
“If you have been diagnosed with COPD, smoking cessation is the most important thing you can do to slow the progression of disease, alleviate symptoms and reduce your risk for lung cancer and other diseases, such as stroke and cardiovascular disease,” McCrea said. “Stopping smoking is a tremendous challenge for many, but your doctor can help you find the support and resources you need, including medication to help you quit. Quitting smoking is a lifestyle change that will not only help your breathing but also will enhance your overall health and life expectancy.”
It is also important to maintain a proper diet and activity level, even as COPD progresses, McCrea noted.
“It’s very common for patients with COPD to experience fatigue and shortness of breath that make it difficult to do all of the activities they once enjoyed, but I encourage my patients to be as active as they can,” said McCrea. “Physical activity can strengthen the muscles that help you breathe and improve your overall wellness.”
McCrea also added that common illnesses, such as the flu, can exacerbate COPD symptoms, and she urges patients to get a flu shot every year and to wash hands frequently to prevent illness.
There are medications available that can help manage COPD symptoms. Bronchodilators – usually inhalers – relax the muscles around the airways and help make breathing easier. These medications can either be long or short acting and can be used every day or as needed. Some medications are used to treat inflammation and include inhaled and oral steroids.
Oxygen therapy is also an option for some patients with advanced symptoms who experience low blood-oxygen levels. Supplemental oxygen – administered either all the time or during certain activities – can help patients be more active, sleep better and protect the heart and other organs from damage due to low oxygen levels. In the most advanced cases, lung reduction surgery or lung transplantation performed at specialized medical centers may be considered.
Many physicians recommend that patients with COPD participate in a pulmonary rehabilitation program. These programs are designed to improve patient well-being, and may include an exercise program, disease management training and/or nutritional and psychological counseling.
“More than just treating COPD symptoms with medicine, we want to teach our patients how to live with their condition, so they can stay active, avoid hospitalization and have the best quality of life possible,” said McCrea. “Novant Health’s Pulmonary Rehabilitation program has been a tremendous asset in the treatment of our patients, and some of my most skeptical patients have come out of the program with not only improvement in their exercise tolerance but also a more positive outlook.”