Chronic Obstructive Pulmonary Disease (COPD)

Chronic Obstructive Pulmonary Disease (COPD) Is the fourth leading cause of death in the United States. However, it is one of the most preventable diseases. As many as 24 million U.S. adults have evidence of impaired lung function, indicating an under diagnosis of chronic obstructive pulmonary disease (COPD), reports the American Lung Association. The U.S. COPD Coalition reports that Tennessee is one of the states experiencing high death rates from COPD.

COPD is a term used to describe several progressive lung diseases. Although emphysema and chronic bronchitis are the most common forms of COPD, other lung diseases include refractory asthma and severe bronchiectasis. COPD causes airflow blockage and breathing-related problems.

“COPD claims the lives of more than 120,000 Americans every year,” said Dr. James Shamiyeh, a UT Medical Center pulmonologist. “Smoking is the primary risk factor for COPD, but several other environmental and hereditary factors also can put someone at risk. There are so many people out there who don’t even realize they suffer from COPD and, therefore, aren't being treated for it. I’d strongly encourage everyone to take advantage of lung function screenings.”

COPD Risks

Smoking is the leading cause of COPD. The more a person smokes, the more likely that person will develop COPD although some people smoke for years and never get COPD.  A smoker is approximately three times more likely to have COPD than a non-smoker. And, as much as 20 percent of long-term smokers will develop COPD. Quitting smoking is the best way to prevent COPD, or if you already have been diagnosed, stop smoking immediately and it may slow down the disease’s progression.

Other risk factors for COPD are:

  • Exposure to certain gases or fumes in the workplace
  • Exposure to heavy amounts of secondhand smoke and pollution
  • Frequent use of cooking gas without proper ventilation

COPD Symptoms

Although there is no cure for COPD, early detection is important in order to receive proper treatment, which can slow the progression of the disease as well as treat many of the symptoms. The severity of symptoms is based on how much damage there has been to the lungs. The primary symptom of COPD is difficulty breathing due to airway obstruction of various causes. However, other COPD symptoms include the following.

  • Shortness of breath (dyspnea) that gets worse with mild activity
  • Wheezing
  • Decreased exercise tolerance
  • Coughing with or without phlegm
  • Chest tightness

COPD Treatment Options

Treatment of COPD begins with a thorough evaluation from your doctor. He may order a chest X-ray, chest CT Scan, blood samples, pulmonary function testing or any combination of these. Your doctor also will tell you to stop smoking immediately.

COPD treatments are used to relieve symptoms, slow disease progression, improve overall health and quality of life, prevent and treat complications and improve activity levels. COPD patients may require the use of inhalers to dilate the airways. Oral medication may be used to prevent and treat wheezing, shortness of breath and difficulty breathing by relaxing and opening the air passages. Respiratory infections should be treated with antibiotics, and some patients may require supplemental oxygen.

Lastly, pulmonary rehabilitation can be beneficial to almost anyone with lung problems. Rehabilitation includes exercise training and education/counseling. The rehabilitation team teaches the participant how to cope with lung problems and deal with fears about the future. Pulmonary rehabilitation is a safe and effective way to help the participant feel better faster, become stronger, reduce stress and improve overall quality of life.

What to Expect at Your Doctor's Office

Your health care provider will take a detailed medical history and perform a physical examination.

You may be asked the following medical history questions:

  • Do you notice shortness of breath?
  • Do you make grunting sounds while breathing?
  • Do you have to work hard to breathe?
  • How long have you had breathing difficulty?
  • Did it slowly progress over weeks to months?
  • Did it begin recently?
  • Did it begin suddenly?
  • Did it come on slowly (gradual onset)?
  • Is there a sequence of separate occurrences (episodes)? How long does each last, and does each episode have a similar pattern?
  • Has the breathing difficulty worsened recently?
  • Does breathing difficulty cause you to wake up at night (paroxysmal nocturnal dyspnea)?
  • Does the amount of breathing difficulty change (variable over hours)?
  • Does breathing difficulty occur at rest?
  • How long does each episode last?
  • Is it worse when you lie flat (orthopnea)?
  • Is it worse when you change body position?
  • Did it develop within 4 to 6 hours after exposure to something that you are or may be allergic to (antigen)?
  • Is it worse after exercise?
  • Does shortness of breath occur only when you are wheezing?
  • Is your breathing pattern irregular?
  • Do you draw back the chest muscles with breathing (intercostal retractions)?
  • What other symptoms do you have?

The physical examination will include a thorough check of your lungs, heart, and upper airway passages.

Tests that may be performed include the following:

  • Blood tests (may include arterial blood gases)
  • Measurement of blood oxygen saturation (pulse oximetry)
  • ECG
  • X-ray of the chest
  • Pulmonary function tests
  • Exercise testing
  • CT scan of the chest
  • Echocardiogram

In severe cases of difficulty breathing, hospitalization may be required. Many different medications aimed at treating the cause of breathing difficulty may be used.

If your blood oxygen level is very low, you may need to receive oxygen. High doses of supplemental oxygen may be hazardous for some patients, however. Oxygen is not necessary in all cases of shortness of breath.

Create a Friendlier Environment

Aside from professional treatment, there are things you can do in your environment and lifestyle that may help control some of your COPD symptoms.

  • Keep smoke and fumes out of your home and work environments.
  • Cook near an open window.
  • Wear loose clothing.
  • If your home must be painted or sprayed for bugs, do it when you can be away.
  • Keep windows closed when there is a lot of pollution or dust outside, including when riding in a car.
  • Climb stairs only when necessary.
  • If heating with wood or kerosene, keep a door or window open.
  • Ask for help when needed.

Early recognition and treatment are keys to slowing down the progress of COPD. If you smoke, stop immediately. If you suspect you have COPD symptoms, contact your doctor right away. Request an appointment today by calling 865.305.6970

Go to the emergency room or call the local emergency number (such as 911) if you have a rapid increase in shortness of breath. Click here for the online COPD Risk Assessment or to read the National Institutes of Health’s Key Points for COPD.