Do you have a chronic cough or feel short of breath with simple activities? Have you been a smoker or worked around fumes? Do you know someone with COPD, emphysema, chronic bronchitis, or asthmatic bronchitis? Could you, like more than 10 million Americans suffer from one of these diseases?

What exactly is COPD?
COPD or “chronic obstructive pulmonary disease” is often used interchangeably with chronic bronchitis, emphysema, or asthmatic bronchitis. It is a condition in which the flow of air in the lung is limited due to lung destruction and chronic inflammation and spasm. It is most often caused by cigarette smoking but exposures at work or in the environment and second hand smoke contribute to some cases. In 1% of patients COPD is due to a rare genetic disease.

What are the symptoms of COPD?
Chronic cough, shortness of breath with activity, and wheezing are the most common symptoms. Sometimes people with even severe disease may not report symptoms. COPD starts out with minimal symptoms but can end with severe disability and often death! Patients may start out with only a mild morning cough. As the disease progresses patients may develop frequent episodes of bronchitis, and wheezing often confused with asthma. Shortness of breath with activity is often a sign of advanced disease.

How is it diagnosed?
Pulmonary function tests are the most accurate way to diagnose COPD. During testing, you simply have to breathe into a machine which measures the size of your lungs and bronchial air flow. It is a painless quick procedure that can diagnose the disease even before symptoms begin.

What can be done about COPD?
The most important steps are to diagnose the disease and stop ongoing lung damage. Often this means quitting smoking. There are medicines that can lessen the symptoms of cough, shortness of breath, wheezing, and decrease severe episodes of bronchitis. Lung rehabilitation programs provide education, support, and specific exercises for COPD patients. New medicines and even surgery are being studied. As more therapies become available, a lung specialist may help with complicated treatment decisions.

What can happen if the disease goes untreated?
COPD is the most common reason for hospitalization in the United States. It is the 4th leading cause of death in America with over 100,000 people dying every year. Patients are at higher risk of lung cancer. As COPD progresses and quality of life suffers, patients often develop depression. Patients with severe disease can develop severe malnutrition, heart disease and increased risk of hip fractures.

Summary:
COPD is an extremely common, progressive disease. If diagnosed early by pulmonary function testing it can be stopped even before symptoms develop. If symptoms develop there are treatments available; however, if left untreated it can lead to severe symptoms and even death. If you think you are at risk, ask your doctor about being tested or being referred to a lung specialist.

Christian B. Lloyd MD

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