Chronic obstructive pulmonary disease (COPD) is a disease of the respiratory system causing damage to the lungs and bronchial tubes.  It encompasses two related diseases called emphysema and chronic bronchitis.  

COPD is the fourth leading cause of death in the U.S.  By far, the major risk factor for developing COPD is smoking.  Long-term smoking leads to eighty to ninety percent of COPD deaths.  

Environmental factors such as pollution may contribute to the development of COPD; occupational exposure, such as with coal mining, grain handlers, metal molders and other workers exposed to excessive dust also contribute.  Some cases are caused by a genetic disorder (alpha 1-antitrypsin deficiency).  

The bronchial tubes contain special cells that make mucus.  The purpose of the mucus is to protect the lining and to trap material that may be inhaled into the lungs.  Other specialized cells have tiny hairs that move the mucus and other material up and out of the respiratory tract.  

Over time, inhaled irritants such as cigarette smoke will damage these cells and impair the respiratory tract’s ability to expel noxious substances.  Individuals with COPD are therefore at risk for getting more complicated respiratory infections.

Emphysema mainly affects the lung tissue itself.  The lungs are responsible for getting oxygen into the blood stream and getting rid of carbon dioxide.  This is accomplished in millions of very small air sacs (alveoli) within each lung.  In emphysema, the air sacs are damaged and lose their elasticity.  They do not function properly to exchange the gases.

Individuals with emphysema experience shortness of breath due to lack of oxygen.  They may also have a chronic cough due to the damage within the lungs.  Hereditary deficiency of a protein called alpha 1-antitrysin leads to a hereditary form of emphysema.

Chronic bronchitis affects the bronchi or breathing tubes.  There is inflammation and thickening of the lining of the bronchial tubes.  These changes make it more difficult to move air in and out of the respiratory system.  The affected individual experiences chronic coughing and lots of phlegm production in addition to feeling short-winded.

The end result of both these diseases is a decrease in the ability to get oxygen into the body.  Without proper oxygen, vital organs, particularly the heart, will be damaged over time.  

There is no cure for COPD.  However, there are treatments that can reduce the symptoms.  Bronchodilators help to open up the narrow breathing tubes.  Anti-inflammatory medicines (steroids) reduce the inflammation of the bronchial lining.  

If the blood oxygen levels are very low, some individuals will need supplemental oxygen.  This is usually administered via an oxygen tank and a nasal device through which the person breaths extra oxygen.

As you can probably guess, prevention is the best medicine in COPD; that is, don’t smoke.

If you’ve just started smoking, stop now and your chances of getting COPD will be greatly reduced.  If you’ve been smoking for years, but haven’t had symptoms of COPD, quitting now may still reduce your chance of developing COPD.

If you have COPD, there are things that you can do each day to help manage the disease.  Quit smoking if you are still smoking!  Avoid exposure to dusts, fumes, pollution and smoke.  Avoid excess heat and cold.  Limit exposure to people with respiratory infections (colds & flu).  Drink plenty of fluids and eat a healthy, well-balanced diet. 

Follow your physician’s instructions on activity and exercise and take your medications as prescribed.

The content in this column is for informational purposes only.  Consult your physician for appropriate individual treatment.  Dr. Reynolds practices Family Medicine in Chesterfield.


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