COPD: Causes & Symptoms

As the name suggests, COPD, or chronic obstructive pulmonary disease, blocks the flow of air into and out of the lungs. This group of lifelong ailments includes emphysema, chronic bronchitis and severe asthma that doesn't respond to treatment (called refractory asthma). According to the National Heart Lung and Blood Institute, about 16 million people in the U.S. have been diagnosed with COPD and many more millions likely have it and don't know it.

Smoking is the cause of many cases of chronic obstructive pulmonary disease. Many people with COPD, in fact, have smoked at least 20 cigarettes a day for 20 or more years. But one in six people with COPD have never smoked.

What Causes COPD Other Than Smoking?

Most cases of COPD are related to smoking or inhaling secondhand smoke. In response to the smoke, the lungs produce mucus, which eventually becomes so thick that it hampers breathing. In patients with COPD, smoking scars lung tissue and makes it easier for infections to settle in. Over time, smoking also damages the air sacs in the lungs. The air sacs normally expand and contract like balloons, moving air in and out of the lungs. But with COPD, they lose their elasticity and can't work properly, making it hard to breathe. However, you can get COPD without smoking. Other factors can also increase the likelihood of developing these lung diseases.

Other causes of COPD besides smoking include:

Pollutants

Exposure to air pollutants such as industrial chemicals, fumes and dust in the workplace over a long period of time can compromise lung health. Other substances that irritate the lungs, like air pollution, dust, or industrial chemicals, may also contribute to COPD.

But COPD can strike people who never smoked or inhaled air pollutants. That's probably due to another factor: genetics.

Genetics

The genes you inherit from your family can make you more likely to develop certain diseases, including COPD. So far, researchers have pinpointed a variation in one specific gene (alpha-1 antitrypsin) that can cause a deficiency.

This gene abnormality can cause lung damage and emphysema, even without smoking or breathing irritants. If COPD runs in your family, consider genetic testing for the alpha-1 antitrypsin anomaly.

But besides the alpha-1 gene, there may be more than 100 genetic differences that can make you more susceptible to COPD. The more of these gene variations you have, the higher your risk.

What Are Symptoms Of COPD?

COPD symptoms may start as a nagging cough or feeling short of breath during your regular activities. Since COPD symptoms most often appear after the age of 40, you might be tempted to chalk it up to getting older. But these symptoms aren't a normal part of aging. Lung disease symptoms typically creep up over time. 

Symptoms of COPD include:

• Shortness of breath
• Constant and ongoing cough
• Wheezing
• Tightness in chest
• Frequent respiratory infections
• Lack of energy
• Unintended weight loss
• Shortness of breath, especially with mild exercise
• Blueness of the lips or fingernails (cyanosis)
• Chronic cough with mucus

People with COPD are also likely to have periods when their symptoms worsen and persist for days or longer, called exacerbations.

Although there is no cure for chronic pulmonary obstructive disease, COPD symptoms can be treated, and your quality of life can be improved. The first step is to stop smoking and to avoid any environments with smoke or air pollutants. Additional lifestyle changes, including healthy eating, regular exercising and controlling stress, are recommended.

If you have any COPD symptoms or risk factors such as smoking or poor workplace air quality, talk to your family doctor. Your doctor may recommend you see a pulmonologist, a doctor who specializes in lung health or pulmonary medicine.

How Is COPD Diagnosed?

A simple breathing test called spirometry can help doctors diagnose COPD. The earlier you find out that you have chronic obstructive pulmonary disease, the sooner you can start treatment to slow the progression of the disease.

How Is COPD Treated?

While there currently isn't a cure for COPD, there are many options available to treat COPD and prevent its symptoms. COPD medications can prevent flare-ups as well as quickly open up airways when it feels difficult to breathe.

Your doctor may prescribe medications such as bronchodilators, anti-inflammatory drugs, steroids, oxygen, theophylline, phosphodiesterase-4 inhibitors and antibiotics. Finally, there are other therapies such as supplemental oxygen therapy and pulmonary rehabilitation.

These medications are delivered through a fine mist that you inhale, using either:

• Inhaler - a device that sprays the medication in your mouth
• Nebulizer - a machine that turns liquid medicine into a mist you inhale through a face mask

People living with COPD can also take steps at home to maintain optimal health, including:

• Stop smoking
• Exercise regularly
• Maintain a healthy weight
• Get flu and pneumonia shots

Participating in a pulmonary rehabilitation program can also improve quality of life. These programs give you a better understanding of the illness and help you adjust to living with the disease. Pulmonary rehabilitation specialists provide tips on breathing techniques, safe ways to exercise, proper nutrition and how to cope with anxiety.