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Chronic obstructive pulmonary disease - Introduction
- Highlights
- Introduction
- Causes
- Symptoms
- Diseases with Similar Symptoms
- Complications
- Risk Factors
- Diagnostic Tests
- Treatment
- Medications
- Oxygen-Replacement Therapy
- Lifestyle Changes
- Surgical Procedures
Description
An in-depth report on the causes, diagnosis, treatment, and prevention of COPD -- emphysema and/or chronic bronchitis.Alternative Names
COPD; Alpha-1 antitrypsin deficiency; Bronchitis - chronic; Chronic bronchitis; Emphysema
Introduction:
Chronic obstructive pulmonary disease (COPD) is a condition in which there is limited airflow in the lungs. The disease develops and worsens over time. COPD is not reversible, but therapy can slow its progress.
Although patients can breathe in normally, changes in the small airways cause the walls to narrow during expiration, making it hard to breathe out. In many patients with COPD, the small sacs where oxygen and carbon dioxide are exchanged are destroyed, gradually starving the body of oxygen.
COPD is associated with a set of breathing-related symptoms:
- Being out of breath, at first when doing physical activities, but as lung function deteriorates, also at rest
- Chronic cough
- Spitting or coughing mucus (phlegm)
The ability to exhale (breathe out) gets worse over time.
The two major diseases in this category are emphysema and chronic bronchitis, both covered in this report. The third, less common disease, is obstructive bronchiolitis, an inflammatory condition of the small airways. Asthma shares some of the same symptoms, but is a very different disease. People can have asthma and COPD at the same time. [See In-Depth Report #4: Asthma in adults.]
Because smoking is the most common cause of both emphysema and chronic bronchitis, these conditions often develop together and frequently require similar treatments and approaches. When chronic bronchitis occurs together with emphysema, it is often difficult for a physician to distinguish between the two diseases.
Emphysema
Emphysema is a disease in which the alveoli, grape-like clusters of air sacs at the end of the smallest airways (the bronchioles) are destroyed. It generally takes the following course:
- The walls of the alveoli become inflamed and damaged. Over time they lose the ability to stretch and shrink (elasticity), and pockets of dead air (called bullae) form in the injured areas.
- The pockets interfere with the normal working of the lungs by narrowing the airways, trapping air, and making breathing out more difficult.
- The ability to breathe in is not affected. Until the late stages of the disease, oxygen and carbon dioxide levels remain normal.
Click the icon to see an image of emphysema.
Chronic Bronchitis
Chronic bronchitis is defined as coughing and excess mucus production that occurs for at least 3 months, during at least 2 consecutive years. In chronic bronchitis, the disease process generally has the following characteristics:
- Inflammation of the bronchial tubes (from smoking, air pollution, etc.) causes the production of mucus, which clogs the airways and makes breathing difficult.
- The mucus is cleared through coughing. Both constant coughing and inflammation can damage the bronchial tubes. The tubes swell and thicken, leaving less room for air flow.
Click the icon to see an image of bronchitis.
The Lungs
The lungs are two spongy organs surrounded by a thin, moist membrane called the pleura. Each lung is made up of smooth, shiny lobes. The right lung has three lobes, and the left has two. About 90% of the lung is filled with air; only 10% is solid tissue.
When a person inhales, air travels through the following pathways into the lungs:
- Air is carried from the windpipe (trachea) into the lung through flexible airways called bronchi.
- Like the branches of a tree, bronchi divide into more than a million smaller airways called bronchioles.
- The bronchioles lead to grape-like clusters of microscopic sacs called alveoli.
- In each adult lung there are millions of these tiny alveoli. The thin membrane of the alveoli allows oxygen and carbon dioxide to pass to and from capillaries.
- When the person breathes in deeply, the elastic alveoli unfold and unwind to allow this exchange of gases to occur.
Capillaries, the smallest of the blood vessels, carry blood throughout the body. Red blood cells carry oxygen throughout the body, and return carbon dioxide to the lungs. White blood cells are the critical infection fighters in the body.
Click the icon to see an image of normal lungs.
Resources
- www.lungusa.org -- American Lung Association
- www.nhlbi.nih.gov -- National Heart, Lung, and Blood Institute
- www.aarc.org -- American Association for Respiratory Care
- www.njc.org -- National Jewish Medical and Research Center
- www.alpha1.org -- Alpha1 National Association
- www.emphysemafoundation.org -- The National Emphysema Foundation
- www.nlhep.org -- National Lung Health Education Program
- www.thoracic.org -- American Thoracic Society
- www.sts.org -- Society of Thoracic Surgeons
- www.unos.org -- United Network for Organ Sharing
- www.copd-international.com -- COPD International (patient support site)
References
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- Reviewed last on: 4/20/2009
- Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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