Chronic obstructive pulmonary disease (COPD) is a long-term inflammatory lung condition that obstructs airflow from the lungs. It causes difficulty breathing, coughing, mucus production, and wheezing. The disease is typically caused by prolonged exposure to irritating gases or particulate matter, most commonly from cigarette smoke. Individuals with COPD are at a higher risk of developing heart disease, lung cancer, and other health issues.

Emphysema and chronic bronchitis are the two primary conditions that contribute to COPD, often occurring together and varying in severity. Chronic bronchitis involves inflammation of the bronchial tubes, leading to persistent coughing and mucus production. Emphysema is characterized by the destruction of the alveoli, the small air sacs in the lungs, due to damaging exposure to smoke and other irritants.

While COPD is a progressive disease that worsens over time, it is treatable. With appropriate management, most people with COPD can achieve good symptom control and quality of life, and reduce the risk of associated conditions.

Symptoms

COPD symptoms typically do not appear until significant lung damage has occurred, and they usually worsen over time, especially if smoking continues. Common symptoms include:

• Shortness of breath, particularly during physical activities
• Wheezing
• Chest tightness
• Chronic cough producing clear, white, yellow, or greenish mucus
• Frequent respiratory infections
• Lack of energy
• Unintended weight loss (in later stages)
• Swelling in ankles, feet, or legs

People with COPD may also experience exacerbations, which are episodes where symptoms become significantly worse for several days.

When to See a Doctor

Consult your doctor if your symptoms are not improving with treatment, are worsening, or if you notice signs of an infection such as fever or changes in sputum. Seek immediate medical attention if you have difficulty breathing, severe blueness of your lips or fingernail beds (cyanosis), a rapid heartbeat, or confusion and trouble concentrating.

Causes

The primary cause of COPD in developed countries is tobacco smoking. In developing countries, it often results from exposure to fumes from burning fuel for cooking and heating in poorly ventilated homes. Not all chronic smokers develop COPD, suggesting genetic susceptibility plays a role.

How Your Lungs Are Affected

Air travels through your windpipe (trachea) into your lungs via large tubes (bronchi), which branch into smaller tubes (bronchioles) ending in tiny air sacs (alveoli). The alveoli have thin walls filled with blood vessels (capillaries) where oxygen enters the bloodstream and carbon dioxide is exhaled. COPD damages the elasticity of the bronchial tubes and alveoli, causing air to become trapped in the lungs.

Causes of Airway Obstruction

• Emphysema: Destruction of the alveoli walls and elastic fibers, causing airway collapse.
• Chronic Bronchitis: Inflammation and narrowing of the bronchial tubes with increased mucus production, leading to blocked airways and a chronic cough.

Irritants

COPD is mostly caused by long-term cigarette smoking. Other irritants include cigar smoke, secondhand smoke, pipe smoke, air pollution, and workplace exposure to dust, smoke, or fumes. Genetic factors, such as alpha-1-antitrypsin (AAt) deficiency, also contribute to COPD in some cases.

Risk Factors

Risk factors for COPD include:

• Long-term tobacco smoke exposure
• Asthma and smoking
• Occupational exposure to dust and chemicals
• Exposure to fumes from burning fuel in poorly ventilated homes
• Genetic factors, including alpha-1-antitrypsin deficiency

Complications

COPD can lead to several complications, such as:

• Respiratory infections
• Heart problems
• Lung cancer
• High blood pressure in lung arteries (pulmonary hypertension)
• Depression

Prevention

Preventing COPD involves avoiding its main cause—cigarette smoking. Quitting smoking can significantly reduce lung damage. Occupational exposure to lung irritants should be minimized with protective measures. Vaccinations against the flu and pneumococcal pneumonia can help prevent respiratory infections. If you experience depression, seek help from your doctor.

Conclusion

Managing COPD effectively involves lifestyle changes, medical treatments, and preventive measures to maintain a good quality of life and reduce complications. Quitting smoking and protecting your lungs from irritants are crucial steps in preventing and managing COPD.