Patient education: Chronic obstructive pulmonary disease (COPD) (The Basics)

What is COPD? — COPD is a lung disease that makes it hard to breathe. In people with COPD, the airways (the branching tubes that carry air within the lungs) become narrow and can be clogged with mucus. The air sacs can also become damaged (figure 1). This makes people feel out of breath and tired.

COPD can be a serious illness. It cannot be cured and can get worse over time. But there are treatments that can help.

You might have heard COPD called "chronic bronchitis" or "emphysema." These are types of COPD.

What causes COPD? — The most common cause of COPD is smoking. Smoke can damage the lungs forever and cause COPD. People can also get COPD from breathing in toxic fumes or gases. In rare cases, COPD is caused by a genetic problem. A blood test can check for this.

What are the symptoms of COPD? — At first, COPD often causes no symptoms. As it gets worse it can make you:

●Feel short of breath, especially when you are moving around

●Wheeze (make a whistling or squeaking noise as you breathe)

●Cough and spit up sputum (mucus)

People who have COPD are also at increased risk for:

●Infections, such as pneumonia

●Lung cancer

●Heart problems

Is there a test for COPD? — Yes. Your doctor or nurse can give you a test called "spirometry" to check for COPD. During spirometry, you take a deep breath and then blow out as fast and hard as you can into a tube. A machine connected to the tube measures how much air you can blow out of your lungs and how fast you can blow.

If the results of your spirometry are not normal, you will get a medicine in an inhaler to see if your breathing gets better. Then after a few minutes, you will repeat the spirometry. This will help the doctor or nurse find out if your problem is caused by COPD or another lung problem, such as asthma. People with asthma usually get normal results after they use an inhaler. People with COPD often do not.

Will I need other tests? — Your doctor might order other tests, too. These can check to see if other problems besides COPD might be causing your symptoms. They can also look for some of the problems that COPD can lead to. Tests you might get include:

●A blood test – This can check for a genetic problem called "antitrypsin deficiency" that can cause early COPD in people who smoke.

●A chest X-ray

●An electrocardiogram (also called an "ECG") – This test measures the electrical activity in your heart.

●A low-dose CT scan – This is an imaging test used to screen for lung cancer. (Imaging tests create pictures of the inside of the body.) Your doctor or nurse might suggest lung cancer screening depending on your age, how much you have smoked in the past, and whether you still smoke.

How is COPD treated? — There are 4 main types of treatment for COPD:

●Medicines – There are a lot of medicines to treat COPD. Most people use inhalers that help open up their airways or decrease swelling in the airways. Often people need more than 1 inhaler at a time. You might need to take a steroid medicine in a pill for a COPD "flare." A flare is when symptoms suddenly, but temporarily, get worse.

●Oxygen – If the disease gets worse, you might need to use oxygen. Your doctor or nurse can test your blood oxygen to see if you need this.

●Pulmonary rehab – In pulmonary rehab, you learn to improve your symptoms in new ways. You learn exercises and ways to breathe that can help ease symptoms. Even if you don't do a pulmonary rehab program, staying active can help your breathing.

●Surgery and endobronchial valves – Rarely, people with the emphysema type of severe COPD will need surgery. Surgery removes the most damaged parts of the lung. This surgery can reduce symptoms, but it does not always work.

Also rarely, doctors can place small "endobronchial valves" in the damaged airways. This can help shrink abnormal areas of lung and help the healthier parts of the lungs work better. The valves are placed using a thin tube that goes down your throat, called a "bronchoscope."

Is there anything I can do on my own? — Yes. To take care of yourself, you can:

●Avoid smoking – Quitting smoking is the most important thing that you can do for your health. This is true no matter how long you have smoked or how much you smoke. If you are having trouble quitting, your doctor or nurse can help.

●Avoid triggers – If things like fumes, pollution, or dust make your breathing worse, try to avoid them.

●Lower your risk of infection – Certain infections can be very hard on your lungs and can cause COPD symptoms to flare up. You can lower your risk by getting certain vaccines. These include the flu shot every year, the pneumonia vaccine at least once, and the COVID-19 vaccine and boosters.

In addition, wash your hands often and stay away from people who are sick. Wearing a face mask in crowded places can also help lower your risk of infection.

●Make healthy lifestyle changes – Eating a healthy diet can help improve your health. You can also improve your health by following your pulmonary rehab plan if you have one, or finding other ways to move your body.

When should I call the doctor? — Call for an ambulance (in the US and Canada, call 9-1-1) if:

●You are having trouble breathing, even when you are resting.

●You are coughing up blood.

●You have signs of a heart attack, such as:

•Severe chest pain, pressure, or discomfort with:

-Trouble breathing, sweating, upset stomach, or cold clammy skin

-Pain in your arms, back, or jaw

-Worse pain with activity like walking up stairs

•Fast or irregular heartbeat

•Feeling dizzy, faint, or weak

Call your regular doctor for advice if:

●You have a fever of 100.4°F (38°C) or higher or chills.

●You are feeling weak or more short of breath than usual when doing your normal activities.

●You have new or worsening cough, wheezing, sputum, or shortness of breath.

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Patient education: Cough in adults (The Basics)
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Patient education: Medicines for chronic obstructive pulmonary disease (COPD) (The Basics)
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Patient education: Lung cancer screening (The Basics)
Patient education: Inhaled corticosteroid medicines (The Basics)
Patient education: Pulmonary rehabilitation (The Basics)

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