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COPD is a progressive disease that includes chronic bronchitis and emphysema, with smoking being a primary cause. COPD is the fourth leading cause of death in the US, with symptoms including coughing, shortness of breath, and difficulty performing daily activities. Treatment includes smoking cessation, inhaled steroids, and oxygen as needed. Experimental treatments, such as lung transplants and lung removal, may be effective but are often not covered by insurance.
Chronic obstructive pulmonary disease (COPD) refers to two progressive diseases that both may be present, or each may be present on its own. These diseases are chronic bronchitis and emphysema. Both result in a high mortality rate, as they cause airway obstruction that continues to deteriorate. Smoking is a primary cause of both types of COPD, and quitting significantly reduces the risk of COPD of one or both types.
COPD is currently the fourth leading cause of death in the United States, accounting for over 100,000 deaths annually. It can also significantly affect quality of life by limiting activity, causing an inability to tolerate oxygen, and furthermore requiring people to use oxygen when the disease has progressed.
Scarring of the bronchi leads to chronic bronchitis. This scar results in airway restriction, which causes people to produce more phlegm, causing further restriction. Those with chronic bronchitis usually have a constant cough for three months of the year, two years in a row. Bronchoscopy, a tube placed down the throat to look at the bronchial tubes, confirms the diagnosis.
Treatment of COPD resulting from chronic bronchitis includes smoking cessation, asthma medications, and the use of inhaled steroids such as Pulmocort to help calm swelling. Despite these treatments, the disease often progresses to the point where these treatments no longer provide adequate airways. Death from COPD caused by bronchitis is usually related to bacterial infections that cannot be resolved with antibiotics.
Emphysema and COPD are often thought of as the same thing. Emphysema is caused by the gradual destruction of portions of the lungs called the alveoli. As more alveoli are cleared, the lungs become less able to oxygenate the blood flowing to them, resulting in more difficulty breathing and a lower than normal blood oxygen count.
Symptoms of this form of COPD include a persistent cough, inability to perform strenuous exercise, and shortness of breath. As emphysema-type COPD progresses, symptoms will include extremely labored breathing and the inability to perform even normal household activities without exhaustion. Pulmonary function tests diagnose emphysema and can also suggest the progress of the disease.
In most cases, emphysema is caused by smoking or exposure to secondhand smoke. In some cases, however, an inherited disease can cause emphysema. This disease means that the body lacks an essential protein that protects the alveoli.
In all cases of emphysema-related COPD, treatment includes inhaled steroids, oxygen as needed, and continuous monitoring of airway function. Smoking cessation is essential. Continuing to smoke will only aggravate the symptoms and make them progress more quickly.
Some recent treatments for emphysema include lung transplants and also the removal of part of the lungs, which appears to restore strength and function to the remaining air sacs. However, because COPD is often linked to smoking, some insurers and the US Medicare Service will not pay for such treatment.
Since this is the case, many with COPD could be helped, but lack the funds to pay for experimental treatments. Some in the health care profession believe that smokers, fully aware of the risks, are essentially risking these risks and must pay the consequences. Conversely, others believe that, like many other addictive diseases, those who have been unable to overcome nicotine addiction should not be punished by death.
