Health & Fitness

Once known as two separate conditions (emphysema and chronic bronchitis), COPD is a serious, disabling lung disease that makes breathing difficult.

Chronic obstructive pulmonary disease (COPD) is the fourth-leading cause of death in the United States and a significant cause of disability.
Most people are more familiar with the terms emphysema or chronic bronchitis, but COPD is the term doctors are using more today. "COPD is a term that the scientific and medical community is trying to get the public to recognize. It encompasses chronic bronchitis and emphysema. The reason we combined them is because they come from the same thing, mostly smoking, and they usually coexist," explains Norman Edelman, MD, chief medical officer for the American Lung Association in Washington, D.C.
COPD is a progressive disease, which means that it gets worse as time goes by if nothing is done to slow the course of the disease. While doctors cannot cure COPD or undo the damage to your lungs, changing your lifestyle (giving up smoking, staying physically active) and taking certain medications may help you remain active and healthy longer.
COPD: What Happens in Your Lungs
Changes in your airways and the air sacs in your lungs characterize COPD. These changes, which all reduce your ability to breathe easily, include:

• Less elasticity of the airways, so there is less expansion to make room for the air you breathe in
• Destruction of tissue walls between the air sacs (or alveoli) which means there is less ability to take in oxygen from air
• Swelling of your airways due to irritation of the lining
• Production of a greater amount of mucus, which then makes it harder to breathe

Emphysema is largely characterized by the destruction of the lung and air sac wall tissues, while chronic bronchitis results from inflamed or clogged airways. If you have a cough and a lot of mucus on most days for three months a year (at least) for two years in a row, you have chronic bronchitis. However, since both of these conditions occur together in the same person much of the time, they are now considered to be part of COPD.


The Timeline of COPD
For most people, COPD takes many years to become disabling. Unfortunately, says Dr. Edelman, many people do not talk to their doctor when they first become aware of the earliest signs and symptoms, such as shortness of breath. Many mistakenly believe this is a natural part of aging or slowing down, or they may think it doesn't matter because they are only feeling breathless during or after exercise. This is why many people don’t get diagnosed until COPD has progressed.
"We think anybody who is at risk for COPD — that is anybody who ever smoked — and anybody who is short of breath for any reason, even if they haven't smoked, should tell their doctor and ask for a test we call spirometry. It's a simple test that measures how well you breathe," he says. Depending on the results of that test, you might need further testing to find out if you have COPD or another lung disorder.
Initially you may only have COPD symptoms such as coughing or occasional shortness of breath. Periods when symptoms become worse are called acute COPD or exacerbations. As COPD progresses you may be told you have chronic COPD, which means that without medication to improve lung function you could have symptoms all the time. Even when you have chronic COPD that is under control, there may be times when you have acute COPD symptoms because of infections or something in the air that irritates your lungs and airways.
Understanding COPD can help you make choices that will prolong your active, healthy life.