Chronic Obstructive Pulmonary Disease (COPD)


What is COPD?

Chronic obstructive pulmonary disease (COPD) is a term for a group of respiratory conditions where your airways become narrowed and inflexible from long-standing inflammation. This is similar to asthma, but the key difference between the two is the reversibility of airway narrowing. Asthma responds to steroids, and lung function can be fully restored with such treatment. In COPD, the airway damage is not fully reversible. 

The two most common diseases included under the COPD umbrella are chronic bronchitis and emphysema. Chronic bronchitis is the ongoing inflammation of the bronchial tubes that carry air into and out of the lungs. Emphysema results when the alveoli, or air sacs in the lungs where gas exchange occurs, are damaged. Both of these conditions lead to difficulty breathing and maintaining proper oxygen levels in your body.

Pathophysiology and Risk Factors

Chronic obstructive pulmonary disorder occurs when any part of the lungs becomes obstructed or damaged due to long-term inflammation. Therefore, the most common risk factors are things that contribute to inflammation:

  • Smoking or use of inhaled drugs
  • Exposure to respiratory irritants such as smoke, chemicals, or dust 
  • Asthma
  • A genetic deficiency in alpha-1-antitrypsin, a substance secreted by the liver that helps to protect your lungs 

COPD Symptoms and Signs

COPD is a chronic and progressive disease, so you may notice symptoms appear slowly and worsen. The most common early signs of COPD include:

  • Shortness of breath
  • Chronic cough
  • Wheezing
  • Increased mucus 
  • Chest tightness or pain
  • Fatigue 
  • Frequent respiratory infections
  • Exercise intolerance 

Unfortunately, if left untreated for long periods, end stage COPD symptoms include systemic effects like swelling of your legs and feet or unintended weight loss. Also, patients can experience an acute exacerbation of COPD. This presents as rapid worsening of the above symptoms and usually persists for multiple days before treatment can begin to bring it under control.

If you notice that any of the above symptoms affect your quality of life, see one of our online doctors now.

COPD Diagnosis

Diagnosis of this condition requires a doctor’s visit. Your physician will likely begin by taking your health history and performing a physical exam, including listening for COPD lung sounds and breath sounds. They may also perform lung function tests using a spirometer to measure how much air you can inhale and exhale. You may also do something called a six-minute walk distance to measure your exercise tolerance as part of your COPD test. 

Your assessment can also include imaging your lungs with a COPD chest x ray or a computerized tomography (CT) scan. Your physician may order a blood draw for lab tests and to analyze your arterial blood gases to rule out other causes of your symptoms. 

Chronic obstructive pulmonary disease can be challenging to recognize because its symptoms are nonspecific. It is often mistaken for an upper respiratory tract infection, pneumonia, asthma, or another lung disease. For this reason, your primary care doctor may refer you to a pulmonologist for follow-up and specialized care in some cases. 

If your doctor determines you have COPD, they may stage your disease, which can leave you wondering what are the 4 stages of COPD? The COPD gold stages consider the severity of your symptoms, results of your COPD spirometry tests, the likelihood of your condition worsening, and other comorbidities. Based on these criteria, your doctor will determine which of the following categories best describes your disease: 

  • Stage 1 COPD - Mild
  • Stage 2 COPD - Moderate
  • Stage 3 COPD - Severe
  • Stage 4 COPD - Very severe

COPD Treatment

If you have mild symptoms, lifestyle changes may be all that is needed to control your disease. Smoking is a significant contributor, and quitting can help prevent progression and improve your overall health. If environmental or workplace irritants like smoke, dust, or aerosols are present, avoiding them can be beneficial. A medically supervised fitness plan can also assist in improving respiratory capacity.

Medication is usually necessary for managing moderate to severe COPD. Your doctor may prescribe a short- or long-acting bronchodilator to help to relax your airways and allow you to breathe easier. These come in inhalers you will be instructed to use on either a regular basis or as needed. Inhaled steroids can also reduce inflammation in your respiratory system and make breathing less difficult. 

Oral steroids may be used short-term for COPD exacerbation treatment or long-term in more severe COPD. Phosphodiesterase 4 (PDE4) inhibitors and theophylline are also medications available for use in severe disease unresponsive to other therapies. Antibiotics, as needed, can help with the frequent respiratory infections that often accompany COPD.

In addition to medication, you may receive long term oxygen therapy for COPD if your doctor determines your blood oxygen saturation level is low. While usually started in the hospital, you can continue oxygen at home and even get a portable tank to allow you to continue an active lifestyle.

Pulmonary rehabilitation with a respiratory therapist can help manage your disease. These programs often include breathing exercises and lifestyle and nutrition counseling. This can help to improve your quality of life and decrease your chances of needing hospitalization. Surgery to improve your condition may be possible in some cases.


COPD Prognosis

While COPD is a chronic and incurable condition, a healthy lifestyle and medical treatment can make living with COPD possible. A common question you may pose if you have this disease is how fast does COPD progress? No two cases follow the same course. Seeking medical care as soon as you notice symptoms and working with your doctor can help to preserve respiratory function.

If left untreated, potential complications of COPD include:

  • Frequent respiratory infections
  • Increased risk of heart disease and lung cancer
  • Increased pressure in the blood vessels of your lungs
  • Depression

To prevent these and get help for COPD symptoms today, see one of our online doctors now!

Our board certified doctors can treat a wide variety of medical conditions through SkyMD®. Common conditions that can be diagnosed and treated through our online platform include but are not limited to:

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Dr. Yarledis Salcedo
Dr. Yarledis Salcedo
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Dr. Cshantara Audap
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