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COPD (Chronic Obstructive Pulmonary Disease)
What happens with Chronic Obstructive Pulmonary Disease?
Your airways branch out inside your lungs like an upside-down tree. At the end of each branch are small, balloon-like air sacs. In healthy people, both the airways and air sacs are springy and elastic. When you breathe in, each air sac fills with air like a small balloon. The balloon deflates when you exhale. In COPD, your airways and air sacs lose their shape and become floppy, like a stretched-out rubber band.
What are the Causes of Pulmonary Disease?
Cigarette smoking is the most common cause of COPD. Breathing in other kinds of irritants, like pollution, dust or chemicals, may also cause or contribute to COPD. Quitting smoking is the best way to avoid developing COPD.
Treatment can make you more comfortable, but there is no cure.
National Heart, Lung, and Blood Institute
What Is COPD?
COPD, or chronic obstructive pulmonary (PULL-mun-ary) disease, is a progressive disease that makes it hard to breathe. "Progressive" means the disease gets worse over time.
COPD can cause coughing that produces large amounts of mucus (a slimy substance), wheezing, shortness of breath, chest tightness, and other symptoms.
Cigarette smoking is the leading cause of COPD. Most people who have COPD smoke or used to smoke. Long-term exposure to other lung irritants, such as air pollution, chemical fumes, or dust, also may contribute to COPD.
To understand COPD, it helps to understand how the lungs work. The air that you breathe goes down your windpipe into tubes in your lungs called bronchial tubes, or airways.
The airways are shaped like an upside-down tree with many branches. At the end of the branches are tiny air sacs called alveoli (al-VEE-uhl-eye).
The airways and air sacs are elastic. When you breathe in, each air sac fills up with air like a small balloon. When you breathe out, the air sac deflates and the air goes out.
In COPD, less air flows in and out of the airways because of one or more of the following:
- The airways and air sacs lose their elastic quality.
- The walls between many of the air sacs are destroyed.
- The walls of the airways become thick and inflamed (swollen).
- The airways make more mucus than usual, which tends to clog the airways.
Healthy Alveoli and Damaged Alveoli
The illustration shows the respiratory system and images of healthy alveoli and alveoli damaged by COPD.
In the United States, the term "COPD" includes two main conditions, emphysema (em-fi-SE-ma) and chronic obstructive bronchitis (bron-KI-tis).
In emphysema, the walls between many of the air sacs are damaged, causing them to lose their shape and become floppy. This damage also can destroy the walls of the air sacs, leading to fewer and larger air sacs instead of many tiny ones.
In chronic obstructive bronchitis, the lining of the airways is constantly irritated and inflamed. This causes the lining to thicken. Lots of thick mucus forms in the airways, making it hard to breathe.
Most people who have COPD have both emphysema and chronic obstructive bronchitis. Thus, the general term "COPD" is more accurate.
COPD is a major cause of disability, and it's the fourth leading cause of death in the United States. More than 12 million people are currently diagnosed with COPD. An additional 12 million likely have the disease and don't even know it.
COPD develops slowly. Symptoms often worsen over time and can limit your ability to do routine activities. Severe COPD may prevent you from doing even basic activities like walking, cooking, or taking care of yourself.
Most of the time, COPD is diagnosed in middle-aged or older people. The disease isn't passed from person to person, you can't catch it from someone else.
COPD has no cure yet, and doctors don't know how to reverse the damage to the airways and lungs. However, treatments and lifestyle changes can help you feel better, stay more active, and slow the progress of the disease.
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Facts About Chronic Obstructive Pulmonary Disease (COPD)
- What it is
- What causes it
- Who has it
- Why women's COPD rates are rising so much faster than men's
- How COPD can be prevented
- How COPD is treated
- More information
Chronic obstructive pulmonary disease, or COPD, refers to a group of diseases that cause airflow blockage and breathing-related problems. It includes emphysema, chronic bronchitis, and in some cases asthma.
COPD is a leading cause of death, illness, and disability in the United States. In 2000, 119,000 deaths, 726,000 hospitalizations, and 1.5 million hospital emergency departments visits were caused by COPD. An additional 8 million cases of hospital outpatient treatment or treatment by personal physicians were linked to COPD in 2000.
In the United States, tobacco use is a key factor in the development and progression of COPD, but asthma, exposure to air pollutants in the home and workplace, genetic factors, and respiratory infections also play a role. In the developing world, indoor air quality is thought to play a larger role in the development and progression of COPD than it does in the United States.
In the United States, an estimated 10 million adults had a diagnosis of COPD in 2000, but data from a national health survey suggest that as many as 24 million Americans are affected.
From 1980 to 2000, the COPD death rate for women grew much faster than the rate for men. For U.S. women, the rate rose from 20.1 deaths per 100,000 women to 56.7 deaths per 100,000 women over that 20-year span, while for men the rate grew from 73.0 deaths per 100,000 men to 82.6 deaths per 100,000 men.
U.S. women also had more COPD hospitalizations (404,000) than men (322,000) and more emergency department visits (898,000) than men (551,000) in 2000. Additionally, 2000 marked the first year in which more women (59,936) than men (59,118) died from COPD.
However, the proportion of the U.S. population aged 25-54, both male and female, with mild or moderate COPD has declined over the past quarter century, suggesting that increases in hospitalizations and deaths might not continue.
These increases probably reflect the increase in smoking by women, relative to men, since the 1940s. In the United States, a history of currently or formerly smoking is the risk factor most often linked to COPD, and the increase in the number of women smoking over the past half-century is mirrored in the increase in COPD rates among women. The decreases in rates of mild and moderate COPD in both men and women aged 25-54 in the past quarter century reflect the decrease in overall smoking rates in the United States since the 1960s.
Early detection of COPD might alter its course and progress. A simple test can be used to measure pulmonary function and detect COPD in current and former smokers aged 45 and over and anyone with respiratory problems. Avoiding tobacco smoke, home and workplace air pollutants, and respiratory infections are key to preventing the initial development of COPD.
Treatment of COPD requires a careful and thorough evaluation by a physician. The most important aspect of treatment is avoiding tobacco smoke and removing other air pollutants from the patient's home or workplace. Symptoms such as coughing or wheezing can be treated with medication. Respiratory infections should be treated with antibiotics, if appropriate. Patients who have low blood oxygen levels in their blood are often given supplemental oxygen.
- American Lung Association*
- American Thoracic Society / European Respiratory Society* Task Force. Standards for the Diagnosis and Management of Patients with COPD*
- Global Initiative for Chronic Obstructive Lung Disease
- National Institutes of Health
- National Lung Health Education Program*
- U.S. COPD Coalition
Page last reviewed: April 22, 2009
Page last modified: April 22, 2009
Content source: National Center for Chronic Disease Prevention and Health Promotion, Division of Adult and Community Health