Chronic Obstructive Pulmonary Disease     

Chronic obstructive pulmonary disease (COPD) is the fifth leading cause of death in the United States. Although many people think first of emphysema when they hear COPD, chronic bronchitis is actually more common and equally serious -- because it can lead to emphysema and eventually cause death if it is not controlled.

Causes

Cigarette smoking is the number one cause of COPD, accounting for 82 percent of cases. Other causes include repeated exposure to lots of dust (such as in coal mines, granaries, or metal molding shops), chemical vapors, and possibly air pollution.

Types of COPD

Chronic Bronchitis

Chronic bronchitis is an inflammation of the lining of the bronchial tubes, which are part of  the airway that brings oxygen to the lungs. It causes the bronchial tubes to produce too much mucus. As chronic bronchitis progresses, the tiny hairs (cilia) that sweep away irritants from the air passages may stop working or die.

Chronic bronchitis often begins as repeated cases of acute bronchitis following colds. With chronic bronchitis, however, coughing and mucus production occur more frequently and last longer after each cold. Unlike the occasional 1- to 2-week bout of acute bronchitis after a cold or flu in otherwise healthy people, those with chronic bronchitis have inflammation and coughing, with mucus, for at least 3 months each year.

Emphysema

Emphysema occurs when the tiny air sacs (alveoli) in the lungs become larger and less elastic, making it harder for oxygen to get in and for carbon dioxide to get out of the lungs. Therefore, less oxygen gets into the blood. This leads to shortness of breath, eventually making even the most basic tasks, such as eating or getting dressed, difficult and tiring.

Treatment

Neither chronic bronchitis nor emphysema can be cured, but with medical treatment, the damage they cause to the lungs and heart can be slowed and their symptoms can be eased.

Because of the gradual onset of symptoms, you should see a doctor at the first signs of shortness of breath or "smoker's cough." Your doctor may prescribe some combination of bronchodilator medications (oral or inhaled), which help relax and open airways; corticosteroids, which decrease inflammation; antibiotics; and exercise, which helps optimize lung function.

Self-Care

In addition to taking medications prescribed by your doctor, there are several things you can do to slow further lung damage and make living with COPD easier:

• Quit smoking! Talk with your doctor about ways to stop smoking. Continuing to smoke will only speed up the progression of emphysema.

• Call your doctor at the first signs of respiratory illness, such as a cold or the flu.

• Drink plenty of fluids. Six to eight glasses of clear fluids a day, such as juice or water, will help keep air passages clear of mucus, making it easier to breathe.

• Eat a well-balanced diet. If you have emphysema, spread your meals out. By eating five or six small meals a day, you avoid having a full stomach, which interferes with your breathing.

• Strengthen your heart with aerobic exercise, and build your upper-body strength. Strengthening the muscles in your upper body will make breathing easier. Moderate aerobic exercise, such as 15 minutes of daily walking, will make your heart less susceptible to complications of COPD.

• Do breathing exercises. If you have emphysema, ask your doctor about exercises to help you breathe better. Two common exercises are "pursed-lip" breathing (inhaling through your nose and exhaling twice as long through pursed lips) and breathing from the diaphragm (expanding your diaphragm and abdomen, rather than your chest, when you inhale).

• Get a flu shot each fall and a pneumococcal pneumonia vaccination as recommended by your doctor.