COPD: causes, symptoms and treatment
Chronic obstructive pulmonary disease, or COPD, is a long-term and progressive lung disease. COPD causes the airways in your lungs to become inflamed and thickened.1 This means less air flows in and out of your airways, making it hard to breathe.2 Fortunately, COPD is often treatable and preventable.1
Types of COPD
There are two main types of COPD:3
- Emphysema affects the air sacs in your lungs, as well as the walls between them. They become damaged and less elastic. Because your air sacs are less stretchy, it’s harder for your lungs to move air in and out of your body.2
- Chronic bronchitis happens when the lining of your airways is constantly irritated and inflamed. As a result, the lining swells and makes thick mucus, narrowing your airways.
COPD causes
COPD develops when your lungs and airways are exposed to irritants (like smoke and chemicals) over time. While smoking is the main cause of COPD, nonsmokers can get it too.4 Let’s go over some of the possible causes of COPD.
Smoking
Cigarette smoking causes about 85 to 90 percent of all COPD cases. The toxins in cigarette smoke weaken your lungs' defense against infections. They also narrow air passages, cause swelling in air tubes and damage air sacs. Together, all these factors cause COPD to develop.4
Environment
You may not even think about it, but the air you breathe can have an impact on your health. Whether at home or at work, long-term exposure to secondhand smoke, air pollution, fumes and chemicals can cause COPD.4
Alpha-1 deficiency
A small number of people have a rare form of COPD called alpha-1 deficiency-related emphysema. It’s genetic, which means you inherit it from your family. This type of COPD affects your body’s ability to produce a protein (alpha-1) that protects your lungs.4
COPD risk factors
Because COPD is so linked to your habits and environment, some COPD risk factors are the same as COPD causes. Risk factors include:5
- Smoking: By far the biggest risk factor – most people who have COPD smoke or used to smoke. If you have a family history of COPD, you’re more likely to develop the disease if you smoke.
- Long-term exposure to other lung irritants: These typically come from your home or work environment. Irritants may include secondhand smoke, air pollution and chemical fumes and dust.3
- Changes to lung growth and development: Diseases (like asthma or chronic lung infections) that affect the lungs during childhood or when a baby is still in the uterus can increase COPD risk.
- Infections: Conditions like tuberculosis and HIV can raise your risk.
- Age: Your age can play a role if you have other COPD risk factors, such as smoking. Most people who have COPD are at least 40 years old when symptoms begin.
- Asthma: This is a lung disease that causes swelling and narrows the airways. About 1 in 5 people who have COPD also have asthma.
- Alpha-1 deficiency: A rare genetic (inherited) form of COPD.
What are COPD symptoms?
It can be easy to miss COPD in its early stages. Maybe that lingering cough or occasional shortness of breath just feels like a sign of getting older. But it’s important not to ignore these symptoms, especially if you’re at risk for COPD. Common signs of COPD to watch for include:6, 7
- Frequent, ongoing cough
- Cough that produces a lot of mucus
- Shortness of breath while doing everyday activities
- Wheezing, whistling or squeaky sound when you breathe
- Frequent respiratory infections (like a cold or the flu)
- Blueness of the lips or fingernail beds
- Fatigue
- Chest tightness or heaviness
Diagnosis of COPD
If you think you’re experiencing COPD symptoms, schedule an appointment with your doctor. You’ll likely cover these key areas to help make a diagnosis.
Knowing your personal and family health history can help your doctor determine if you have COPD. Typically, your doctor will want to know if you:6
- Smoke or have a history of smoking
- Have regular exposure to secondhand smoke, air pollution, chemicals or dust
- Experience shortness of breath, chronic cough or coughing with lots of mucus
- Have family members who have had COPD
The most common test for COPD is spirometry. It’s a simple test to see how well your lungs work. It’s easy and painless – all you do is blow air into a mouthpiece. The air travels through the mouthpiece to a tube connected to a small machine. The machine measures the amount of air you blow out and how fast you can blow it. Spirometry can help detect COPD before symptoms develop. If you already have COPD, it can help determine how severe your COPD is and help set treatment goals.
Your doctor may want to do other tests to see how well your lungs work. They may also give you a chest X-ray to look at your lungs and check for other conditions, like pneumonia .6, 8
What are COPD treatments?
Since symptoms vary, COPD treatment plans are unique to each person. You and your doctor will work together to create the best treatment plan for you. COPD treatments may include:
- Quitting smoking. This is the most important thing you can do to help slow COPD progression. It’s also the best way to prevent COPD if you haven’t developed it yet.9 If you need help, these quitting smoking tips and resources can help you get started.
- COPD medications: The most common COPD medicines are bronchodilators. They help open your airways and make breathing easier. Most bronchodilators are taken through an inhaler. In more severe cases, COPD inhalers may also contain steroids, a type of medicine that reduces inflammation or swelling.3
- Pulmonary rehabilitation: This is a type of program that typically combines exercise training, health education, nutritional programs and breathing techniques. The goal is to help rebuild lung strength and improve your quality of life.9
- Oxygen therapy: Also called supplemental oxygen, this treatment delivers oxygen for you to breathe. You usually receive oxygen from short tubes that rest in your nose, or through a mask. You may need this type of therapy if your blood oxygen levels are too low. It may help you feel better and stay more active.9
- Surgery: This is usually a last resort for people with severe COPD who have not improved from taking medicines or other treatments. Your doctor can discuss whether surgery is an option for you. 9
Management of COPD
While there isn’t yet a cure for COPD, there are plenty of things you can do to make living with COPD easier. Lifestyle changes, along with treatments, can help you feel better, stay more active and slow COPD progress.10
Sometimes, shortness of breath and fatigue can make it difficult to eat. Not getting the calories and nutrients you need can make symptoms worse and raise your risk for infections. Talk with your doctor to see if resting before eating, eating smaller meals more frequently throughout the day or taking vitamins could be good options for you. It’s also important to remain active if you can. Physical activity can strengthen the muscles that help you breathe and improve your overall wellness. Your doctor can help determine what type of activity may be good for you.
Talk to your doctor about ways you can manage your COPD and create an action plan together. This can help you stay on top of your medications and treatments and know when you may need to seek care. Here’s an example COPD action plan from the American Lung Association.11
If you have someone who can help, move items in your home to make them more accessible in easy-to-reach places. Think about things you regularly use, like personal care items, medications and devices. This can be a big help, especially if you live in a home with stairs. There are also simple changes you can make:
- Consider a small table or cart with wheels to easily move things around when you’re cooking or doing chores
- Use a pole or tongs with long handles to help you reach things
- Choose loose-fitting clothing and simple shoes that are easy to put on and take off
A sudden worsening of symptoms is called a flare-up. It may happen with exposure to certain triggers – things like secondhand smoke, chemical fumes, dust and other lung irritants. Learning what your triggers are can help you avoid them. Infections can also trigger flare-ups, so it’s important to:
- Avoid people who are sick
- Get your annual flu shot
- Stay up to date on your COVID vaccines
- Talk with your doctor about being up to date on your pneumonia vaccine
Living with an ongoing health condition like COPD can be challenging. Fortunately, many organizations and health providers offer support programs to help you cope. United Healthcare members have access to our clinical and disease management support programs, which can connect you with experts trained in COPD management and care.