COPD (chronic lung disease)

Overview

COPD includes emphysema, where the tiny air sacs in the lungs are damaged, and chronic bronchitis, where the airways are swollen and make extra mucus. Most people have both.

Damaged lungs can't move air in and out well, so you get winded easily. Symptoms usually start after age 40 and slowly get worse. Stopping smoking is the best way to slow it down.

Symptoms

Symptoms start slowly. Many people think they're just getting older.

• Getting winded easily with activity or stairs
• Cough with mucus most days
• Wheezing
• Chest tightness
• A history of smoking or vaping

Less common

• Frequent colds or chest infections
• Tiredness
• Weight loss and weak muscles in severe COPD
• Swollen ankles

Look up a symptom: Cough · Cough with mucus most days · Getting winded easily with activity or stairs · Mucus or phlegm · Smoke or used to smoke · Vaping or using nicotine · Wheezing

When to get medical care

Causes

Smoking causes most COPD. Breathing in secondhand smoke, air pollution, dust, chemical fumes, or smoke from cooking fires can also cause it.

A rare inherited condition, alpha-1 antitrypsin deficiency, can cause COPD even in young people.

Does it spread or run in families?

• Yes, it can spread from person to person.
• How it spreads: coughs or sneezes.
• Washing hands often and staying home when sick help protect others.
• It's linked to changes in genes and can be passed from parent to child.
• A genetic counselor can explain the chance of passing it on and testing for relatives.

Who is more likely to get it

• Smoking, now or in the past
• Dust, fumes, or smoke at work or home
• Asthma
• Age over 40
• Alpha-1 antitrypsin deficiency

Possible complications

• Pneumonia: Chest infections are more common
• Heart failure: Strain on the right side of the heart
• Lung cancer: Higher risk
• Respiratory failure: In severe flare-ups

Diagnosis

COPD is diagnosed with a simple breathing test.

Questions you may be asked

• Whether you smoke or used to
• Whether you've breathed in dust, fumes, or smoke at work
• How far you can walk before getting winded

The exam

They'll listen to your lungs and check your oxygen level.

Tests

Common tests:

• Spirometry: You blow hard into a tube to measure how well air moves out of your lungs.
• Chest X-ray or CT scan: To look at the lungs and rule out other problems.
• Alpha-1 blood test: Checks for an inherited cause.

Treatment

Treatment eases symptoms, prevents flare-ups, and keeps you active.

Self-care

• Quit smoking and avoid smoke and fumes
• Use your inhalers exactly as prescribed
• Practice pursed-lip breathing when you feel winded
• Stay active, and ask about pulmonary rehab
• Get your flu, COVID-19, pneumonia, and RSV vaccines

Medicines

Most COPD medicines are inhaled, so they go right to the lungs.

OwieClear doesn't give doses: follow the label or your healthcare professional. Medicine names here are examples, not a full list.

Pulmonary rehab teaches exercise and breathing skills. People with low oxygen may need oxygen therapy. A few people with severe COPD may have surgery or a lung transplant.

How it compares

Prevention

The best ways to prevent COPD or slow it down:

• Don't smoke, or quit now
• Avoid secondhand smoke
• Wear protection around dust and fumes
• Get recommended vaccines

Which doctor treats this

• Start with your primary care provider (family doctor or internist).
• They may send you to a pulmonologist (lung doctor).
• A medical geneticist or genetic counselor can explain genetic tests and family risk.

Living with it

• Use your inhalers as prescribed.
• Ask about pulmonary rehab.
• Get flu, COVID-19, and pneumonia vaccines.
• Long-term illness can affect mood. Tell your doctor if you feel down or anxious.

Support groups and helplines

• American Lung Association: Lung HelpLine 1-800-586-4872 and Better Breathers support groups.

Back to school, work, or sports

• Stay home until you've had no fever for 24 hours without fever medicine and you're feeling better.
• For the next 5 days, wash hands often and wear a mask around others.

Children, pregnancy, and older adults

• People who never smoked: Can still get COPD from pollution, work exposures, or alpha-1 deficiency.

Pregnancy and breastfeeding

• If you're pregnant or planning to be, tell your prenatal provider about this condition.
• Genetic counseling before or early in pregnancy can explain the chance of passing it on and testing options.
• Some infections can pass to the baby during pregnancy or birth. Tell your provider if you've been exposed.
• Don't start or stop any medicine on your own. Some are safe in pregnancy and some need to be changed.
• Ask before taking any pain reliever. The FDA advises avoiding ibuprofen and naproxen after 20 weeks unless your doctor says to.
• Breastfeeding: Most medicines are fine, but ask. The NIH LactMed database lists what's known about each one.

For caregivers

• Go to visits when you can and take notes.
• Keep a list of medicines, allergies, and doctors in one place.
• Learn the warning signs that need fast care.
• Take breaks and ask for help. Caregivers need care too.

Outlook

COPD can't be cured, but quitting smoking, using inhalers, and pulmonary rehab help many people breathe better and stay active for years.

Getting ready for your visit

Bring your inhalers so your healthcare professional can check how you use them.

What to bring

• All your inhalers and medicines
• How far you can walk and how often you have flare-ups

Questions to ask

• Do I need a COPD action plan?
• Would pulmonary rehab help me?
• Do I need oxygen?
• Which vaccines do I need?

Research studies

Research studies test new ways to find and treat health problems. Some are looking for volunteers. Talk with your doctor before joining one.

Search ClinicalTrials.gov for studies on COPD (chronic lung disease)