What is COPD (Chronic Obstructive Pulmonary Disease)?

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Gross pathology of lung showing centrilobular emphysema characteristic of smoking. Closeup of fixed, cut surface shows multiple cavities lined by heavy black carbon deposits.
Gross pathology of lung showing centrilobular emphysema characteristic of smoking. Closeup of fixed, cut surface shows multiple cavities lined by heavy black carbon deposits. | Source

Chronic obstructive pulmonary disease (COPD) results from progressive destruction of or decreased functionality of lung tissue. Cough, shortness of breath and low oxygen levels become more prominent as time goes on.

COPD is actually a collective term for two separate, but often overlapping, lung conditions:

  • Emphysema: The lining of the air sacs in the lungs are weakened and destroyed over time. Emphysema is usually the main component of COPD.
  • Chronic Bronchitis: Inflammation narrows the airways. Mucous builds up and a wet cough may be prominent.

These conditions both result in the decreased ability to transfer oxygen into and carbon dioxide out of the blood. This is a crucial function of lung tissue and all other organ systems depend on it.

Smoking is by far the most common cause of COPD.

Definition of COPD: Chronic Obstructive Pulmonary Disease

The phrase "chronic obstructive pulmonary disease" gives some clues as to the nature of the disorder. Chronic means this is an ongoing problem that does not have a real cure. Obstructive provides insight that the disorder relates to blockage of air. Indeed, air trapping and inability to fully exhale the air from the lungs becomes part of the pathology. Pulmonary disease tell us that this is affecting the pulmonary system- the lungs and exchange of oxygen and waste gases.

Normal Gas Exchange in the Lungs

Alveoli are the air sacs at the end of the air tubes in the lungs. The alveoli are the sites of actual air exchange. The video below provides a good visual demonstration of gas exchange in the lungs.

Oxygen that is inhaled in the air passes down the lung tubes which branch out through the lung tissue until they end at a cluster of alveoli. The thin walls of the alveoli sacs touch the walls of tiny blood vessels. Oxygen is transferred across the alveolar walls and into the blood stream. It can then be distributed to the rest of the body.

Likewise, carbon dioxide and other waste gases are gathered up throughout the body into the blood stream. When that blood reaches the lungs, it is eventually passed to the small vessels that are paired with alveoli. The waste gas transfers across blood vessel walls and into the alveoli and is then exhaled out.

Gas Exchange between Alveoli and Capillaries

Chronic Asthmatic Bronchitis - A Closer Look

This component of COPD is characterized by inflammation of the airways. The inflammation crowds the inside of the tiny airway tubes through which air must pass. Mucous also can build up in the airways. All of this results in the uncomfortable symptoms of

  • wheezing
  • cough (wet cough with mucous may occur)
  • shortness of breath
  • Pain or tightness of the chest

Emphysema - Closer Look

The symptoms and complications of emphysema result from pathology at the level of the alveoli.

As the disease progresses, the thin walls of the alveoli weaken and eventually are destroyed. Gas exchange cannot occur normally. Because the walls between adjoining alveoli disintegrate, the air sacs become fewer but abnormally large pockets. The elasticity of the sacs decreases causing air to become trapped since with lower alveolar elasticity, it cannot be exhaled out normally.

Signs and Symptoms of Emphysema

  • shortness of breath- gradual onset, then progressive
  • fatigue- and easy fatigue with activity
  • cyanosis (blue lips or fingertips)
  • cough
  • wheeze
  • 'barrel chest'

Risk Factors for COPD

SMOKING is far and away the most common risk factor for COPD. Not all smokers will develop COPD, but a great majority of COPD patients are smokers of former smokers.

Once COPD starts to develop, the damage is irreversible. Quitting smoking will, however, keep the disease from progressing.

There are a few other known causes of COPD:

  • A genetic disorder called alpha-1-antitrypsin deficiency
  • Exposure to certain fumes or chemicals

Oxygen for Home Use.

Oxygen requirement goes up as COPD progresses.
Oxygen requirement goes up as COPD progresses. | Source

Treatment for COPD

Treatment for COPD targets control of symptoms and halting progression of the disease.

Quitting smoking is the single most important measure to achieve both of these goals.

Often, medicines given via inhalers or nebulizers to decrease inflammation, relax the airways and reduce wheezing will be used.

Other medications such as steroids (inhaled or oral) may become necessary.

As the disease worsens, oxygen may be needed on a progressive basis.

What is COPD? A Review

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Comments 7 comments

dinkan53 profile image

dinkan53 4 years ago from India

Due to shortness of breathe, the patients with COPD usually avoid exercises (as i heard while taking history of patients). But actually lack of exercise can cause drop your lung function even worse. Keep your body as active as possible can reduce breathing problems in a long run. Well wrtten article and thanks for sharing. Voted as useful.


eHealer profile image

eHealer 4 years ago from Las Vegas

This is a great anti-smoking hub! Very informative and useful. Expert information is so valuable and needed. Great and voted up!


meloncauli profile image

meloncauli 4 years ago from UK

Good hub. My dad has this disease and it is not nice to watch someone you love get less and less mobile, straining to breathe. He was a smoker, but stopped smoking three years ago. He had to stop smoking because he was put on oxygen therapy at home. He is now on oxygen 24 hours a day. Awful, slow progressive disease.


Nettlemere profile image

Nettlemere 4 years ago from Burnley, Lancashire, UK

Oddly this is a common disease in horses as well (clearly not smoking related in their case, but perhaps an allergic reaction to fungal spores in hay). It was interesting to read about the human equivalent.


MizBejabbers profile image

MizBejabbers 4 years ago

I have a question, but Nettlemere may have given me a clue. Here's the scenario: someone is told that their lungs aren't functioning up to par because the cillia don't work properly and can't evacuate the natural mucus that forms in the lungs. The pulmonary specialists say it isn't asthma but can't put a name on it, and puts the person on steroid inhalers and albuterol inhalers that seem to help. Could this be caused by histoplasmosis or another environmental factor? When several family members, not necessarily smokers, have this problem and it is generational, would this likely be hereditary? Very good hub that has good explanations. Just hope someone can answer the question the docs leave out. Voted you up!


Marcy Goodfleisch profile image

Marcy Goodfleisch 4 years ago from Planet Earth

My brothers and I grew up around cigarette smoke (from our father), and we all have issues of some sort, even though we've never been smokers. And of course for years smoking was allowed in stores, restaurants and workplaces. How I wish there had been more restrictions on that deadly habit years ago. The photo of smoke-scarred lungs is frightening!

Voted up - outstanding information here.


Melovy profile image

Melovy 4 years ago from UK

Two friends of mine have family members who died of Emphysema, but I didn't really know what it was. Now I do: this is a very easy to understand and informative hub, and very useful too. Voted up.

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