Chronic Obstructive Pulmonary Disease (COPD) is a group of lung diseases that make it hard to breathe and worsen over time. It is an umbrella term used to describe lung diseases, including:
- Emphysema: the walls of the alveoli (air sacs) are damaged or destroyed
- Chronic bronchitis: inflammation of the bronchioles or airways
- Asthma: treatment-resistant asthma that doesn’t get better with inhalers or standard therapies
COPD reduces airflow in and out of your airways (obstruction). This reduction can have different causes, including:
- The airways and air sacs (alveoli) in your lungs become less elastic
- The walls of the airways become thick and inflamed
- The airways create more mucus than usual and become clogged
What Are the Symptoms of COPD?
- Shortness of breath, especially during exertion
- Wet cough
- Dry cough
- Trouble taking a deep breath
- Wheezing or whistling sound when you exhale
- Frequent chest infections or colds
How Is COPD Diagnosed?
- Pulmonary function tests
- Chest X-ray
- Chest CT Scan
- Blood tests and other laboratory diagnostics
Can COPD Be Cured?
Unfortunately, there is no cure for COPD, but there are treatments that may improve your breathing and improve your quality of life.
How Is COPD Treated?
There are steps you can take to make living with COPD easier. Lifestyle changes and support steps that can dramatically improve quality of life include:
- Stop smoking
- Avoid second-hand smoke and pollution
- Exercise regularly
- Drink water regularly
- Keep airways clear
- Maintain vaccination schedule
- Adhere to medical management plan—even when you feel fine
There are medication to help to open the airways. Many of these medicine are taken using an inhaler, and can offer relief during a flare-up of symptoms.
- Inhaled steroids
- Combination medications
- Oral steroids
Pulmonary rehabilitation focuses on teaching how to exercise while concentrating on breathing techniques, oxygen levels, and safety precautions. Participation in pulmonary rehabilitation programs has also been shown to decrease hospitalizations. Exercise can help patients with COPD:
- Improve endurance
- Manage symptoms like shortness of breath
- Increases maximal oxygen consumption
These programs can help patients safely maintain exercise programs that include:
- Cardiovascular workouts like walking, swimming, or bike riding
- Diaphragmatic breathing: deep breathing techniques that focus on using the large muscle between the lungs and abdomen (diaphragm)
Benefits vary among individuals, and consistent participation in an exercise regimen is necessary to maintain improvements. It's important to note that pulmonary rehabilitation may not change an individuals' pulmonary function tests (PFTs) or overall oxygen requirements.
With COPD, impaired breathing reduces oxygen levels, leading to fatigue and discomfort. Supplemental oxygen can help to keep blood oxygen levels normal.
Lung Volume Reduction
Lung volume reduction (LVR) may be an option when medical treatment does not improve COPD symptoms.
The goal of LVR is to reduce the areas of the lung that are severely damaged, allowing the remaining portion to function better and making it easier to breathe. The two methods used for LVR are:
- Lung Volume Reduction Surgery (LVRS) is an operation to remove the most damaged parts of both lungs. LVRS removes damaged lung tissue during a minimally invasive thoracoscopy. During a video-assisted thoracoscopic surgery (VATS) procedure, a tiny camera and surgical instruments are inserted between the ribs through small incisions. The purpose of the surgery is to remove the most damaged parts of the lungs (up to 30% of each lung), giving the healthier areas room to expand.
- Bronchoscopic Lung Volume Reduction (bLVR) uses a special instrument called a bronchoscope to place tiny valves in the lungs to block a diseased lobe. This valve creates airflow that collapses the lobe, making more room in the chest and allowing the healthier lobe to function more effectively. This novel procedure provides an alternative for some patients to surgery.
Both LVRS and bLVR can dramatically improve overall health and quality of life by reducing trapped air to improve lung function.
Lung transplantation may be an option for COPD that doesn't respond to other tresatment options and for patients where lung function is severely impaired. Transplantation candidate must meet specific criteria to be eligible. A lung transplant can improve breathing, but carries significant risks and requires lifelong support, including taking immune-suppressing medications.
COPD Care at Columbia
The Jo-Ann F. LeBuhn Center for Chest Disease and Respiratory Failure at CUIMC/NYP is a state-of-the-art facility for the diagnosis and treatment of pulmonary disease like COPD. As part of the Price Family Center for Comprehensive Chest Care, our team of specialists from across Columbia provide expert care and support.