Chronic Obstructive Pulmonary

Chronic Obstructive Pulmonary Disease (COPD) is a disease attributable to the blocking of the airways in the lungs.

The common form of COPD consists of Emphysema, Chronic Bronchitis, and Chronic Asthma.

Emphysema: Emphysema is the chief "culprit" in COPD. It occurs when some of the air sacs deep in the lungs have been progressively damaged. An enlargement and destruction of the alveoli (air sacs) in the lungs results in the collapse of the surrounding airways.

Chronic Bronchitis: As a first step toward impending Emphysema/COPD, Chronic Bronchitis often results from cold or flu. With proper care it need not lead to COPD. In a COPD patient, Chronic Bronchitis occurs when the airways in the lungs have become narrow and partly clogged with mucus, presenting cough and sputum for more than three months for two consecutive years. 

Chronic Asthma: Asthma is also a pulmonary disease in which there is obstruction to the flow of air out of the lungs, but unlike Chronic Bronchitis and Emphysema, the obstruction in asthma is usually reversible. Between attacks of asthma the flow of air through the airways is usually good. COPD is permanent. Certainly, most asthma patients do not have COPD. In some patients with COPD the obstruction also can be partially reversed by medications that enlarge or dilate the airways as with asthma. Conversely, some patients with asthma can develop permanent airway obstruction if chronic inflammation of the airways leads to scarring and narrowing of the airways.

COPD gradually reduces the ability to breathe. In the normal healthy nonsmoker, lung capacity gradually declines with age, but in those with COPD, capacity declines more rapidly, particularly among heavy smokers. COPD is the fourth leading cause of death in the U.S. after coronary heart disease, stroke and lung cancer. Nineteen out of 20 of those dying of COPD are 55 or older. 


COPD gets gradually worse over time. At first there may only be a mild shortness of breath and occasional coughing. Then a chronic cough develops with clear, colorless sputum. As the disease progresses, the cough becomes more frequent and more and more effort is needed to get air into and out of the lungs. In later stages of the disease, the heart may be affected. Eventually death occurs when the function of the lungs and heart is no longer adequate to deliver oxygen to the body's organs and tissues.

It is estimated that about two million Americans have Emphysema, and another 14 million have some form of Chronic Bronchitis. Men are more likely to die of the disease than women.

The chief symptom of COPD is cough-- a productive cough yielding large amounts of dark, thick phlegm or mucus. Other symptoms may be skipped breaths, insomnia or frequent nocturnal waking, memory loss, morning headaches, impotence, nasal flaring, blurred vision, increased breathing difficulty while lying down, chronic fatigue, impaired concentration, atypical irritability or loss of temper, excessive daytime sleepiness, and swelling of feet, ankles, or legs.

In normal healthy people, lung capacity gradually declines with age, but in those with COPD, capacity declines more rapidly, particularly among heavy smokers. The prognosis in patients with mild airway obstruction is good, but for those with severe obstruction the prognosis is poor. In most cases, death from COPD is precipitated by acute respiratory disease such as pneumonia, cardiac arrhythmia or pulmonary embolism.

Most patients lose 50 to 70% of their functional lung tissue before they become aware of the symptoms of the disease. Breathlessness is usually the first symptom people notice.

To prevent the onset of COPD, quit smoking if you smoke. Avoid air pollutants such as fine particulate, aerosol sprays, industrial pollutants, herbicides, pesticides, and the dust stirred up while cleaning carpets and upholstery. 

Nutrition including vitamin supplementation may help prevent Emphysema. Special attention should be given to the intake of antioxidants to prevent the breakdown of functional lung tissue by free radicals. Regular exercise builds up lung capacity and helps cleanse the lungs of stale air.

Like lung cancer, COPD is primarily a result of smoking. Smoking causes about 80% to 90% of all Emphysema and Chronic Bronchitis cases. However, only 10-15% of heavy smokers usually develop COPD.
Cigarette smoking is the most important risk factor for COPD; it would probably be a minor health problem if people did not smoke. Other risk factors include age, heredity, exposure to air pollution at work and in the environment, and a history of childhood respiratory infections. Living in low socioeconomic conditions also seems to be a contributing factor.

COPD can also result from occupational exposure. Exposure to chemical fumes and organic dusts such as grain, cotton, wood or mining dusts can contribute to COPD. 
COPD does not appear to be caused by air pollution for non-smokers. For smokers, air pollution can contribute to the development of more severe COPD. 

Another important factor to cause Emphysema is an enzyme deficiency known as alpha-1-antitrypsin deficiency (A1AD or AAT deficiency). About 2 out of every 1000 Americans have inherited AAT deficiency. The deficiency leads to A1AD-related Emphysema when the liver produces insufficient AAT to control a natural enzyme known as neutrophil elastase. It eventually causes irreversible damage to the alveoli by damaging or destroying their elastic fibers, if there is not enough AAT to neutralize it. 
For AAT-deficient individuals who smoke, the risk of developing Emphysema is much greater than for the general population. A1AD-related Emphysema usually strikes people in their thirties or forties and is very rarely seen in children. 

Physical damage caused by an accident and followed by scarring can give rise to scar Emphysema. Tuberculosis and asthma can also give rise to lung overstretching, severely damaging the elastic fibers of the alveoli walls and bringing on Emphysema.

Researchers are still looking for accurate methods to predict a person's chances of developing airway obstruction. None of the current ways used to diagnose COPD detects the disease before irreversible lung damage occurs. While many measures of lung function have been developed, those most commonly used determine: 1) air-containing volume of the lung (lung volume), 2) the ability to move air into and out of the lung, 3) the rate at which gases diffuse between the lung and blood, and 4) blood levels of oxygen and carbon dioxide.

Lung volumes are measured by breathing into and out of a device called a spirometer. Some types of spirometers are very simple mechanical devices, which record volume changes as air is added to or removed from them. Other kinds are more sophisticated and use various types of electronic equipment to determine and record the volume of air moved into and out of the lungs. The three volume measures most relevant to COPD are Forced Vital Capacity (FVC), Residual Volume (RV), and Total Lung Capacity (TLC). The forced vital capacity is the maximum volume of air, which can be forcibly expelled after inhaling as deeply as possible. Not all of the air in the lungs is removed when measuring the vital capacity. The amount remaining is called the residual volume. The total lung capacity is the combination of the forced vital capacity and residual volume. While most of the measured lung volumes or capacities change to some degree with COPD, residual volume usually increases quite markedly. This increase is the result of the weakened airways collapsing before all the normally expired air can leave the lungs. The increased residual volume makes breathing even more difficult and labored.

Eat foods that are not rich in caffeine; concentrate on a diet of vegetables and fruits. It is also advisable to drink plenty of water.

• Stop smoking. Many programs are available to help smokers quit smoking and to stay off tobacco. Some programs are based on behavior modification techniques; others combine these methods with nicotine gum or nicotine patches as aids to help smokers gradually overcome their dependence on nicotine. 
• Avoid work-related exposures to dusts and fumes. 
• Avoid air pollution, including cigarette smoke, and curtail physical activities during air pollution alerts. 
• Refrain from intimate contact with people who have respiratory infections such as colds or the flu and get a one-time pneumonia vaccination (polyvalent pneumococcal vaccination) and yearly influenza shots. 
• Avoid excessive heat, cold, and very high altitudes. (Note: Commercial aircraft cruise at high altitudes and maintain a cabin pressure equal to that of an elevation of 5,000 to 10,000 feet). This can result in hypoxemia for some COPD patients.
• However, with supplemental oxygen, most COPD patients can travel on commercial airlines.
• Drink a lot of fluids. This is a good way to keep sputum loose so that coughing can bring it up. 
• Maintain good nutrition. Usually a high protein diet, taken as many small feedings, is recommended.

Do aerobic exercise. It is a nutrient in itself and no healing programe ever works without it. It is the best consideration for the mind and body.