Chronic Obstructive Pulmonary Disease

Nearly 800,000 Canadians over 35 have chronic obstructive pulmonary disease (COPD) in the form of emphysema or chronic bronchitis. COPD is usually caused by smoking, and quitting is the best way to relieve symptoms. Learn more to start breathing better.

What is COPD?

Chronic obstructive pulmonary disease (COPD) refers to two lung diseases: chronic bronchitis and emphysema. A person may suffer from both diseases at the same time or just one. These diseases are characterized by a permanent obstruction of the airways, as opposed to asthma, which causes the airways to narrow at different times during attacks.

The job of the lungs is to supply the body with oxygen and get rid of carbon dioxide. This gas exchange occurs in the alveoli, which are thousands of tiny sacs located in the bronchi . In people with COPD, the alveoli are damaged or blocked, and this leads to a poor exchange of oxygen and carbon dioxide.

Chronic bronchitis

In cases of chronic bronchitis, inflammation of the airways and heavy mucus secretion block the alveoli. A productive or “wet” cough then develops to expel the mucus. Too much mucus promotes repeated respiratory infections.

Emphysema

When it comes to emphysema, exposure to irritants gradually causes the alveoli to lose their elasticity. This makes it harder to exhale. The air that stays trapped in the lungs contains little oxygen and too much carbon dioxide, which means that the body has less oxygen to use. The main symptom of emphysema is difficulty breathing, or “dyspnea.”

COPD appears in people aged 45 and over, especially people who have smoked for many years. The disease progresses slowly but surely, and symptoms become more severe over time. Damage to the airways is irreversible. COPD can also increase the risk of heart failure, because the heart has to work harder to pump blood through damaged lungs.

What causes COPD?

Tobacco use is responsible for 80% to 90% of COPD cases. Exposure to second-hand smoke also has risks, as do outdoor pollution and workplace exposure to various irritants (e.g., asbestos fibre or glass or ceramic dust). Extreme (very cold or very hot) temperatures can also be problematic for people who struggle to breathe. Repeated respiratory infections as well as a family predisposition may also contribute to the development of COPD.

COPD symptoms

The first symptoms often go unnoticed. People tend to dismiss coughing and shortness of breath as normal for smokers. They usually consult a doctor when symptoms have become so severe that they interfere with daily activities.

People with COPD can experience the following symptoms: 

• difficulty breathing or the feeling of being short of breath (dyspnea)
• persistent cough
• excessive production of bronchial secretions
• chest pressure
• constant fatigue
• weight loss (in the case of emphysema)

At the start of the illness, people usually get these symptoms only when they exert themselves. But as the disease progresses, symptoms appear with less intense exercise until they are present even at rest.

Flare-ups

When someone has COPD, they’ll have periods when their symptoms get worse. This can happen due to a bacterial infection . To know when to consult your doctor and when to apply your “action plan”, you need to recognize flare-up symptoms:

• coloured secretions (yellow, green or brown)
• secretions that are heavier, thicker, or more difficult to spit out
• unusual increase in coughing or shortness of breath

Warning signs

Some symptoms require immediate medical attention:

• fever
• chest pain
• blood in phlegm or spit
• swollen ankles
• difficulty sleeping while lying down
• headaches, dizziness, confusion
• feeling sick (generally feeling run down)
• blue lips or fingers

COPD treatment

COPD can't be cured, but treatment can slow COPD progression, control symptoms, reduce the risk of new infections, and maintain your quality of life.

Adopt a healthy lifestyle

• For smokers, the most effective thing to do is quit smoking. This is the only way to stop the disease from progressing and reduce the risk of complications. Quitting will help reduce your risk of cardiovascular disease and lung cancer. You can try various smoking cessation aids. Talk to your pharmacist or doctor for more information. They can help choose the best method for you and support you through the process. You also need to avoid second-hand smoke, air pollution, and irritants (perfumes, car exhaust, dust), which are also harmful to the lungs.
• Getting regular physical activity is also important. Exercise improves lung capacity, resistance to infections, and cardiovascular health. It also has a positive effect on sleep and mood. When combined with a healthy diet, exercise also helps you maintain a healthy weight and gives you more energy. 
• You should also drink a lot of water (unless your doctor tells you otherwise). Staying hydrated makes airway secretions less sticky and easier to expel.

Get respiratory rehabilitation

Join a respiratory rehabilitation program to help you live better with COPD. Through this program, you'll learn breathing strategies , exercise tips, and other techniques. Find out more from your doctor.

Prevent lung infections

People with COPD are much more prone to lung infections. A simple cold can a have major impact on your health. This is why you need to get the flu shot each fall. The pneumonia vaccine is also recommended. Frequent hand washing is a good habit to help you avoid contracting or spreading germs.

Take your prescribed medication

Different types of medications are currently available to treat COPD, and most of these drugs come in the form of various types of inhalers . You need to use the inhaler properly to get the maximum effect from the medication. Don’t hesitate to consult your pharmacist , who can give you advice about inhalers and how to manage the side effects of your medication.

• Bronchodilators open the airways to let air pass more easily, which relieves shortness of breath. There are 2 classes of bronchodilators: beta2-agonists and anticholinergics. Your doctor may prescribe both, since they act differently to relieve shortness of breath and decrease coughing. You usually take them on a daily basis.
• Inhaled corticosteroids are frequently combined with bronchodilators to reduce airway inflammation.
• For lung infections, your doctor will prescribe oral antibiotics. You also need to follow your pharmacist’s instructions to ensure the medication is as effective as possible. Your doctor may also prescribe cortisone tablets to reduce airway inflammation and improve your breathing. A combination of an antibiotic and cortisone is commonly called an action plan.

Supplemental oxygen

Some people will need to be put on supplemental oxygen. This can be for a short period, for example, during a flare-up (infection), or over the long term for more advanced cases of COPD. A lack of oxygen makes the heart work unnecessarily, increases shortness of breath, decreases quality of life and increases confusion. Oxygen therapy makes up for the lack of oxygen in the blood and improves quality of life.

Get support

As with most chronic diseases, COPD can cause sleep disorders, anxiety disorders, or a depressed mood. If you have these symptoms, don’t hesitate to talk about them with a health care professional, such as your doctor, pharmacist, or psychologist. With support, you can overcome these challenges. Support from your family is also key to maintaining your quality of life.

Resource:
BreathWorks^TM Program