What is copd?


Chronic obstructive pulmonary disease (COPD): Overview

Chronic obstructive pulmonary disease (COPD) is a lung disease that makes it hard to breathe. With COPD, the airways that lead to the lungs are narrowed, and the tiny air sacs in the lungs are damaged and lose their stretch. People with COPD have decreased airflow in and out of the lungs, which makes it hard to breathe. The airways also can get clogged with thick mucus. Cigarette smoking is a major cause of COPD.

Although there is no cure for COPD, you can slow its progress. Following your treatment plan and taking care of yourself can help you feel better and live longer.

Chronic obstructive pulmonary disease (COPD)

Chronic obstructive pulmonary disease (COPD) is a lung disease that makes it hard to breathe. With COPD, the airways that lead to the lungs are narrowed, and the tiny air sacs in the lungs are damaged and lose their stretch. Over time, it may lead to severe shortness of breath and heart problems.

COPD can't be cured, but medicines and lifestyle changes may help reduce symptoms.

The best way to slow COPD is to stop smoking.

What happens when you have COPD?

COPD gradually gets worse over time. As it gets worse, you may be short of breath even when you do things like get dressed, fix a meal, or eat. People often feel weaker and limit activities. And some people may get lung infections and heart problems.

What are the symptoms of COPD?

When you have COPD, you have a cough that won't go away, and you're often short of breath. You may also cough up mucus. At times, your symptoms may suddenly flare up and get much worse.

How is COPD treated?

COPD may be treated with medicines and oxygen, along with self-care.

  • Medicines called bronchodilators are used to open or relax your airways. They can help you breathe easier. There are two types:
    • Short-acting bronchodilators ease your symptoms. They are considered a good first choice for treating stable COPD in a person whose symptoms come and go (intermittent symptoms).
    • Long-acting bronchodilators help prevent breathing problems. They help people whose symptoms do not go away (persistent symptoms).
  • Oxygen therapy boosts the amount of oxygen in your blood and helps you breathe easier.
  • Self-care means the things you can do for yourself to help manage your COPD. They are things like:
    • Quitting smoking.
    • Eating well.
    • Staying active.
    • Avoiding colds, infections, and other things that may trigger your symptoms.
    • Staying current on vaccines.

A lung (pulmonary) rehab program can help you learn to manage your disease. This program teaches you how to breathe easier, exercise, and eat well.

What is lung volume reduction surgery for COPD?

In lung volume reduction surgery (LVRS), a large area of damaged lung is removed to allow the remaining lung tissue to expand when you breathe in. This surgery is done only for people with severe chronic obstructive pulmonary disease (COPD) or with certain types of emphysema.

The National Emphysema Treatment Trial has examined the results of LVRS. The results of this study report that people not considered good candidates for this surgery include people who have:

  • Severely impaired lung function as measured by breathing tests or a uniform pattern of emphysema throughout the lungs.
  • Largely non-upper lung emphysema and who are able to exercise for a longer time than other people with COPD.
  • Certain other serious medical problems.

For other people LVRS, compared to medical treatment, may provide an increased ability to exercise and may result in fewer symptoms. LVRS also can reduce the number of COPD exacerbations for some people. But it does not improve the survival rate compared to medical treatment, except for people who have emphysema mainly in the upper portion of the lungs and who are not able to exercise well even after pulmonary rehabilitation.

Although selecting candidates for LVRS is subjective, criteria identifying good candidates for LVRS include people:

  • Who have severe emphysema that does not respond to medical therapy.
  • Who are younger than 75 to 80 years old.
  • Who have not smoked for at least 4 months.
  • Who have reasonable expectations of surgery results.
  • Who have areas of the lung that can be targeted.
  • Who have severe difficulty breathing, as determined by breathing tests.

Decision to have the surgery

The decision to have this surgery is not an easy one. Not all patients who have emphysema or COPD will benefit from this surgery. Detailed testing is needed to find out if a person is likely to be helped by LVRS. Talk with your doctor about all of the treatment options available for COPD.

How can you help prevent COPD?

The best way to keep COPD from starting is to not smoke. And if you smoke, the best way to prevent COPD from getting worse is to quit smoking. There are clear benefits to quitting, even after years of smoking. When you stop smoking, you slow down the damage to your lungs.

How is COPD diagnosed?

To find out if you have COPD, your doctor may:

  • Do a physical exam and listen to your lungs.
  • Ask you questions about your past health and whether you smoke or have been exposed to other things that can irritate your lungs.
  • Have you do breathing tests, including spirometry, to find out how well your lungs work.
  • Do a chest X-ray to look at your lungs.
  • Do a one time test for Alpha-1 antitrypsin (AAT). People who have a low AAT are more likely to get emphysema.
  • Do other tests to help rule out other problems that could be causing your symptoms.

How are medicines used to treat COPD?

Medicines most commonly used for COPD include bronchodilators. They open or relax your airways and help your shortness of breath. Short-acting bronchodilators ease your symptoms. Long-acting bronchodilators help prevent breathing problems. Other medicines may be used for severe symptoms or to treat flare-ups.

Who can diagnose and treat COPD?

Health professionals who can diagnose COPD and provide a basic treatment plan include:

  • Family medicine physicians.
  • Internists.
  • Nurse practitioners.
  • Physician assistants.

You may need to see a specialist in lung disease, called a pulmonologist (say "pull-muh-NAWL-uh-jist"), if:

  • Your diagnosis of COPD is uncertain or hard to make because you have diseases with similar symptoms.
  • You have unusual symptoms that are not usually seen in people with COPD.
  • You are younger than 50 and/or have no history or a short history of cigarette smoking.
  • You have to go to the hospital often because of sudden increases in shortness of breath.
  • You need long-term oxygen therapy.
  • You and your doctor are considering surgery, such as a lung transplant or lung volume reduction.

How can you care for yourself when you have COPD?

You can't undo the damage to your lungs from COPD. But you can take steps to prevent more damage and to feel better.

Quit smoking

This is the most important thing you can do to slow down the disease and improve your quality of life.

You may think that nothing can help you quit. But there are several treatments shown to be very good at helping people stop smoking. Talk to your doctor if you need help quitting.

Avoid things that can irritate your lungs

These things include smoke and air pollution.

Find ways to make breathing easier

Here are some ways you can make breathing easier.

  • Conserve your energy. You may get more tasks done and feel better if you learn to save energy while doing chores and other activities. For instance, take rest breaks and sit down whenever you can while you fold laundry, cook, and do other household tasks. An occupational or physical therapist can help you find ways to do everyday activities with less effort.
  • Learn breath-training methods—such as breathing through pursed lips—to improve airflow in and out of your lungs. Learn ways to clear your lungs that can help you save energy and oxygen.
  • Discuss pulmonary rehabilitation with your doctor.
  • Take the medicines prescribed by your doctor. If you use inhalers, be sure you know how to use each of them properly.

Stay as active as you can

Try to do activities and exercises that build muscle strength and help your heart. If you get out of breath, wait until your breathing is back to normal before you keep going.

Eat well

Getting enough to eat will help you keep up your strength. If you are losing weight, ask your doctor or dietitian about ways to make it easier to get the calories you need.

Avoid COVID-19, colds, and the flu

Wash your hands often. Get a flu vaccine every year. Stay up to date on your COVID-19 vaccines. And ask your doctor about getting the pneumococcal and whooping cough (pertussis) shots.

Seek education and support

Treating more than the disease and its symptoms is very important. Here are some things that can help you cope and live better with COPD.

  • Educate yourself and your family about COPD and your treatment program. This helps you and your family cope with your lung disease.
  • Counseling and support groups can help you learn to live with COPD. You may feel socially isolated because you can't enjoy activities with your family and friends the way you used to. But many people with COPD can lead a full life.
  • Ask for help from family, friends, and health professionals. Learning that you have a disease that may shorten or change your life may lead to depression or anxiety. These can make your COPD symptoms worse. But support can make it easier.
  • Try to follow your treatment plan. It may make you feel better and less likely to become depressed. A self-reward system—such as a movie night after staying on your medicine and exercise schedule for a week—can help keep you motivated.

How is surgery used to treat COPD?

Lung surgery is rarely used to treat COPD. Surgery is never the first treatment choice and is only considered for people who have severe COPD that has not improved with other treatment.

Surgery choices include:

Lung volume reduction surgery.

This removes part of one or both lungs. It makes room for the rest of the lung to work better. It is used only for some types of severe emphysema.

Lung transplant.

This surgery replaces a sick lung with a healthy lung from a person who has just died.


This removes the part of the lung that has been damaged by the formation of large, air-filled sacs called bullae. This surgery is rarely done.

Other procedures:

Bronchoscopic interventions.

These non-surgical techniques collapse (or close off) diseased parts of the lungs to help the remaining parts work better.

Sarah's Story: Dealing with the emotions from COPD

Sarah, 67
Read more about how Sarah deals with her emotions.
"Not being the person I used to be—it makes me really sad sometimes. There are lots of days I don't want to even get up, but then I think about taking my walk or seeing my friends, and I want get out there. COPD may slow me down, but it isn't going to stop me."

More good days. It's possible to have them, even with COPD, says Sarah, who found out 3 years ago that she had the disease.

COPD sneaked up on Sarah. She began coughing more often, and the coughing lasted longer. Every day it got a little bit harder to breathe. One day she found she couldn't walk up the basement stairs without having to stop and catch her breath. And then she began coughing and couldn't stop.

"It was scary," she says. "I'd try to take a breath, but I'd cough instead. I was coughing up all this liquid—it felt like I was drowning. I just sat on the step and hung onto that railing until it stopped. It seemed like a really long time."

After that, Sarah knew she had to quit smoking.

"My husband had been telling me for years to quit, but I just couldn't," says Sarah, 67. "But when my doctor told me I had COPD, I knew I really had to do it. My mom had COPD but never quit smoking, and her last years were really hard."

It took a year, a few tries, the help of a quit-smoking group at a local hospital, and medicines before Sarah was able to quit for good. But it turns out that, for Sarah, quitting smoking isn't the toughest part about having COPD.

"Not being the person I used to be—it makes me really sad sometimes," Sarah says. "When I was in my 20s and 30s, I worked full-time and chased four kids around the house. Some days now I can't even get dressed without taking a break. And I need to take this oxygen tank with me every time I leave the house."

Feeling depressed and angry makes it hard to make it through the day, Sarah says. But going to a COPD support group every week at her local hospital helps a lot.

"I fit in there. I'm not the only one with a hose up my nose," she says. "I can talk about how mad I am that I have this disease. And it helps me to hear how other people are dealing with it."

The group helps Sarah stay on track with her pulmonary rehab program, medicines, and diet. She and a friend walk in the mall every morning. Sarah says that those walks make her feel strong. These days she's breathing a little easier too.

"Every time I have a good day, it makes me want to keep trying. There are lots of days I don't want to even get up," she says. "But then I think about taking my walk or seeing my friends, and I want to get out there. COPD may slow me down, but it isn't going to stop me."

This story is based on information gathered from many people facing this health issue.

COPD: Keeping Your Quality of Life

What puts you at risk for COPD?

Tobacco smoking is the most important risk factor for COPD. Having asthma can also increase your risk for COPD. Other things that put you at risk include breathing in chemical fumes, industrial dust, or air pollution over a long period of time.

How does exercise help you feel better when you have COPD?

When you have COPD, activity and exercise can:

  • Build muscle strength and endurance. This will help you be more active—you will be able to do more activities for longer amounts of time.
  • Reduce shortness of breath.

Upper body exercises increase strength in arm and shoulder muscles, which provide support to the rib cage. They help in daily tasks such as carrying groceries and doing housework.

Lower body exercises develop lower body muscles and will help you move around more easily for longer periods of time.

Aerobic exercise gets more oxygen to your muscles. This allows them to work longer.

Exercises for COPD can be done nearly anywhere. They are often done as part of a pulmonary rehabilitation program.

How do upper respiratory infections (URIs) affect COPD?

Colds, the flu, and other upper respiratory infections can make COPD symptoms worse. These symptoms include having too much mucus in your lungs, coughing, and being short of breath.

COPD: When to call

Call 911 anytime you think you may need emergency care. For example, call if:

  • You have severe trouble breathing.
  • You have severe chest pain.

Call your doctor now or seek immediate medical care if:

  • You have new or worse trouble breathing.
  • You have new or worse chest pain.
  • You cough up blood.
  • You have a fever.

Watch closely for changes in your health, and be sure to contact your doctor if:

  • You cough more deeply or more often, especially if you notice more mucus or a change in the color of your mucus.
  • You have new or worse swelling in your legs or belly.
  • You have feelings of anxiety or depression.
  • You need to use your antibiotic or steroid pills.
  • You are not getting better as expected.

Getting the nutrition you need when you have COPD

The following tips can make eating easier and help you get the nutrition you need. But if you have other diet limitations, talk with your doctor or a registered dietitian before making changes in what you eat.

  • Make eating easier.
    • Choose foods that are easy to prepare.
    • Eat in a relaxed setting.
    • Eat with friends and family.
    • If you eat a main meal, try to eat it early. This way, you will have energy throughout more of the day.
    • Try to include a favorite food in your meals.
  • Avoid shortness of breath while eating.
    • Rest before eating if eating makes you short of breath or tired.
    • Use your bronchodilator about an hour before you eat. Then clear your lungs. This can help you breathe better during your meal.
    • Eat while sitting up. This helps remove pressure on your lungs.
    • If you use oxygen, use it while eating. Eating and digestion require energy, which causes your body to use more oxygen.
    • Try eating smaller, frequent meals so the stomach is never too full. A full stomach can push on the muscle that helps you breathe (your diaphragm) and make it harder to breathe.
    • Drink your beverage at the end of the meal. Drinking before or during the meal can fill you up more quickly.
    • If you notice that you have belly bloating that makes it hard to breathe, limit the amount of foods you eat that cause gas. These foods include onions, broccoli, cauliflower, cabbage, and beans.
    • Avoid foods that are hard to chew. Eat and chew slowly so you are less likely to become short of breath. Try putting your spoon or fork down between bites to slow your eating speed.
    • If you have trouble breathing while eating solid food, try a liquid meal replacement, such as Ensure, Boost, or instant breakfast drinks.
  • Eat healthy foods.
    • Try to eat a variety of foods, including fruits and vegetables, dairy products, grains, and proteins.

Exercises for adults with breathing problems

Before starting any exercise program, talk to your health professional. They may ask that you do specific exercises and will help you decide how often and how long to do them.

Start the exercise slowly and gradually. Either keep track of how long you can do it or count the number of times you can do it before you are mildly out of breath. Then rest and move on to the next exercise. Each week, increase the amount of time you do them or how many you do.

Arm extensions

  1. Sit or stand with your feet slightly apart.
  2. Start with your arms by your side.
  3. Breathe out as you raise one arm to shoulder height, keeping the arm straight and pointing to the side.
  4. Breathe in as you return your arm to your side.
  5. Repeat at least 3 times. Over time, increase to 8 to 12 times.
  6. Repeat these steps with your other arm.

Elbow circles

  1. Sit or stand with your feet slightly apart.
  2. Place your hands on your shoulders with your elbows at shoulder level and pointing out.
  3. Slowly make a circle with your elbows.
  4. Breathe out as you start the circle and breathe in as you complete the circle.
  5. Repeat at least 3 times. Over time, increase to 8 to 12 times.
  6. Change direction and repeat your circles.

Elbow breathing

  1. Sit or stand with your feet slightly apart.
  2. Lift your elbows to shoulder level, and touch your fingertips in front of your chest.
  3. Breathe in as you pull your elbows back so that your fingertips separate.
  4. Breathe out as you return your elbows and fingertips to the original position.
  5. Repeat at least 3 times. Over time, increase to 8 to 12 times.

Knee extension

  1. Sit in a chair with your feet slightly apart.
  2. Breathe out as you straighten one knee and raise your leg.
  3. Breathe in as you return your foot to the floor.
  4. Repeat at least 3 times. Over time, increase to 8 to 12 times.
  5. Repeat these steps with your other leg.

Leg lift

  1. Sit in a chair with your feet slightly apart.
  2. Breathe out as you lift one leg straight up so that the knee rises toward your shoulder.
  3. Breathe in as you return your foot to the floor.
  4. Repeat at least 3 times. Over time, increase to 8 to 12 times.
  5. Repeat these steps with your other leg.

Step up

  1. Stand on the floor, facing a bottom step. Hold on to the handrail. Or you can use a thick book or a case of soup cans. Hold on to a chair or counter.
  2. Breathe out as you step up with your right leg.
  3. Breathe in as you step back down.
  4. Repeat at least 3 times. Over time, increase to 8 to 12 times.
  5. Repeat these steps with your left leg.

Why do you need to monitor your COPD symptoms?

At times, your symptoms may suddenly get much worse. These attacks are called COPD flare-ups, or exacerbations. They may be life-threatening. So it's important to keep track of your symptoms and know what to do if they get worse.

In a COPD flare-up, your usual symptoms suddenly get worse.

  • You have more shortness of breath and wheezing.
  • You have more coughing, with or without mucus.
  • You may cough up more mucus than usual, and it may be a different color.

Your doctor can help you make a plan to manage flare-ups. Quick treatment at home may help prevent serious breathing problems.

COPD: What Happens to Your Lungs

How does COPD affect your body?

COPD slowly damages the lungs and affects how you breathe.

COPD's effect on breathing

In COPD, the airways of the lungs (bronchial tubes) become inflamed and narrowed. They tend to collapse when you breathe out and can become clogged with mucus. This reduces airflow through the bronchial tubes. This is called airway obstruction. It makes it difficult to move air in and out of the lungs.

The inflammation of the bronchial tubes makes the nerves in the lungs very sensitive. In response to irritation, the body forces air through the airways by a rapid and strong contraction of the breathing muscles—a cough. The rapid movement of air in the breathing tubes helps remove mucus from the lungs into the throat. People with COPD often cough a lot in the morning after a large amount of mucus has built up overnight (smoker's cough).

The oxygen and carbon dioxide exchange

The lungs are where the blood picks up oxygen to deliver throughout the body and where it disposes of carbon dioxide that is a by-product of the body processes. COPD affects this process.

Emphysema can lead to destruction of the alveoli. These are the tiny air sacs that allow oxygen to get into the blood. Their destruction leads to the formation of large air pockets in the lung called bullae. These bullae do not exchange oxygen and carbon dioxide like normal lung tissue. Also, the bullae can become very large. Normal lung tissue next to the bullae can't expand as it should, reducing lung function.

Chronic bronchitis affects the oxygen and carbon dioxide exchange because the airway swelling and mucus production can also narrow the airways. This can reduce the flow of oxygen-rich air into the lung and carbon dioxide out of the lung.

The damage to the alveoli and airways makes it harder to exchange carbon dioxide and oxygen during each breath. Decreased levels of oxygen in the blood and increased levels of carbon dioxide cause the breathing muscles to contract harder and faster. The nerves in the muscles and lungs sense this increased activity and report it to the brain. As a result, you feel short of breath.

Fran's Story: Finding support when you have COPD

Read more about how Fran draws strength from others who understand her experience.
"Someone told me to go online and connect with a support group. I did, and it literally changed my life."

"I was so scared when the doctor told me I had emphysema. I was afraid to go anywhere or do anything.

"Someone told me to go online and connect with a support group. I did, and it literally changed my life. I was pretty shy at first, and all I did was read what everyone else was writing. Then one day I was having trouble with the company that supplies my oxygen. I went online and asked for advice. I got it. I was able to clear up the problem the very next day thanks to a woman who'd had the same thing happen to her.

"The next advice I took was to talk to my doctor about my depression. I wish I had done it sooner. He put me on antidepressants and had me see a counselor. I'd never been to a counselor before and didn't really believe in that kind of thing. But this counselor really did help me deal with my fears. I feel so much better about things now. I look forward to every day.

"Now there's no stopping me. I go online every day and 'chat' with people. They cheer me up when I'm feeling blue. They answer questions. They give me tips. They've become true friends. I still have bad days. But no matter how bad my day has been, I usually feel much better after checking in with my online friends.

"And the best part is that now I'm one of the ones giving tips and trying to cheer people up. It's amazing how good it feels to help someone else like that. It really makes your day."

This story is based on information gathered from many people facing this health issue.

What is chronic obstructive pulmonary disease (COPD)?

COPD is a lung disease that makes it hard to breathe. COPD stands for chronic obstructive pulmonary disease. It is caused by damage to the lungs over many years, usually from smoking.

Other things that may put you at risk for COPD include breathing chemical fumes, dust, or air pollution over a long period of time. Secondhand smoke is also bad.

Chronic bronchitis and emphysema are two lung problems that are types of COPD. In chronic bronchitis, the airways that carry air to the lungs (bronchial tubes) get inflamed and make a lot of mucus. This can narrow or block the airways, making it hard for you to breathe. It can also make you cough. In emphysema, the air sacs in your lungs are damaged and lose their stretch. Less air gets in and out of your lungs, which makes you feel short of breath.

What causes COPD?

COPD is almost always caused by smoking. Most people with COPD have smoked for a long time. And research shows that smoking cigarettes puts you at risk for COPD. Over time, breathing tobacco smoke irritates the airways and damages the lungs.

People who get emphysema in their 30s or 40s may have a disorder that runs in families, called alpha-1 antitrypsin deficiency. This is a rare condition in which your body may not be able to make enough of a protein (alpha-1 antitrypsin) that helps protect the lungs from damage.

COPD: Try a New Quit-Smoking Strategy

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