Is COPD curable?
Chronic obstructive pulmonary disease, more commonly known as COPD, is a lung disease that affects more than 15 million adults in the U.S., making it difficult for them to breathe. Pulmonologist Matthew Varner, DO, explained what you need to know about COPD, including how it’s caused, if it’s curable and more.
What are the types of COPD?
The two main conditions of COPD are chronic bronchitis and emphysema. Chronic bronchitis involves long-term inflammation and narrowing of the airway tubes that carry air to and from the lungs. This inflammation leads to increased mucus production, causing the airways to be even more obstructed. Emphysema involves damage to the air sacs in the lungs.
“Tissue destruction damages the air sacs, reducing their elasticity and making it difficult for them to expand and contract properly during breathing,” Dr. Varner explained. “This results in decreased oxygen exchange in your lungs.”
Do only smokers get COPD?
While smoking is the leading cause of COPD, non-smokers who have been exposed to other lung irritants can develop the condition.
These lung irritants can include:
- Secondhand smoke
- Occupational dust such as coal dust, silica or asbestos
- Air pollution
- Chemical fumes
- Indoor biomass fuels, such as fumes from wood or coal used for cooking and heating
Genetics can also increase your risk of COPD.
“There are people who have genetic predispositions to developing COPD, even with relatively low levels of exposure to lung irritants,” Dr. Varner said. “There are also individuals who have what’s called alpha-1 antitrypsin deficiency, which is a genetic condition that affects the production of a protein that helps protect the lungs. Individuals with this deficiency are at higher risk for developing COPD, especially if they do smoke.”
Overall, anyone exposed to lung irritants over an extended time is at risk for developing COPD. But individuals who are most at risk are current or former smokers.
“The longer and more heavily someone smokes, the greater the risk of developing the disease,” he said.
What are some signs you might have COPD?
Shortness of breath is the hallmark symptom of COPD. Initially, patients will get short of breath with physical exertion, but as the disease advances, they can progress to being short of breath even at rest.
Other symptoms of COPD can include:
- A chronic, persistent cough that produces mucus, usually worse in the morning.
- A wheezing, whistling or squeaky sound when breathing in and out, particularly when exhaling.
- Chest tightness that feels like you can’t really take a deep breath in or out.
- Frequent respiratory infections. COPD can weaken the immune system and make individuals more susceptible to respiratory infections such as cold, flu and pneumonia.
- Lack of energy and fatigue due to the extra effort of trying to breathe.
- Unintentional weight loss caused by a decreased appetite.
Does COPD affect women differently than men?
“Yes, COPD can affect women differently than men in terms of symptoms, disease progression and treatment response,” Dr. Varner said. “Women may be more susceptible to the harmful effects of cigarette smoke and may experience more severe symptoms at a younger age compared to men.”
How is COPD diagnosed?
The only way to confirm a diagnosis of COPD is by a pulmonary function test, which a pulmonologist can perform. During this breathing test, a patient sits in a booth while the pulmonologist does maneuvers to check for obstruction.
Can COPD be cured? How is it treated?
Unfortunately, COPD cannot be cured, but its progression can be slowed, and symptoms can be managed through various treatments. The goals of COPD treatment are to relieve the symptoms, improve quality of life and reduce the frequency and severity of flareups.
Treatments can include inhaled medications such as:
- Beta-agonists. “We have beta receptors in our airways and these medications hit those receptors and help the muscles relax around the airways to make it easier to breathe,” Dr. Varner said. “There are short-acting versions such as albuterol, which many people know about, and long-acting versions.”
- Corticosteroids. These medications help reduce airway inflammation.
- Muscarinic antagonists. These medications help relax the muscles around the airways leading to a widening the airways and improve airflow.
Other treatments include:
- Monoclonal antibody biologic therapies for patients with type 2 inflammation. These are injections that target and prevent immune cells from causing inflammation.
- Phosphodiesterase-4 inhibitors for patients with severe COPD, which can help reduce inflammation and relax the airways.
- Pulmonary rehab, which uses exercise, training, education and support to help individuals with COPD improve their exercise tolerance, learn breathing techniques and manage their symptoms more effectively.
- Bronchoscopic volume lung reduction, which is a minimally invasive procedure used in the treatment of COPD with severe emphysema. This procedure aims to reduce the hyperinflation and improve lung function by reducing the volume of the diseased lung tissue, allowing healthier lung tissue to function more effectively.
In this procedure, one-way valves are placed in the airways leading to the diseased lung region. These valves allow air and mucus to exit the affected area during exhalation, but prevent them from reentering during inhalation, effectively blocking airflow to the diseased lung region.
- Oxygen therapy is used to maintain a certain oxygen saturation level to improve oxygenation and reduce symptoms such as shortness of breath.
- Annual flu and pneumococcal vaccines are recommended to help reduce the risk of respiratory infections that can worsen symptoms and lead to exacerbations.
Lifestyle modifications such as regular exercise, eating a balanced diet, and avoiding exposure to lung irritants (such as smoking) are also ways to reduce symptoms of COPD.
“Although it may seem counterintuitive to engage in physical activity when breathing is already difficult, exercise is highly beneficial for patients with COPD,” Dr. Varner said. “Exercise can actually improve lung function, strengthen the respiratory muscles, increase endurance and enhance overall quality of life.”
Do air purifiers help people with COPD?
Air purifiers with HEPA filters can be beneficial for patients with COPD by helping to remove airborne particles, pollutants and allergens from indoor air, but there are other ways you can improve the air quality in your house. Dr. Varner recommended taking these steps:
- Improve the ventilation in your house. When you can, try opening windows and doors to allow fresh air to circulate. Use exhaust fans in the kitchens and bathrooms to remove moisture and pollutants and use proper ventilating gas appliances and wood burning stoves.
- Maintain indoor humidity levels between 30% and 50% to prevent mold growth and reduce the proliferation of dust mites.
- Avoid smoking indoors.
- Regularly vacuum and dust your home to remove any pet dander, dust or other allergens from surface and carpets. Be sure to use cleaning products with low VOC emissions.
Dr. Varner said it’s also important to be aware of and prepare for weather changes, especially during seasonal changes.
“People with COPD may be sensitive to changes in temperature, humidity, air pressure, and air quality,” he said.
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