COPD – Symptoms and Causes
What is COPD?
COPD (Chronic obstructive pulmonary disease) is a long-term lung condition that makes breathing difficult. It happens when the airways in the lungs become inflamed and damaged, limiting airflow.
People with COPD often experience breathing problems, daily coughing with mucus, and wheezing sounds when breathing.
The main cause of COPD is exposure to harmful substances over many years. Cigarette smoking is the most common cause, but other irritants like chemicals, dust, and fumes can also damage the lungs.
Two main types of COPD:
- Chronic bronchitis – inflammation of the bronchi (air tubes in the lungs) that creates excess mucus and blocks airflow.
- Emphysema – damage to the alveoli (tiny air sacs in the lungs) that reduces oxygen transfer to the blood.
These two conditions usually occur together in people with COPD, though the severity varies from person to person.
COPD is treatable but not curable. With proper care and treatment, people can:
- Control their symptoms
- Improve their quality of life
- Slow the progression of the disease
- Reduce the risk of related health problems
Many people with COPD can manage their condition effectively with medication, lifestyle changes, and pulmonary rehabilitation programs.
Signs and Symptoms
COPD typically progresses gradually over time. Many people don’t notice symptoms until their lungs have already been damaged. Symptoms worsen over time, particularly if the person continues to smoke or inhale harmful substances.
Common symptoms of COPD include:
- Shortness of breath, especially during physical activity
- Wheezing when breathing
- Persistent cough that may produce mucus (clear, white, yellow, or green)
- Feeling of tightness or heaviness in the chest
- Fatigue and lack of energy
- Frequent respiratory infections
- Unintended weight loss in later stages
- Swelling in the ankles, feet, or legs
People with COPD sometimes experience flare-ups called exacerbations. These periods when symptoms get worse may last from several days to weeks. Triggers can include:
- Strong odors
- Cold air
- Air pollution
- Colds or other infections
During an exacerbation, you might notice:
- More difficulty breathing than usual
- Increased chest tightness
- More frequent coughing
- Changes in mucus (amount, color, or thickness)
- Fever
When Medical Help Is Needed
Contact your healthcare provider if your symptoms don’t improve with treatment or if they worsen. Seek medical advice if you notice signs of infection, such as fever or changes in your mucus.
Seek emergency medical attention if you:
- Can’t catch your breath
- Notice blue coloring in your lips or fingernails
- Have a rapid heartbeat
- Feel confused or have trouble concentrating
These symptoms could indicate a serious problem that needs immediate treatment.
What Causes COPD
How COPD Affects Your Lungs
When you breathe, air moves through your windpipe (trachea) into two large tubes called bronchi that lead to your lungs. Inside the lungs, these tubes branch out many times into smaller tubes called bronchioles.
These small tubes end in tiny air sacs called alveoli. The alveoli have very thin walls with tiny blood vessels. Oxygen passes from these air sacs into your bloodstream, while carbon dioxide moves from your blood into the air sacs to be breathed out.
Healthy alveoli are elastic, allowing them to push out old air during exhalation and make room for fresh air during inhalation.
Types of Airway Blockages
Long-term exposure to harmful substances damages your lungs and prevents air from moving freely. This makes it hard for your lungs to provide oxygen to your body and remove carbon dioxide. Two main conditions block airflow in COPD:
-
Emphysema: This condition destroys the walls between air sacs, creating larger, less efficient spaces. These damaged air sacs:
- Have less surface area for gas exchange
- Trap old air, leaving little room for fresh air
- Lose their stretchiness, making it harder to push air out
-
Chronic bronchitis: In this condition, the breathing tubes become:
- Inflamed and narrowed
- Thickened, reducing airflow
- Clogged with excess mucus
- Irritated, causing ongoing coughing as the body tries to clear the airways
Smoking and Other Harmful Substances
The most common cause of COPD in developed countries is tobacco smoking. Not everyone who smokes gets COPD, indicating that genetics may influence who develops the disease.
Other substances that can cause COPD include:
| Irritant | Source |
|---|---|
| Cigar and pipe smoke | Tobacco products |
| Secondhand smoke | Being near smokers |
| Air pollution | Industrial emissions, traffic fumes |
| Workplace exposure | Dust, chemicals, fumes |
In developing countries, COPD is often caused by inhaling fumes from burning fuels for cooking and heating in poorly ventilated homes.
Genetic Alpha-1-Antitrypsin Deficiency
About 1% of people with COPD have a genetic condition called alpha-1-antitrypsin (AAT) deficiency. This inherited disorder causes:
- Low levels of the protective protein alpha-1-antitrypsin
- Earlier onset of COPD symptoms, often before age 40
- Family patterns of COPD and liver disease
Alpha-1-antitrypsin is normally made by the liver and released into the bloodstream.
It protects the lungs from damage caused by smoke, fumes, and dust. Without enough of this protein, the lungs become more vulnerable to irritants, leading to emphysema.
Individuals with this genetic form of COPD often have relatives with similar lung issues and show symptoms at a younger age compared to those whose COPD results from smoking or other environmental irritants.
Risk Factors
Several factors can increase your chance of developing COPD:
- Smoking is the leading risk factor. The risk grows with how long and how much you smoke. This includes cigarettes, pipes, cigars, and marijuana. Breathing secondhand smoke regularly also raises your risk.
- Asthma can make you more likely to develop COPD, especially if you also smoke.
-
Workplace exposures to certain substances can harm your lungs over time, including:
- Chemical fumes
- Dust
- Vapors
- Smoke
- Indoor air pollution from cooking and heating with fuel in poorly ventilated homes increases COPD risk, particularly in developing countries.
Alpha-1 antitrypsin (AAT) deficiency is a rare inherited condition that can cause COPD even without smoking. Other genetic traits may make certain smokers more vulnerable to developing the disease.
COPD mainly affects people over 40, especially those with a history of smoking or prolonged exposure to lung irritants.
Health Problems Linked to COPD
People with COPD face several possible health complications beyond breathing difficulties. Those with COPD have higher chances of getting respiratory infections like colds, flu, and pneumonia.
These infections make breathing even harder and may further damage the lungs.
Heart disease risk increases with COPD, including heart attacks, though scientists don’t fully understand why. Lung cancer rates are also higher among COPD patients.
COPD can lead to pulmonary hypertension—high blood pressure in the arteries that carry blood to the lungs. This puts extra strain on the heart.
The emotional toll of COPD shouldn’t be overlooked. When breathing problems limit daily activities, patients often develop anxiety and depression. These mental health challenges can make managing the physical symptoms more difficult.
Prevention
Preventing COPD begins with avoiding its main cause: tobacco smoke. Not smoking is the single most effective way to protect your lungs.
For smokers who already have COPD, quitting immediately can significantly slow the disease’s progression.
Quitting smoking can be challenging, especially after multiple attempts. Finding an effective smoking cessation program is crucial for long-term success.
Speak with a healthcare provider about medications, counseling, and other support options that might work for your situation.
Workplace hazards represent another significant risk factor for COPD. People exposed to chemical fumes, dusts, or vapors should take protective measures.
This includes using proper ventilation systems, wearing appropriate respiratory protection, and following workplace safety guidelines.
