Chronic Obstructive Pulmonary Disease (COPD)

Chronic obstructive pulmonary disease (COPD) refers to a group of lung diseases that block airflow due to lung damage and make it increasingly difficult to breathe. Unlike asthma, obstruction of the lungs that develops in COPD patients does not improve and is not fully reversible. Emphysema and chronic bronchitis are the common conditions that make up COPD where the normal exchange of oxygen and carbon dioxide are impaired.

COPD is a leading cause of death and illness worldwide. Most COPD is caused by long-term cigarette smoking and progression of the disease can be prevented by quitting smoking. Because the established damage to the lungs cannot be reversed, treatment focuses on quitting smoking, controlling day-to-day symptoms and preventing further lung damage by preventing flare-ups or exacerbations of respiratory symptoms.

COPD lungs:

The bronchial airways, the tubes leading to the lungs become narrowed as a result of chronic inflammation and injury. These changes limit air flow in and out of the lungs making it more difficult to breathe with exertion or exercise. At the end of the bronchial airways are many tiny balloon-like air sacs, which inflate and deflate when you breathe in and out. These air sacs lose their elasticity and structure limiting air flow in and out of the lungs. Also, air gets trapped in the lung, making it more difficult to breath. It is common for people with COPD to experience increased cough and shortness of breath brought on by repeated lung infections. These episodes are called "COPD exacerbations" and, if not prevented, can lead to progression of the disease.

Causes of COPD

Years of cigarette smoking cause COPD as well as extreme exposure to air pollutants. People who are exposed to significant levels of secondhand smoke and chemical exposure may also be at risk. Some patients developed the disease at an early age and this may be associated with a deficiency of a protective protein in the lung, alpha 1 antitrypsin. Without this protein, the lungs are more vulnerable to tobacco smoke and other environmental factors that cause COPD.

Signs and symptoms of COPD

The most common symptoms of COPD include:

• A cough that doesn't go away
• Coughing up large volumes of mucus, usually in the morning
• Shortness of breath with mild exertion but not at rest
• Wheezing
• Tightness in the chest
• Limitations in activity

Testing and Diagnosing COPD

The doctors will ask about your symptoms and medical history, do a physical exam, and conduct breathing tests. Pulmonary function tests are required to confirm a diagnosis of COPD. These tests involve blowing into a device that measures lung volumes and how much air your lungs forcibly blow out. These tests are reviewed by the doctor, the condition is explained and appropriate medications are prescribed. The doctors may also request a chest x-ray, or a measurement of the level of blood oxygen.

Treatment for COPD

The doctors and staff of Bernstein Allergy Group and Bernstein Clinical Research Center will take the time to explain how to properly use all the COPD medication and answer all questions making sure that you are a knowledgeable COPD patient. Taking control of your disease and care is extremely important to our center. Our doctors and research staff participate in many studies of new medications being developed by pharmaceutical companies in order to improve daily symptoms, quality of life, and prevent acute illness from exacerbations. If you are interested in learning more about participating in a COPD medical research study, please call 513-728-4747.

A COPD treatment program may include:

• Smoking Cessation Programs - including nicotine gum and prescriptions
• Inhaled Bronchodilators: short acting and long-acting drugs that reduce symptoms of shortness of breath, wheezing and cough
• Inhaled anti-cholinergic drugs improve breathing symptoms
• Inhaled Corticosteroids: may reduce airway inflammation and prevent COPD exacerbations especially if given with long acting bronchodilators
• Antibiotics: medicines to help fight bacterial infections
• Annual Flu or periodic pneumonia vaccinations: to reduce the risk of getting the flu or pneumonias
• Oxygen therapy: supplementation of oxygen may be necessary

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