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Chronic Obstructive Pulmonary Disease (COPD) refers to two progressive diseases that may both be present, or each may be present alone. These diseases are chronic bronchitis and emphysema. Both result in a high death rate, since these cause obstruction to the airway that continues to deteriorate. Smoking is one of the primary causes for both types of COPD, and quitting significantly reduces risk for COPD of either or both types.
COPD is currently the fourth leading cause of death in the US, resulting in over 100,000 deaths per year. It can also significantly affect quality of life, limiting activity, causing one to be unable to tolerate oxygen, and as well, requiring that people use oxygen when the disease has progressed.
Scarring of the bronchial tubes causes chronic bronchitis. This scarring results in a restricted airway, which makes people produce more phlegm, causing further restriction. Those with chronic bronchitis usually show presence of consistent coughing for three months out a year, two years in a row. Bronchoscopy, a tube placed down the throat to look at the bronchial tubes confirms diagnosis.
Treatment of COPD resulting from chronic bronchitis includes smoking cessation, asthma medication and the use of inhaled steroids like Pulmocort to help calm swelling. Despite these treatments, the illness often progresses to the point where these treatments no longer provide an adequate airway. Death from COPD caused by bronchitis is usually related to bacterial infections that cannot be resolved through antibiotics.
Emphysema and COPD are often thought of as one and the same. Emphysema is caused by the gradual destruction of portions of the lungs called alveoli. As more alveoli are killed off, the lungs become less able to oxygenate blood flowing to them, resulting in greater difficult breathing, and a lower than normal oxygen count in the blood.
Symptoms of this form of COPD include persistent cough, inability to perform hard exercise and shortness of breath. As emphysema type COPD progresses, symptoms will include extremely labored breathing and an inability to perform even normal household activities without exhaustion. Pulmonary function tests diagnose emphysema and can also suggest the progress of the disease.
In most cases, emphysema is caused by smoking or exposure to second-hand smoke. In some cases, however, an inherited disease may cause emphysema. This disease means the body lacks an essential protein that protects the alveoli.
In all cases of COPD that are emphysema related, treatment includes inhaled steroids, oxygen as needed and continued monitoring of airway function. Smoking cessation is essential. Continuing to smoke will only aggravate symptoms and make them progress more quickly.
Some recent treatments for emphysema include lung transplants, and also a removal of part of the lungs, which seems to restore some strength and function to the remaining alveoli. However, since COPD is often linked to smoking, some insurances and the US Medicare service will not pay for such treatment.
As this is the case, many with COPD might be helped, but lack the funds to pay for experimental treatments. Some in the health profession feel that smokers, fully apprised of the risks, essentially hazard these risks and must pay the consequences. Conversely others feel that like many other addictive illnesses, those who have been unable to conquer nicotine addiction should not be punished with death.