Chronic Obstructive Pulmonary Disease

Chronic obstructive pulmonary disease (COPD) refers to a group of lung conditions that interfere with normal breathing, including:

  • Bronchiectasis
  • Chronic bronchitis
  • Emphysema
  • Alpha 1 antitrypsin deficiency

These diseases cause a chronic, permanent and typically progressive obstruction of airflow in the lungs.

Bronchiectasis

Bronchiectasis is a type of chronic obstructive pulmonary disease (COPD) in which mucus accumulates and sticks in the airways of the lungs, called bronchi. As a result, the airways become infected and inflamed, eventually leading to enlarged and weak airways, which allows more mucus and bacteria to accumulate.

Bronchiectasis most often affects children, although people of all ages are diagnosed with the condition.

It can be caused by lung injury from other conditions, including cystic fibrosis, tuberculosis, pneumonia and immunodeficiency disorders, such as HIV and AIDS.

Symptoms of bronchiectasis vary for each person and in rare cases, a patient may not experience any symptoms at all. However, common symptoms may include:

  • Cough, which worsens when lying down
  • Shortness of breath
  • Abnormal chest sounds
  • Weakness
  • Weight loss
  • Fatigue
  • Discolored or foul smelling mucus, or mucus that contains blood

The goal of treatment for bronchiectasis is to treat any underlying conditions causing lung injury, help remove mucus from the lungs and prevent further complications.

Treatment may include:

  • Bronchodilator Medications
  • Steroids — Inhaled as an aerosol spray
  • Antibiotics
  • Mucus Thinners and Expectorants
  • Respiratory Therapy
  • Surgery — Lung volume reduction surgery, during which small wedges of damaged lung tissue are removed, may be recommended for some patients with severe cases of bronchiectasis.
  • Lung Transplant — In very severe cases, lung transplantation may be an option for some patients.

Chronic Bronchitis

Chronic bronchitis is a common type of chronic obstructive pulmonary disease (COPD) in which the air passages in the lungs — the bronchi — are repeatedly inflamed, leading to scarring of the bronchi walls. As a result, excessive amounts of sticky mucus are produced and fill the bronchial tubes, which become thickened, impeding normal airflow through the lungs.

Chronic bronchitis affects millions of North Americans each year. Cigarette smoking is the number one risk factor for developing chronic bronchitis. Over 90 percent of patients with chronic bronchitis have a smoking history, although only 15 percent of all cigarette smokers are ultimately diagnosed with some type of COPD, such as chronic bronchitis.

People with chronic bronchitis develop a persistent mucus-producing cough present most days of the month, or for three months of the year for two successive years. Other symptoms include frequent clearing of the throat and shortness of breath.

The goal of therapy for chronic bronchitis is to relieve symptoms, prevent complications and slow the progression of the disease. Quitting smoking is also essential for patients with chronic bronchitis, since continuing to use tobacco will only further damage the lungs.

Treatment may include:

  • Bronchodilator Medications
  • Steroids — Inhaled as an aerosol spray
  • Antibiotics
  • Vaccines — flu shot annually and pneumonia shot every five to seven years
  • Oxygen Therapy
  • Surgery — Lung volume reduction surgery, during which small wedges of damaged lung tissue are removed, may be recommended for some patients with chronic bronchitis.
  • Pulmonary Rehabilitation
    • Education
    • Nutrition counseling
    • Learning special breathing techniques
    • Help with quitting smoking
    • Starting an exercise regimen

Because people with chronic bronchitis are often physically limited, they may avoid any kind of physical activity. However, regular physical activity can actually improve a patient’s health and wellbeing.

Emphysema

When you breathe, air travels to your lungs through airways called bronchi. The bronchi divide into smaller airways, called bronchioles, which end in clusters of tiny air sacs, called alveoli. Emphysema affects the walls of the millions of tiny air sacs in the lungs, which become inflamed and loose elasticity, causing the bronchioles to collapse. As a result, air becomes trapped in the air sacks, which become overstretched and may rupture, greatly affecting a person’s ability to breathe normally.

Emphysema is the fourth leading cause of death in North America. The leading cause of emphysema is cigarette smoking. Other risks factors include:

  • Air pollution
  • Occupational exposure to dust and chemicals
  • Frequent lower respiratory infections
  • Second hand smoke

In rare cases, the genetic disorder — alpha-1 antitrypsin (AAT) deficiency — causes emphysema.

A person with emphysema will have shortness of breath — during physical activity and when the condition is more advanced, also during rest. Patients may eventually need supplemental oxygen and may have to rely on mechanical respiratory devices. Other symptoms of emphysema include chronic cough, frequent respiratory infections, reduced appetite, weight loss and fatigue.

The goal of therapy for emphysema is to provide relief of symptoms, prevent complications and slow the progression of the disease. Quitting smoking is also essential for patients with emphysema, since continuing to use tobacco will only further damage the lungs.

Treatments include:

  • Bronchodilator Medications
  • Steroids – Inhaled as an aerosol spray
  • Antibiotics
  • Vaccines – flu shot annually and pneumonia shot every five to seven years
  • Oxygen Therapy
  • Surgery or Lung Transplant
  • Protein Therapy – Patients with emphysema caused by an alpha-1 antitrypsin (AAT) deficiency may be given infusions of AAT to help slow the progression of lung damage.
  • Pulmonary Rehabilitation
    • Education
    • Nutrition counseling
    • Learning special breathing techniques
    • Help with quitting smoking
    • Starting an exercise regimen

Because people with emphysema are often physically limited, they may avoid any kind of physical activity. However, regular physical activity can actually improve a patient’s health and wellbeing.