COPD: Chronic Bronchitis and Emphysema
Symptoms, Causes, and Treatment
 

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What COPD is
Causes of COPD
Signs and Symptoms
Diagnosis & Life Expectancy
COPD Treatment
Chronic Bronchitis
Emphysema
Air Purifiers for COPD

What is COPD? An Overview

Chronic Bronchitis and Emphysema are the two general diseases that make up COPD, or Chronic Obstructive Pulmonary Disease.  Chronic Obstructive Pulmonary Disease is a group of lung diseases that involve the narrowing of airways or the deterioration of certain parts of the lungs over time, causing significant breathing difficulties.  COPD may also be known as COAD (Chronic Obstructive Airway Disease) and COLD (Chronic Obstructive Lung Disease).  It is one of the leading causes of death in the United States.

Part of the process is similar to that of asthma, wherein airborne particulates, allergens, and smoke particles can trigger the inflammatory response.  However, unlike asthma, Chronic Obstructive Pulmonary Disease is something that worsens over time and is irreversible.  Living with COPD is usually more debilitating and difficult than living with asthma.

The first part of this guide will cover COPD in general, since the signs, causes, and treatment of Chronic Bronchitis and Emphysema are very similar in nature.  The latter sections of this guide will touch on the differences between the two diseases.

What Causes COPD

Smoking is the primary cause of COPD.  In general, it is airborne exposure over time that leads to the disease.  This includes the fine dust byproduct of coal and metal mining, and, to a lesser extent, air pollution.  Sulfur dioxide and other industrial byproducts are well-known to be COPD and asthma irritants.  These irritants have been known to cause other lung issues that are distinct to COPD, but they can certainly exacerbate the development of the disease, especially in smokers.  In the United States, most cases of COPD derive from smoking.  This includes cigars, cigarettes, and pipe tobacco.

Some genetic factors play a role in one’s susceptibility to contract COPD from long-term lung irritant exposure.  Smokers who have relatives with COPD are more likely to develop it.  Furthermore, there is a certain genetic condition that plays a role in a very small portion of cases, called Alpha 1-antitrypsin deficiency. 

Physicians and scientists are still trying to understand the process completely.  There are many missing links within what the scientific community knows for sure, and research remains ongoing.  There may be other causes along the general principle of long-term lung aggravation, which could include repeated infection.  Many experts say that COPD occurs as a result of some kind of predisposition, such a hereditary sensitivity or recurring bacterial infection, combined with smoking or high-volume exposure of fine dusts or chemicals.

COPD Symptoms

The signs of COPD differ based on intensity, level of progression, overall level of health, and the type of COPD. Specific sections for Chronic Bronchitis and Emphysema follow.  Here are some general symptoms and signs of COPD:

- Dyspnea – Shortness of breath; often described as feeling out of breath or being unable to take in enough air.  In early COPD, this occurs during exercise or physical activity.  As the disease progresses, patients may experience dyspnea at rest or during light activity.

- Weaker Breaths – In general, less intense and full breaths.  Also, exhales that are longer than inhales.

- Less Airflow Volume – This is tested and determined by a physician.

- Wheezing – The production of mucus from the airways, called sputum, may cause wheezing or whistling sounds during breaths.  This occurs when airways are partially obstructed

- Straining – Straining muscles or face when trying to breath

- Chronic Cough – More often in Chronic Bronchitis, but a serious sign in any case

- Blueness or Paleness – Seeing blue around the fingernails or lips indicates low oxygen levels

- Rapid Heartbeat

Acute Exacerbations of COPD are when COPD symptoms suddenly and severely worsen.  They are usually triggered by bacterial infections, viral infections, or environmental pollution and irritants.  Pulmonary emboli (blockages within the lungs) can also be a cause.  During an acute exacerbation, breathing increases in difficulty as inflammation increases.  This further reduces airflow and can lead to other severe and life-threatening conditions.

Diagnosis of COPD & Life Expectancy

The disease is diagnosed by a physician, who will measure the exhaling capacity of the lungs using Spirometry (“measuring of breath”).  Other lung function tests can be used to determine the air transfer and breathing capacity of your lungs.   The most significant initial signs of COPD are dyspnea, chronic coughing, and the production of sputum.   It is highly recommended that you visit an expert if you begin to experience these or any of the other symptoms we discussed.

Life expectancy for someone with COPD depends on the otherwise overall health of the patient, along with corrective measures such as quitting smoking and improving air quality.  Risk factors that worsen the prognosis include being overweight, living a sedentary lifestyle, and related complications, such as respiratory failure.  Living with COPD involves the risk of life-threatening complications at any time, so COPD live expectancy is very difficult to determine.  Consult with your doctor to develop a plan for general living with the disease.

Treatment for COPD

Unfortunately, there is no cure for COPD and its effects are currently irreversible.  However, there are many therapies, medicines, and lifestyle changes that can make a huge difference.

Medicines

• Bronchodilators:  Bronchodilators relax the muscles that surround your airways.  This loosens up the tightness and allows for more airflow.  There are short-acting and long-acting bronchodilators; they last around 5 hours and 12+ hours, respectively.  The vehicle for the medicine is usually an inhaler, and your doctor will decide on which type of bronchodilator is right for you based on the severity of your COPD and overall condition.
• Steroids:  Inhaled Glucocorticosteroids may be used when symptoms have increased in severity.
• Vaccines:  People with COPD are especially susceptible to certain ailments, such as the flu and pneumococcal pneumonia.  Your doctor may recommend precautionary vaccinations against these and other sicknesses if you are living with COPD.

Rehab and Therapy

• Pulmonary Rehabilitation:  A general term that involves working with a team of specialists to improve breathing, fitness level, and overall lifestyle.
• Oxygen Therapy:  A supplementation of Oxygen to alleviate low blood Oxygen levels.

Surgery

• Bullectomy:  The removal of large air spaces, called bulae, that occur when the walls of the lung’s air sacs are damaged.  This is mainly related to cases of Emphysema.
• Lung Volume Reduction Surgery:  Damaged tissue is removed from the lungs and may help with breathing problems.
• Lung Transplant:  This is a very risky operation and should only be considered as a last resort in severe cases of COPD.

Lifestyle Changes

• Quit Smoking:  This is by far the most important step to take.  In terms of COPD, the damage caused by years of smoking is irreversible.  However, it is the first and most crucial step in the right direction.  Talk to your doctor about products that can help you quit.
• Nutrition:  Work toward a healthier diet with less bad fats, cholesterol, sodium, and processed sugars.  Within reason and as directed by your doctor, try to remain active and not live a sedentary lifestyle.
• Avoid Lung Irritants:  Highly-polluted environments can aggravate Chronic Bronchitis and Emphysema.  Be sure to regularly use a HEPA vacuum, clean surfaces, and avoid using household paints, solvents, excessive makeup products, colognes and perfumes, and adhesives; these products produce VOCs (Volatile Organic Compounds), which have been known to aggravate the airways in people who are sensitive.  You should also try to avoid keeping pets, since pet hair and dander can be irritable to the lungs as well.
• Air Purifiers:  This carries over from the previous suggestion.  You may want to invest in a HEPA/VOC Air Purifier, which are effective in filtering out various airborne allergens and smoke odor.  For more information, see the Air Purifiers for Chronic Bronchitis and Emphysema section at the end of this guide.

Chronic Bronchitis

In general, bronchitis is a condition defined by bronchial inflammation.  The bronchial tubes carry air to the lungs; they often secrete mucus during the inflammatory response.  This is what causes difficulty breathing and wheezing, as the airways are being partially inhibited by the mucus.

Acute Bronchitis is short-term bronchitis that occurs as a result of infection or over-inhalation of fine dusts or irritants.  Frequent exposure to lung irritants and pollution can make you susceptible to acute bronchitis.  True acute bronchitis generally lasts for around a week, although some coughing and chest discomfort can remain for another couple of weeks.  “Acute” denotes that it is an isolated case, not a chronic condition.  It is usually caused by a virus, which is why antibiotics are generally not prescribed.

Chronic Bronchitis, on the other hand, is a long-term condition wherein the bronchial tubes are frequently irritated and inflamed.  They remain in a state of sensitivity whereby airborne particulates, allergens, smoke, and odor particles cause severe irritation.  The airways also become more vulnerable to bacterial and viral infections, which drastically worsen symptoms and levels of discomfort.  Signs of chronic bronchitis include chest discomfort, wheezing, and coughing that occurs repeatedly over long periods of time. 

As with COPD on the whole, the first step in treating chronic bronchitis is to quit smoking and improve the overall breathing environment as much as possible.  Chronic Bronchitis treatment can also include humidifier therapy, as steam can help relax the airways and loosen up mucus.  Helpful additional steps to take include moving toward a healthier diet and more active lifestyle, as well as keeping hands and surfaces clean to reduce the likelihood of contracting bacterial and viral infections.  Your doctor may also prescribe some of the medicines discussed earlier in the COPD section.

Emphysema

The signs and symptoms of Emphysema are similar to those already discussed in the general COPD section of this guide.  Just as in Chronic Bronchitis, the main cause of Emphysema is smoking, and the first step in treatment should be to quit.

Whereas Chronic Bronchitis involves inflamed airways and the production of mucus, Emphysema is characterized by damaged alveoli, the air sacs within your lungs.  These sacs are very thin and sensitive.  Emphysema and Chronic Bronchitis may occur together.

Air Purifiers for Chronic Bronchitis and Emphysema

COPD is a group of diseases that, by definition, involves a perpetual respiratory sensitivity to airborne particulates, allergens, and odors.  Just as for those with severe asthma or allergies, an air purifier can be of great relief to those with respiratory sensitivities. 

A HEPA filter is certified to be able to remove 99.97% of particles larger than 0.3 microns that pass through it.  For reference, human hairs range from about 17 to almost 200 microns in width.  HEPA filters are very effective against pollen, mold spores, dust particles, pet dander, and many other irritants.  HEPA air purifiers are commonly used by people with allergies and asthma.

Getting rid of smoke and other odors is more complicated, however, since these particles are usually much smaller than 0.3 microns and steadfastly cling to walls, carpet, and furniture.  Removing smoke odor usually requires a combination of scrubbing and washing in addition to air filtration technology.  For smoke and odors, we use an adsorbent material that traps these particles in tiny pores.  Usually, this material is called activated Carbon or Zeolite.  Models that contain these materials are called VOC air purifiers. 

For people with specific allergies, a HEPA filter is usually enough.  However, COPD is a much more broad respiratory sensitivity, and VOCs (Volatile Organic Compounds) are just as serious of an irritant as larger particles.  An air purifier for Chronic Bronchitis and Emphysema should have both a HEPA filter and a VOC canister.  Ask your doctor if he or she recommends an air purifier as a supplement to your COPD treatment regimen.  For more information on air purifiers, see our Air Purifier Buying Guide.

Sources of Information and Diagrams:
https://www.nhlbi.nih.gov
https://www.nlm.nih.gov

By: Eugene Ravitsky