Chronic Obstructive Pulmonary Disease (COPD)

What is COPD?

The term COPD is applied to a variety of lung diseases that are characterized by impairment in the ability to blow air out of the lungs (as measured by lung function testing, or "PFT’s"). The major individual diseases included in this group are chronic bronchitis and emphysema.  COPD is a major cause of serious illness in the U.S., and more than 15 million Americans are affected. Cigarette smoking accounts for 80-90% of the risk of developing COPD, although a very small number of patients have a genetic form of emphysema (called a 1-antitrypsin deficiency). Because not everyone who smokes develops COPD, other less well-defined genetic and environmental factors probably also determine a person’s likelihood of developing COPD with smoking.

What is chronic bronchitis?

Bronchitis is an inflammation of the bronchial tubes, the air passages connecting the windpipe to the lungs. When the bronchial tubes, or bronchi, are inflamed, mucus and phlegm build u, making breathing difficult. Chronic bronchitis is defined by the presence of a mucus-producing cough most days of the month, three months of a year for two successive years without other underlying disease to explain the cough.

What is emphysema?

Emphysema is the damage of the lung tissue - in particular, the loss of alveoli or air sacs, that are essential for gas exchange. Almost all patients have both chronic bronchitis and emphysema with their COPD but some have just chronic bronchitis and some have just emphysema.

How do I know if I have COPD?

Because emphysema and chronic bronchitis often occur together, rather than being one or the other, the symptoms of these diseases overlap. Early in the course of the disease, many patients may experience cough and/or sputum production (often just in the morning at first) that begins gradually and then persists. Other symptoms include wheezing, tightness in the chest, and shortness of breath. Patients may also experience more frequent chest infections (colds, bronchitis, pneumonia) than usual, or may take longer to recover from them.

If these symptoms are present, a doctor must do breathing tests ("PFT’s") in order to make the diagnosis of COPD. A chest x-ray should also be done to make sure other problems aren’t contributing as well.

What can I do if I have COPD?

The most important thing you can do if you have COPD, is to quit smoking! Studies have shown that patients, who are able to quit smoking, dramatically slow down the loss of lung function (which we all experience with age), relative to patients who continue to smoke. Because quitting smoking can be so difficult, ask your doctor for help, and don’t give up – most people require several tries before they are able to successfully break this habit.

Although many of the changes of COPD are irreversible once they occur, good improvement in symptoms and exercise capacity can be obtained through the appropriate use of medications and pulmonary rehabilitation. A small number of patients with severe COPD may also be candidates for surgical treatments (lung transplantation or volume reduction surgery). Your doctor can advise you in more detail about all of these options.

Contact Us

To make an appointment or referral to the UNC Pulmonary Clinic, please call 919-966-7933.

Clinical Research Studies at UNC

Researchers at UNC are often conducting trials of new treatment approaches for patients with COPD. To learn more about these studies, you are invited to contact us by email one of our study coordinators, Fred Fuller, Samantha Earnhardt,  or Sharikia Burt and to visit our clinical studies page.

Additional Resources

Alpha One Foundation

COPD Foundation

GOLD COPD

Medline Plus - resources for patients with alpha1-antitrypsin deficiency