Chronic obstructive pulmonary disease (COPD) makes it difficult to push air out of the lungs. The oxygen poor air will build up. If the lungs are filled with this air, there is no room for fresh, oxygen rich air. COPD includes:

• Emphysema —air sacs of lungs are damaged
• Chronic bronchitis —disorder of the large airways of lungs

The changes to lung tissue differ with the two diseases. However, the causes and treatment are similar.

COPD develops due to:

• Cigarette smoking
• Inhaling toxins or other irritants
• Genetic predisposition can make a person's lungs more susceptible to damage from smoke or pollutants (includes alpha-1-antitrypsin deficiency)

Factors that increase your chance of developing COPD include:

• Smoking cigarettes
• Long-term exposure to second-hand or passive smoke
• Family members with COPD
• Exposure to pollutants
• History of frequent childhood lung infections
• Age: 50 or older

Early symptoms of COPD include:

• Coughing in the morning
• Coughing up clear sputum (mucus from deep in the lungs)
• Wheezing
• Shortness of breath with activity

As the disease progresses, symptoms may include:

• Increased shortness of breath
• Choking sensation when lying flat
• Fatigue
• Trouble concentrating
• Heart problems
• Weight loss
• Breathing through pursed lips
• Desire to lean forward to improve breathing
• More frequent flare-ups (periods of more severe symptoms)

The doctor will ask about your symptoms and medical history. A physical exam will be done.

Tests may include:

• Chest x-ray —x-rays of the chest that may detect signs of lung infection
• CT scan —a type of x-ray that uses a computer to make pictures of structures inside the chest
• Blood tests—to assess the amount of oxygen and carbon dioxide in the blood
• Lung function tests

There is no treatment to cure COPD. Treatment aims to ease symptoms and improve quality of life.

Treatment includes:

Quitting smoking slows the disease. Doctors consider it the most important part of treatment. Smoking cessation programs may include behavior modification and medications to help you quit.

Limiting the number of irritants in the air you breathe. It may help make breathing easier. Avoid smoke, dust, smog, extreme heat or cold, and high altitudes.

Some may be taken by mouth. Nebulizers and inhalers deliver drugs directly to the lungs. Drugs for COPD may work in the following ways:

• Opening the airways
• Relaxing the breathing passages
• Decreasing inflammation
• Helping thin secretions and bring up mucus from the lungs
• Treating lung infections (antibiotics)
  • If you have chronic bronchitis and mild-to-moderate COPD, you may not need antibiotics. If you do need them, a study found that shorter antibiotic treatment (five days or less) is as effective as longer treatment (more than five days).

Get vaccinated against pneumonia and the flu . The flu vaccine may reduce COPD flare-ups.

It is given to improve the air you breathe in. It increases the amount of available oxygen. This can increase energy levels and heart and brain function.

Special exercises can strengthen chest muscles and make breathing easier. Physical activity builds endurance and improves quality of life. Follow your doctor's recommendations for activity levels and restrictions.

Special methods of breathing can help bring more air into and force trapped air out of the lungs. Coughing helps clear the lungs of mucus.

• Maintain a normal weight. Excess weight causes the lungs and heart to work harder.
• Eat a healthy diet that is low in saturated fat and rich in fruits, vegetables, and whole grain foods.
• Eat several small meals during the day. It makes breathing easier.
• Avoid gas-producing foods. Large meals and excess gas swell the stomach, which pushes up on the diaphragm.
• Drink fluids to keep mucus thin.

• Pace your activities.
• Learn relaxation techniques and other methods to manage stress.
• Seek emotional support from professionals, family, and friends. Anxiety can increase the rate of respiration, making breathing more strenuous.

A small number of patients may benefit from surgery.