The two conditions that make up COPD are emphysema and chronic bronchitis.
Bronchitis refers to a kind of upper respiratory illness. It damages lung tissue through inflammation of bronchial tubes, which carry air to and from lungs. Bronchitis can be caused by a cold or other infection. However, it becomes severe when it is experienced many times over years (chronic).
Emphysema is damage to walls between air sacs of the lungs. The air sacs lose their shape and it becomes difficult to fill air spaces while breathing. As time goes on, the walls of air sacs can be destroyed. This leads to fewer, larger air sacs, making lungs less efficient.
COPD is diagnosed through a series of tests that may include chest x-rays and spirometry. Spirometry is a test that measures the volume of air you exhale. Blood testing is used to eliminate the possibility of other conditions that produce symptoms similar to COPD.
Nearly 16 million American adults have COPD. However, the disease is under-diagnosed and COPD diagnosis comes as a surprise to many. Patients are at higher risk of complications from many factors, from air pollution to respiratory infections like COVID-19.
COPD progresses in four phases. Phase one symptoms are relatively mild. In each phase, symptoms become worse. This reflects the difficulty that the lungs have processing oxygen. COPD symptoms include:
With later progression of COPD, COPD patients might experience more frequent respiratory infections, swelling of the lower extremities, chest tightness, and wheezing or coughing when performing basic tasks. Oxygen levels in the blood will tend to decrease over time.
COPD medicine has come a long way in recent years thanks to ongoing clinical studies for COPD. Dozens of COPD clinical studies are carried out in the average year. Although 2020 has seen a slowdown in most clinical trial activity, COPD is an area that is sure to receive continued attention.
The category of COPD drugs is extremely large and is growing bigger all the time. Because there are so many COPD medications, it can take some time and testing before the right one is found for any given patient. Luckily, many COPD medications produce at least some positive results in most patients.
Some of the most common COPD medications include:
COPD medicine for those with more severe symptoms includes:
Oral steroids reduce inflammation for people who experience periodic, severe COPD flare-ups. Short-term use for a few days can cause a COPD flare-up to clear up faster than it normally would.
A COPD medicine approved for the most severe cases, this decreases airway inflammation and allows the airways to relax. Patients should be alert for side effects including weight loss and diarrhea.
Used when other COPD medications are ineffective, theophylline benefits breathing and controls nausea. The medication is relatively inexpensive and side effects can be curbed with careful dose management.
Once a COPD medicine is chosen for a patient, he or she should take it in accordance with the doctor’s instructions. Occasional re-testing is performed to check lung function and monitor for signs that the disease is progressing from one phase to the next. COPD medications and dosages may change over time.
Several new COPD treatments are in the testing phases or will soon be available:
Targeted Lung Denervation
Radiotherapy is used to interrupt nerve transmissions that affect bronchial tubes. This creates permanent opening of the airways and reduction in both mucus production and inflammation in the treated region.
Robotic Lung Volume Reduction Surgery
Lung volume reduction surgery is now being performed using specialized robotic devices. These robots precisely target and remove damaged areas of the lungs, reducing scarring and improving lung function.
Bronchoscopic Thermal Vapor Ablation
BTVA combats the effects of lung sac damage caused by emphysema. Heated water vapor is used to reduce lung volume in precisely targeted areas. COPD clinical trials of this new treatment are ongoing.
Endobronchial Coils, Endobronchial Valves, and Intrabronchial Valves
This COPD treatment focuses on placing coils or valves into the lungs for severe emphysema. Research has shown promising results in the form of improved lung function, exercise capacity, and quality of life.
This minimally invasive COPD surgery destroys mucus-producing cells in the lungs. Short electrical bursts are applied to the inner walls of bronchial tubes. This makes mucus-producing cells break open and die.
While a true COPD cure is not yet in sight, there is hope. A COPD cure would need to not only stop the progression of COPD, but help the body repair existing bronchial damage. Medical researchers have made great progress in the fight to stop COPD damage, but it may be many years before a COPD cure is available. Until then, COPD patients and their families can advance the fight by participating in COPD clinical trials.