What is COPD?

COPD is an acronym that stands for chronic obstructive pulmonary disease. Often times this acronym is incorrectly only associated with smoking-related entities such as emphysema or chronic bronchitis which are only two examples of COPD.

What does chronic obstructive pulmonary disease mean?  In order to be diagnosed with obstructive pulmonary disease an individual must undergo spirometry.  Spirometric measurements determine whether an individual has limitation to airflow upon rapid exhalation or “obstruction” to airflow upon rapid exhalation.  The definition of obstructive pulmonary disease rest on whether or not an individual has a reduced forced expiratory volume at one second (FEV1) in comparison to the patient's forced vital capacity or lung volume (FVC). A reduced FEV1/FVC ratio, depending on your age, will help determine the diagnosis.

There are many lung diseases that fit into the category of obstructive pulmonary disease, not just smoking-related emphysema or chronic bronchitis.  An extremely common form of obstructive pulmonary disease is asthma.  Asthma is classic for having reversibility of obstruction to airflow hence presenting in an episodic fashion.  Cystic fibrosis is another example of obstructive pulmonary disease.  Bronchiolitis obliterans is a very severe form of obstructive pulmonary disease and can occur after a severe infection, or can be associated with autoimmune diseases or associated with lung transplantation.  Lastly, many individuals who live in third world countries exposed to extremely poor air quality or in first world countries exposed to pollution in large cities can develop chronic inflammation of the airways leading to obstructive lung disease.

Who is predisposed to developing obstructive lung disease? Individuals with

1) a history of prematurity

2) a history of severe viral illnesses as a child

3) a history of chronic exposure to secondhand smoke or pollution

4) a familial disposition for severe allergies

5)  chronic environmental exposures to significant allergens such as farmers etc.

6) a history of smoking tobacco

Individuals can mitigate their risks and are encouraged not to ignore chronic pulmonary symptoms. The airways when they are chronically inflamed can develop scarring and fixed obstruction over time; therefore, arresting this chronic inflammatory process is paramount to prevent COPD.