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This information was reviewed and approved by Russell P. Bowler, MD, PhD, Irina Petrache, MD (3/1/2021).

Chronic obstructive pulmonary disease (COPD) affects more than 14 million people in the United States. “Chronic" means long term, "obstructive" means it is hard to get air out of the lungs. The most familiar diseases in this group are emphysema and chronic bronchitis. A person with COPD may have emphysema, chronic bronchitis, or both. COPD shares characteristics of asthma.

Let’s take a look inside the lungs to see what is happening. The air sacs, also called alveoli, and the airways have been damaged in COPD, most often by cigarette smoking or poor air quality. In the healthy lung, the air sacs or alveoli look like a bunch of grapes. Look at the alveoli of emphysema. In emphysema, the walls of the alveoli are partially destroyed. This results in a smaller total number of alveoli in the lungs. Fewer air sacs mean that the lungs are not able to absorb oxygen into the bloodstream as well expel carbon dioxide. Also the airways may collapse a little.

Now look at the healthy airway. Air moves in and out of the middle of the airway. Now look at the airway of chronic bronchitis. In chronic bronchitis, the airway walls are swollen and produce more mucus. In chronic bronchitis a person has a chronic productive cough. This is often due to cigarette smoking.

The earliest symptom of COPD is more shortness of breath with strenuous activity than what would normality be reported from someone of a similar age. Many people do not realize this and may simply reduce the amount of activity they do. An example includes running for the bus. Later symptoms with COPD include shortness of breath with lesser activity. An example includes walking across the street.

COPD was once deemed to be a disease with a hopeless prognosis, but is now known to be very treatable. Early diagnosis and treatment can enable people with COPD to take charge of their breathing and regain control of their lives. Common treatment goals include becoming more active, decreasing shortness of breath, a lowering of anxiety and depression and an improved quality of life.


Quit Smoking

Even if you have COPD, symptoms are milder and chances of living longer are improved if you quit smoking. It is never too late to quit smoking if you have COPD or are at risk for developing COPD because of a smoking habit. When you quit smoking you will:

  • Live longer
  • Have decreased cough and phlegm (mucus)
  • Slow loss of lung function and symptom progression.

As more people quit smoking, fewer will develop COPD, and its prevalence should continue to decline.


Alpha-1 Antitrypsin

A person who doesn't have enough alpha-1 antitrypsin, a major protein in the blood, might have Alpha-1 Antitrypsin Deficiency, sometimes called Alpha-1. Alpha-1 antitrypsin is one of the body’s ways of limiting damage from too much inflammation.  Without enough functional Alpha-1 antitrypsin protein in the blood, too much inflammation can occur. The lungs are particularly susceptible to damage from too much inflammation, especially if other risk factors are present like cigarette smoking. When Alpha-1 affects the lungs, it can cause COPD and is called inherited emphysema. Alpha-1 deficiency may also affect the liver, causing inherited liver disease. Learn more about alpha-1 antitrypsin.


National Jewish Health experts provided information on this topic for use on the U.S. News & World Report (Opens in a new window) website.