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Chronic obstructive pulmonary disease

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Chronic obstructive pulmonary disease (COPD), also known as chronic obstructive lung disease (COLD), and chronic obstructive airway disease (COAD), is a collection of diseases which make breathing gradually more difficult.

Chronic obstructive pulmonary disease
Other namesChronic obstructive lung disease (COLD), chronic obstructive airway disease (COAD)
Section of a lung showing centrilobular emphysema, with enlarged airspaces in the centre of a lobule usually caused by smoking and a major feature of COPD
Medical specialtyPulmonology
SymptomsShortness of breath, chronic cough[1]
ComplicationsAnxiety, depression, pulmonary heart disease, pneumothorax[2][1]
Usual onsetOver 35 years old[1]
DurationLong term[1]
CausesTobacco smoking, air pollution, genetics[3]
Diagnostic methodSpirometry[4]
Differential diagnosisAsthma, congestive heart failure, bronchiectasis, tuberculosis, obliterative bronchiolitis, diffuse panbronchiolitis[5]
PreventionStopping smoking, improving indoor and outdoor air quality, tobacco control measures[3][6]
TreatmentPulmonary rehabilitation, long-term oxygen therapy, lung volume reduction,[6]
MedicationInhaled bronchodilators and steroids[6]
Frequency174.5 million (2015)[7]
Deaths3.2 million (2019)[3]

Symptoms of COPD include difficulty breathing and cough, in particular coughing up lots of phlegm.[8] It is usually caused by smoking cigarettes, and around half of people who smoke for their whole lives will develop COPD.[9] Air pollution can be another cause, particularly in countries where indoor fires are used without ventilation.

At the beginning of the disease, the difficulty breathing is only noticeable when exercising, but over many years it gradually becomes worse, until there is difficulty breathing even when sitting or lying down.[10] It can also lead to infections of the lung, which may be serious enough to cause death.

The most important step in preventing COPD or its progression into a worse illness is to stop smoking.[11] Exercise and medications can also help. The most commonly used medications are called bronchodilators, which help to open up the airways and allow more air into the lungs.[11]

3% of all disability is related to COPD.[12] Patients with COPD should be screened for mental depression or low mood. Chronic obstructive pulmonary disease were the third most common cause of death globally in 2019.[13] It is thought that more people will die from it in the future.

Types of COPD

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References

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  1. 1.0 1.1 1.2 1.3 "Chronic obstructive pulmonary disease". nice.org. Retrieved 5 July 2021.
  2. Cite error: The named reference BMJbp was used but no text was provided for refs named (see the help page).
  3. 3.0 3.1 3.2 Cite error: The named reference WHO2021 was used but no text was provided for refs named (see the help page).
  4. Gold Report 2021, pp. 20–27, Chapter 2: Diagnosis and initial assessment.
  5. Gold Report 2021, pp. 33–35, Chapter 2: Diagnosis and initial assessment.
  6. 6.0 6.1 6.2 Gold Report 2021, pp. 40–46, Chapter 3: Evidence supporting prevention and maintenance therapy.
  7. Cite error: The named reference GBD2015Pre was used but no text was provided for refs named (see the help page).
  8. Vestbo, Jorgen 2013. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. Global initiative for chronic obstructive lung disease, Chapter 2.
  9. Laniado-Laborín R. 2009. Smoking and chronic obstructive pulmonary disease (COPD). Parallel epidemics of the 21 century. International Journal of Environmental Research and Public Health. 6 (1): 209–24. doi:10.3390/ijerph6010209. PMC 2672326. PMID 19440278.
  10. What Are the signs and symptoms of COPD?. U.S. National Heart Lung and Blood Institute. 8 June 2012.
  11. 11.0 11.1 Decramer M; Janssens W. & Miravitlles M. 2012. Chronic obstructive pulmonary disease. Lancet 379 (9823): 1341–51. doi:10.1016/S0140-6736(11)60968-9. PMID 22314182.
  12. Murray C.J. et al 2012. Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 380 (9859): 2197–223. doi:10.1016/S0140-6736(12)61689-4. PMID 23245608.
  13. "The top 10 causes of death". www.who.int. Retrieved 2024-05-22.