COPD hampers the ability to breathe easily
Dear Dr. Roach: Would you tell me about the causes and treatment of COPD? I would like to know if medication is available, and whether the progression of the disease can be slowed or stopped. Is exercise appropriate?
Also, I have seen ads for stem cell therapy; does this hold any promise?
COPD, which stands for “chronic obstructive pulmonary disease,” is a lung disease that limits the ability to move air into and out of the lungs. It is the third leading cause of death in the U.S., and the fourth in Canada.
The two most-common forms of COPD are emphysema and chronic bronchitis. Some people have symptoms of both asthma and COPD.
COPD is occasionally misdiagnosed as asthma. The earliest symptom of COPD is shortness of breath on exertion, and the other important symptoms are cough and sputum production.
In the U.S. and Canada, about 80 percent of people with COPD have a history of smoking, the rest having exposure to dust and fumes in the environment.
Alpha-1 antitrypsin is an enzyme that some people are missing: These people are prone to develop COPD and liver disease. This happens in people who have never smoked, but smoking dramatically worsens the condition. People with COPD should be evaluated for this enzyme deficiency as early as possible.
Treatment for COPD is designed to improve symptoms and slow progression of the disease. Inhaled medicines to reduce obstruction, such as albuterol and ipratropium, are effective for short-term improvement in symptoms. Inhaled steroids reduce exacerbations and modestly slow progression of the disease.
For the majority of people with COPD due to smoking, the most important therapy is quitting smoking as soon as possible. Pulmonary rehabilitation, physical therapy and supplemental oxygen improve certain subgroups of people with COPD. Surgery, including lungreduction surgery and lung transplant, rarely are used, but they may be appropriate for some individuals. I do not recommend stem cell therapy at this time, unless it is part of a clinical trial. You can find out about trials at