Can People With COPD Get Better?

The three major goals of the comprehensive treatment and management of chronic obstructive pulmonary disease (COPD) are to lessen airflow limitation, prevent and treat secondary medical complications such as hypoxemia infection, decrease respiratory symptoms and improve quality of life. 

The treatment options for chronic obstructive pulmonary disease (COPD) include:

• Short-term and long-term bronchodilators (inhalers)
• Oral steroids or steroid inhalers to suppress inflammation
• Medication to clear thin mucus and clear the airway
• Antibiotics to treat infections of the lungs
• Quitting smoking and avoiding exposure to other irritants
• Pulmonary rehabilitation 
• Oxygen therapy
• Surgery in severe cases (Stage IV of COPD), including lung transplant, may be required

Chronic obstructive pulmonary disease (COPD) is a group of diseases causing an inflammatory reaction and irreversible damage to the lungs. They obstruct airflow and lead to difficulty breathing. Emphysema and chronic bronchitis are the most common diseases that make up COPD. It’s a lifelong disease with periods of flare-ups. It negatively impacts the quality of life and longevity.

During inhalation, air travels through the nose and/or mouth into the trachea (windpipe). The trachea further divides into two tubes called bronchi, which open into the lungs. Within the lungs, the bronchi branch out into smaller tubes called bronchioles. The end of bronchioles opens into little air sacs called alveoli, which aid in gaseous exchange. The alveoli are surrounded by blood vessels, through which the exchange of gases, oxygen, and carbon dioxide takes place.

Exposure to causative factors of chronic obstructive pulmonary disease (COPD) leads to the infiltration of different types of white blood cells and inflammatory factors. This leads to tissue inflammation, damage, and increased mucus secretion in the airway and alveoli.

Emphysema is a disease of the alveoli (tiny air sacs in the lungs). There is irreversible damage to the alveoli making them less elastic. There is a decreased exchange of gases leading to decreased oxygenation in the body (hypoxia). Eventually, patients have severe breathing difficulties.

Chronic bronchitis is a disease of the bronchus. The trachea can also be involved. Inflammation due to irritants causes inflammation leading to an increase in the number and size of mucus-secreting glands. There is also damage to the cilia, which are small hair-like structures located in various parts of the body to help clear mucus. Hence, there is also a decreased clearance of mucus, which accumulates and thickens, causing airway obstruction. Chronic inflammation also leads to the narrowing of the airway.

Chronic obstructive pulmonary disease (COPD) is often triggered by certain lifestyle and environmental factors.

Common causes and risk factors for chronic obstructive pulmonary disease (COPD) include:

• Tobacco smoking (accounts for 90% of COPD risk)

Environmental factors:

• Passive smoking
• Indoor cooking with poor ventilation
• Air pollution
• Exposure to chemicals
• Exposure to industrial dust and fumes
• Intravenous drug abuse
• Infections, such as human immunodeficiency virus (HIV)
• Genetic disorders, such as Marfan's syndrome, Alpha1-antitrypsin deficiency, etc.

The signs and symptoms and severity depend on the stage of chronic obstructive pulmonary disease (COPD), and they worsen during flare-ups. There are four stages of COPD and their symptoms:

• Stage I: Mild COPD
• Stage II: Moderate COPD
• Stage III: Severe COPD
• Stage IV: Very severe COPD (end stage)

Signs and symptoms of stage I of COPD:

• Symptoms are mild and often missed, but the damage to the lungs begins.
• Patients may only present with persistent shortness of breath on exertion.

Signs and symptoms of stage II of COPD:

Symptoms are more severe than in stage I, and there is a mild impact on the quality of life. Patients present with

• Persistent cough with mucus, which may be worse in the morning.
• Shortness of breath even with mild routine activity.
• Wheezing on exertion.
• Disturbed sleep.
• Fatigue.

Signs and symptoms of stage III of COPD:

Stage III has a bigger impact on the quality of life. Symptoms in stage III worsen considerably. In addition to that, patients present with

• Frequent respiratory tract infections.
• Swelling of the ankles, feet, and legs.
• Tightness in the chest.
• Trouble taking a deep breath.
• Wheezing and other breathing issues when doing basic tasks.

Signs and symptoms of end-stage of COPD (stage IV):

This is the final stage of COPD. It occurs after years of continuous damage to the lungs. Patients have worsened symptoms of stage III and frequent flare-ups, which could be fatal. Patients have a very poor quality of life.

The patients also present with

• Barrel-shaped chest.
• Constant wheezing.
• Being out of breath.
• Delirium.
• Increased heart rate.
• Loss of appetite and weight.
• Increased blood pressure.