Mrs. L. Johnson of Hobe Sound writes – Can you tell me what COPD stands for?

Chronic Obstructive Pulmonary Disease is an overall term that encompasses three specific diseases: Emphysema, Chronic Bronchitis, and Asthma. They are conditions whereby the airways become narrow, and limits the flow of air into and out of the lungs, and can cause shortness of breath. This narrowing of airways can be difficult to reverse, depending on the severity of the disease.

COPD is caused primarily by mucous particles or noxious gases, notably tobacco smoking. These foreign particles triggers an inflammatory response in the larger airways which causes chronic bronchitis, characterized by chronic sputum production. When this inflammatory response causes actual destruction of lung tissue, it is called emphysema. Many patients may exhibit both disease states.

The natural course of COPD is characterized by occasional exacerbations caused by infection or pollutants, and subsequent increasing damage to the pulmonary airways.

The diagnosis of COPD requires Pulmonary Function Tests and oxygen assessment. Managing COPD includes smoking cessation, weight control, proper diet, and drug therapy.

Chronic Bronchitis

Lung damage and chronic inflammation in the large airways leads to chronic bronchitis. In clinical terms, sputum production on most days for 3 months or more, for two consecutive years, a diagnosis of chronic bronchitis will be made. The defining characteristic is an increase amount of goblet cells which produce mucous. This causes a narrowing of airways and chronic cough.

Patients with advanced COPD that have primary chronic bronchitis rather than emphysema are commonly referred to as “blue bloaters” because of their bluish color of the skin and lips. This is known as cyanosis.


When there is chronic inflammation of the air sacs (alveoli), emphysema is the diagnosis. The alveoli are where oxygen transfers from the air into the bloodstream, and carbon dioxide gas from the blood goes back into the air. This destruction results in less surface area to exchange these gases. These patients are called “pink puffers”, because of their breathing efforts during exhalation. A secondary reason is that they are able to maintain more normal oxygen levels than patients having chronic bronchitis.


Asthma is the third disease pathology considered part of COPD. It is characterized by periodic bronchical wall spasms, often called wheezing. This disease is not always a result of smoking, although it certainly may exacerbate it.

Asthma is generally not a progressive disease, and can be managed fairly well with the proper combination of drug therapy.

Signs and Symptoms of COPD

  1. History of Cigarette Smoking
  2. Chronic cough and sputum production
  3. Shortness of Breath (Dyspnea)
  4. Decreased intensity of breath sounds
  5. Airflow limitation on pulmonary function testing, with limited reversibility

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