University of Iowa Health Science Relations
First Published: 2000
Last Revised: February 2004
Peer Review Status: Internally Peer Reviewed
For people suffering from Chronic Obstructive Pulmonary Disease
(COPD), breathing in and out is anything but easy. Normal breathing
is a two-step process starting with contractions of the diaphragm
creating a vacuum in the lungs. This results in air moving passively
into the lungs (inhale). When enough air has been inhaled, the
diaphragm stops contracting and the lungs passively allow air to move
This process is impaired or altered in people with COPD. The
diaphragm does not work as well, lungs become hyperinflated from air
trapped in the lungs, and exhalation becomes an active process,
resulting in increased work of breathing.
COPD is an umbrella term used to describe the co-existence of
emphysema and chronic bronchitis.
Emphysema destroys the air sacs and/or the smallest
breathing tubes in the lungs. Lungs lose their elasticity, much like
an overused rubber band, and air sacs become enlarged, trapping air
in the sacs and impairing the exchange of oxygen and carbon dioxide.
Symptoms include a cough, shortness of breath, and limited exercise
Emphysema is a progressive disease that develops after years of
exposure to smoking or pollution. Cigarette smoking is the primary
Several treatments are available to help minimize the symptoms of
emphysema and potentially decrease the rate of progression, but one
of the most important treatments is one you can do--stop smoking.
Stopping at any point in the development of the disease will provide
Chronic bronchitis is an inflammation and eventual
scarring of the lining of the bronchial tubes. Long-time irritation
of the bronchial tubes causes the formation of excessive mucus and
the lining of the bronchial tubes becomes thickened, an irritating
cough develops, air flow may be hampered, and the lungs are
endangered. The bronchial tubes then make an ideal breeding place for
Initially patients with early chronic bronchitis look normal in
appearance, but as time passes the lips and skin may appear blue
(from decreased oxygenation of tissues), feet swell, and there may be
abnormal sounds in the lungs.
The treatment of chronic bronchitis is aimed at reducing
irritation in the bronchial tubes. The discovery of antibiotic drugs
has been helpful in treating acute infection associated with chronic
bronchitis. Cigarette smoking is by far the most common cause of
A look at Chronic Obstructive Pulmonary Disease (COPD)*
- COPD is the fourth leading cause of death in the U.S. for
people between the ages of 65 to 84.
- More than 122,000 Americans died of COPD in 2000.
- The annual cost to the nation is approximately $32.1
- An estimated 11 million Americans were diagnosed with chronic
bronchitis in 2001.
- An estimated 2.2 million Americans have been diagnosed with
- Women have higher rates of chronic bronchitis while men have
higher rates of emphysema.
- Approximately 80 to 90 percent of COPD cases are caused by
- A smoker is 10 times more likely than a nonsmoker to die of
* Figures from the American Lung Association.