What Causes COPD?

COPD stands for Chronic Obstructive Pulmonary Disease. It is the term doctors use for the overlapping problems of chronic bronchitis and emphysema. If you have either or both of these, you have COPD.

Chronic Bronchitis

With this breathing disorder, air passages in the lungs (bronchi) are inflamed. Mucus-producing glands in the bronchi enlarge and produce too much mucus, which triggers a cough. In chronic bronchitis, this cough lasts for at least three months in two consecutive years.

You are more likely to develop bronchitis if you:

  • Smoke tobacco.

  • Are exposed to air pollution.

  • Are exposed to airborne toxins in the workplace.

  • Have a history of frequent respiratory illnesses.

  • Live with a smoker.

  • Have an identical twin with chronic bronchitis.


This condition occurs when tiny air sacs in the lungs (alveoli) are destroyed. The lungs can’t contract fully and lose elasticity. Holes develop in the lung tissue, making the lungs less able to exchange carbon dioxide for oxygen. Breathing becomes inefficient and you may find yourself breathless most of the time. Many of the factors that can lead to chronic bronchitis also can lead to emphysema, particularly smoking and being exposed to secondhand smoke.

There is also an inherited form of emphysema in which the lungs lack a protective protein called alpha-1-antitrypsin. In this type of emphysema, lung damage can appear as early as age 30. This is decades sooner than smoking-related emphysema usually starts.

What Are the Symptoms?

People with COPD sometimes have symptoms of both chronic bronchitis and emphysema.

Chronic Bronchitis

Symptoms of chronic bronchitis tend to appear in smokers after age 50. These symptoms persist and gradually worsen for the rest of the smoker’s life, unless he or she stops smoking.

Your first symptom may be a morning cough that brings up mucus. At first, this cough may occur only during the winter months. As the illness progresses, the cough begins to last throughout the day and throughout the year, and produces more mucus.

Over time, some people with chronic bronchitis develop:

  • A continuous cough.

  • Breathlessness.

  • Rapid breathing.

  • A bluish tint to the skin from lack of oxygen.

Chronic bronchitis also makes you prone to frequent respiratory infections and to flare-ups of breathing difficulties that can put you in the hospital. These can be life-threatening. If heart failure develops, there may be swelling of the ankles, legs, and sometimes the abdomen.


Most cases of emphysema occur in smokers who are diagnosed in their 50s or 60s.

If you have emphysema, you may first feel short of breath during activities such as walking or vacuuming. Because lung function decreases slowly in emphysema, you may hardly notice as breathing becomes more and more difficult.

With time, you may develop:

  • Increased shortness of breath.

  • Wheezing.

  • Coughing.

  • A tight feeling in the chest.

  • A barrel-like distended chest.

  • Constant fatigue.

  • Difficulty sleeping.

  • Weight loss.

When Should I Get Help?

See your doctor once a year to be checked for lung disease if you smoke or have any other risk of COPD.

If You Have COPD

If you have been diagnosed with COPD, call your doctor right away if:

  • It has become more difficult to catch your breath.

  • Your coughing has gotten worse, or you are coughing up more mucus.

  • You have signs of an infection, such as a fever.

What Can I Expect at the Doctor’s?

If you visit your doctor with symptoms of COPD, he or she will take the following steps.

Medical History

Your doctor will ask if you smoke or if you used to smoke, and for how long. He or she also will ask whether you live with a smoker.

Your doctor also will want to know about your symptoms. This includes how easily you become winded, whether you cough frequently, and whether you produce mucus when you cough.

Reference: Lungs, Breathing and Respiration section on Better Medicine

Did You Know?

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Chronic obstructive pulmonary disease (COPD) is a progressive disease that makes it difficult to breathe.