DEAR DR. DONOHUE: I have been told I have COPD, and I have also been told I have chronic bronchitis. Are they the same? Someone once said I have emphysema. Where does that fit in? -- Confused
ANSWER: COPD -- chronic obstructive pulmonary disease -- is a term for the two main lung illnesses: emphysema and chronic bronchitis. They aren't the same, but they are frequently found together and often result from cigarette-smoking.
Emphysema is a destruction of the millions of tiny air sacs within the lungs. Oxygen from inhaled air diffuses into the blood through those air sacs, and carbon dioxide, a waste product of body metabolism, flows into the air sacs to be exhaled. A person with emphysema can't ever get enough air. That person is constantly short of breath and pants while doing the slightest physical activity.
Chronic bronchitis is an inflammation of airways -- the bronchi. Irritated, inflamed airways fill with thick mucus and then narrow. The primary symptom of chronic bronchitis is a cough with the production of thick phlegm.
The distinction is important, for if a person predominately has chronic bronchitis, then treatment is directed toward cleaning out the airways and dilating them. Bronchodilators -- medicines often used for asthma -- are also used to dilate bronchitic airways. Sometimes, as in asthma, bronchodilators are combined with cortisone drugs, which reduce airway irritation and mucus production.
When bronchitis worsens, as it often does throughout the year, an aggressive program of antibiotics is begun. Mucus-filled airways are the ideal breeding ground for bacteria.
Pulmonary-rehabilitation programs are sponsored by many hospitals, and they can demonstrate the techniques used to drain airways of mucus. Ask your doctor if there are any local programs.
The booklet on chronic obstructive pulmonary disease describes both emphysema and bronchitis and their treatments. Readers can obtain a copy by writing: Dr. Donohue -- No. 601, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6.75 Can. with the recipient's printed name and address.
Please allow four weeks for delivery.
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