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Is Copd The Same As Emphysema
Emphysema, also known as pulmonary emphysema, is characterized by widespread destruction of the gas-exchanging tissues of the lungs, resulting in abnormally large air spaces. Lungs affected by emphysema show loss of alveolar walls and destruction of alveolar capillaries. As a result, there is less surface area available for the exchange of oxygen and carbon dioxide between the inhaled air and the blood passing through the lungs. In addition, the loss of elastic tissue in the damaged alveolar walls causes the lungs to expand within the chest cavity. The expanding lungs compress the small bronchi, increasing resistance to airflow. This is especially pronounced during exhalation, when contraction of the chest wall and abdominal muscles increases intrathoracic pressure and further reduces the passage of air through the small bronchi.
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Smoking is the most common cause of emphysema. In smokers, emphysema often coexists with chronic obstructive bronchitis. Combined, these two conditions are known as chronic obstructive pulmonary disease (COPD).
About 15 percent of regular smokers will develop progressive emphysema, usually starting within the fourth or fifth decade of smoking. The reason why emphysema develops in some smokers and not in others is often unknown. One factor that predisposes some people to emphysema is an inherited deficiency of alpha-1 antitrypsin, an enzyme that normally protects the lungs from damage caused by cigarette smoke. Smokers who inherit the abnormal alpha-1 antitrypsin gene from both parents usually develop progressive, severe emphysema, especially in the lower lungs, starting before age 40. Non-smokers with enzyme deficiency are usually not affected.
Bullous emphysema is characterized by damaged alveoli that expand to form abnormally large air spaces, especially in the uppermost parts of the lungs. This condition sometimes occurs in otherwise healthy young people. Bullous emphysema is usually first noticed when an abnormal air space ruptures, leaking air into the pleural space and causing the affected lung to collapse (
Pneumothorax). Victims experience sudden severe chest pains and shortness of breath. Impaired breathing requires a tube to be inserted through the chest wall to allow air to escape from the chest cavity. In severe cases, surgery may be required to repair ruptured areas of the lung. COPD (short for chronic obstructive pulmonary disease) is a lung disease that causes difficulty breathing. Rheumatoid arthritis (RA) and other forms of inflammatory arthritis are joint diseases that cause difficulty moving.
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So, what must one do to another? More than you can imagine. Research has shown that people with inflammatory arthritis are likely to develop at least one chronic comorbidity — with COPD being one of the conditions at highest risk for patients compared with those without inflammatory arthritis. In fact, a study published in the journal
Showed that people with rheumatoid arthritis were almost twice as likely to be hospitalized with COPD than the general population. Other studies have shown an association between ankylosing spondylitis and COPD.
When you breathe in, air flows down your windpipe (windpipe) and into your lungs through airways called bronchi. These tubes—sort of like a tree—branch into thousands of thinner tubes, culminating in bundles of tiny round air sacs called alveoli. Small blood vessels run along the walls of the air sac. Oxygen from the air you breathe passes through the walls of the alveoli and into the blood. At the same time, carbon dioxide gas (a waste product) exits the body and is exhaled. Gas exchange brings in the oxygen the body needs to function and removes waste products.
When you have COPD, less air is able to flow in and out of your lungs — which means less oxygen gets into your body and it’s harder to get carbon dioxide out. The two most common conditions that cause COPD are emphysema and chronic bronchitis. Emphysema damages and destroys the air sacs, affecting airflow from the lungs. With chronic bronchitis, the bronchi become inflamed and narrow, and thick mucus forms in the airways, making it difficult to breathe.
Carlos Santos, Md
COPD gets worse over time and there is no cure. As COPD progresses, shortness of breath may prevent you from doing the most basic activities, such as walking or cooking. People with COPD also have an increased risk of heart disease, lung cancer, and other diseases.
The researchers aren’t sure, but they suspect that the chronic inflammation that targets the joints in diseases like rheumatoid arthritis may also play a role in the development of COPD. Many of the same inflammatory markers found in RA are elevated in COPD. Both diseases can have exacerbations or flare-ups.
What the experts know: Smoking is the leading cause of COPD and its major risk factor. The more years and packs you have smoked, the higher your risk of COPD. Your risk of developing COPD is higher if you have asthma and smoke. Smoking also increases the risk of RA.
While most people with COPD smoke or have smoked, up to 25 percent of people with COPD have never smoked. Long-term exposure to other lung irritants — such as secondhand smoke, air pollution, chemical fumes or dust — can also lead to COPD. A rare genetic disorder called alpha-1 antitrypsin deficiency may also be a factor.
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If you experience any of these symptoms, or think you may be at risk for COPD, talk to your doctor. Although there is no cure, effective therapies are available to manage symptoms, reduce the risk of complications and flare-ups, and improve quality of life.
Your doctor will consider your symptoms, family and medical history, and any exposure to lung irritants, especially cigarette smoke. They may order tests to diagnose your condition, such as:
Spirometry: The most common test of lung function, this measures how much air you can inhale and exhale, how quickly you exhale air, and the ability of your lungs to deliver oxygen to the blood. All you have to do is take a deep breath and blow as hard as you can into a tube connected to a small machine called a spirometer. Spirometry can detect COPD even before you have symptoms of the disease. It can also be used to track the progression of the disease and check how well treatments are working.
Chest X-ray or CT scan: These tests help detect emphysema, the leading cause of COPD, and rule out other lung problems or heart failure that may be causing symptoms.
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Arterial blood gas test: This measures the level of oxygen in your blood and can help show the severity of your COPD.
COPD is the leading cause of disability and the fourth leading cause of death in the United States, according to the National Heart, Lung, and Blood Institute. Approximately 16 million people have been diagnosed with COPD, and many more may have the disease and not know it.
Stick to your RA treatment plan. Controlling your RA disease activity can help reduce inflammation in your body. (You can use our ArthritisPower app to track your symptoms and disease activity and share your results with your doctor.)
Always put out cigarettes. Smoking is the reason most people get COPD in the first place; it can also make your COPD and RA worse. For help quitting smoking, talk to your doctor or visit smokefree.gov.
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Avoid exposure to secondhand smoke. Other people’s cigarette smoke can also cause lung damage. Protect yourself from other irritants, such as chemicals, dust, and fumes, at home and at work.
Vaccination. Respiratory tract infections are common in RA and COPD, and complications can be serious. Talk to your doctor about getting flu and pneumonia vaccines. (Learn more about the importance of getting vaccinated when you have arthritis.)
Tell your doctor about any breathing problems. Sometimes people think they are short of breath or unable to perform normal activities because they are “just getting old.” Shortness of breath can be an important symptom of lung disease. Report any COPD symptoms immediately – lung problems are easier to treat if caught early.
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