What Are the Signs and Symptoms of COPD?
COPD can cause breathlessness (also called shortness of breath or dyspnea), cough, production of mucus/sputum/phlegm and tiredness (also called fatigue). Symptoms such as breathlessness and fatigue cannot be seen or easily measured because they are sensations or feelings that you experience. Only the person experiencing the symptom can describe these sensations and how badly they make them feel.
When symptoms first occur, most people ignore them as they think that they are related to smoking, i.e. "It’s just a smoker’s cough" or "I’m just winded/breathless from being out of shape". These symptoms can worsen to the point that people are motivated to stop smoking in order to control the symptoms. Others let the symptoms control them. These signs and symptoms of COPD (breathlessness, tiredness, cough and sputum production) are an indication that the lungs are not normal, even though the lungs are actually responding "normally" to the irritation. Many people with COPD develop most, if not all, of these signs and symptoms.
Is coughing a symptom of COPD?
Cough can be expected with COPD. Cough is a natural reaction of the airways to try and remove mucus or it can be a reaction to protect the airways from inhaled irritants. Coughing is therefore a good thing when it results in moving sputum or phlegm out of the breathing passages. For this reason, you will sometimes find your healthcare provider unwilling or hesitant to give you anything to prevent you from coughing. Conversely, cough resulting in airway spasm is not useful over a long period of time, but can be controlled with cough "suppressants". While a person with COPD will often cough, coughing does not mean you have COPD.
What can I do to treat cough?
When should I call my healthcare provider about my cough?
Incontinence (inability to control passing urine during cough) may be another problem caused by coughing. Urinary incontinence during cough may occur more frequently in men who have had their prostate removed. Controlling the cough will reduce incontinence. Emptying the bladder more frequently than usual (e.g. every 2 hours) may also reduce incontinence. Pelvic muscle exercises are available and have been found to be useful in those with chronic problems with incontinence (www.utdol.com). Unexplained cough or coughing that causes you to "pass out" should be reported to your healthcare provider. Cough that does not go away with inhaler treatment should also be reported.
Is shortness of breath (breathlessness) a symptom of COPD?
Yes, shortness of breath, also known by the term breathlessness or the medical term of dyspnea, is a common symptom of COPD. Breathlessness is a feeling occurring when the lung changes from working in the way it was normally designed to work, to working differently. If the lung senses that it takes more work or effort to move air in and out of the lungs, a feeling of breathlessness will be experienced. While this feeling can be very uncomfortable to the person with COPD, it does not mean that the person is further damaging their lungs by doing things that make them breathless. Unfortunately, people try to avoid this feeling by doing fewer activities or activities less often. This strategy of avoiding activities to avoid breathlessness may work initially, but eventually avoiding activities leads to getting out of shape or becoming deconditioned. Becoming deconditioned can result in even more shortness of breath with activity. One of the greatest challenges for people with COPD is learning to continue leading an active life in spite of the difficulties breathing. Pulmonary rehabilitation programs are useful in helping people learn strategies to reduce this feeling of breathlessness with activities. An important principle for people with COPD to learn is to never avoid an activity because it causes breathlessness. To do so means COPD has taken control of you and you have lost control over your breathing problem.
What can I do to treat breathlessness?
When should I call my healthcare provider about my breathlessness?
Is sputum production a symptom of COPD?
Sputum production, also called phlegm or mucus production, can also be a symptom of COPD. Sometimes, people confuse sputum with the mucus coming from their nose, which has drained from their sinuses. Sinus drainage from the nose may drip down the back of the throat to the trachea, where it may "mix" with mucus coming from the lungs. When your provider asks about sputum production, they are usually asking about the amount coming from your lungs, not your sinuses.
It is normal for the airways to produce several ounces of sputum a day. This mucus is needed to keep the breathing passages moist. When the lungs are bothered by irritants, they try to protect themselves by producing additional mucus to trap any inhaled particles from entering the lungs. Constant attack by irritants, such as smoke, however, makes these glands enlarge and produce two to three times the normal amount of mucus. Chronic irritation also causes a problem with the natural cleaning system in the airways provided by the cilia.
Cilia are destroyed by smoking. Smoking also causes any surviving cilia to become paralyzed for at least 20 minutes following inhalation of cigarette smoke. The result is a poorly working sweeping system that doesn’t clear the air passages very well.
Clearing mucus can be a problem for people who are very weak from illness or if they take medications that make them sleepy. Sometimes medications are needed to loosen the mucus so that the mucus can be coughed out more easily. It is possible that sputum that is allowed to accumulate in the lungs may "grow" bacteria, which can cause acute bronchitis or pneumonia.
What can I do to treat my problem with sputum?
There are usually three types of treatment needed for sputum problems:
A person with COPD may not need any of the three treatments listed above. A common problem for people with COPD is thick sputum, making sputum difficult to cough up and out. Thick sputum may come from a need to increase your fluid intake. The most natural way of thinning mucus is by drinking any type of non-dehydrating liquid, such as water, juices, etc. These will help make the sputum thinner and easier to cough. Since alcohol, coffee and tea are dehydrating, they should be avoided as a means of liquefying mucus. A person with sputum production should drink at least eight glasses (2 quarts/liters) of liquid a day.
If this natural way of thinning mucus does not work, then medications may be used. Expectorants are medications that may help make the mucus looser. Not all medical scientists, however, are convinced that they work. The most common type of expectorant is a substance called guiafenesin. Another approach is to use medications that break up the sputum molecules, called mucolytics. The most common type of mucolytic is a medication called N-acetylcysteine. This medication is available in inhaled form and must be delivered by a nebulizer. N-acetylcysteine is more commonly prescribed to patients in European countries than in the USA.
The use of antibiotics is reserved for sputum that is infected. Sputum that is clear in color is usually not infected. Sputum that is colored light brown, but which you can see through, may be discolored from diet, such as drinking coffee. However, infected sputum (and therefore infected lungs) is likely if the sputum is a deep yellow color that cannot be seen through. Other colors that may indicate an infection is developing are green, brown or reddish mucus.
When should I call my healthcare provider about changes in sputum?
Is tiredness or fatigue a symptom of COPD?
While tiredness or fatigue can be very uncomfortable, it is not dangerous since it is not damaging your lungs or other organs. Tiredness may, however, be a symptom of another condition. Like breathlessness, tiredness is an uncomfortable feeling. It is a common symptom in people with COPD. Tiredness is a feeling of loss of energy or stamina. Generally, breathlessness and tiredness go hand in hand and they are, for some people, difficult to tell apart. Tiredness discourages people from keeping active, which leads to greater loss of energy, which leads to more tiredness. When this cycle begins it is sometimes hard to break. It is estimated that for every day a person is hospitalized, it takes 3-4 days to regain their stamina. Tiredness, like breathlessness, can be prevented or reduced by keeping active and learning how to do activities with less effort.
What can I do to treat tiredness?
When should I call my healthcare provider about my tiredness?
Is wheezing a symptom of COPD?
Wheezing is a sign that air is trying to flow through a narrow passage and it may indicate that the lungs are getting out of control. Airway narrowing can occur from spasms, swelling or mucus accumulating in the airways. Sometimes, when a person with COPD develops an infection in their lungs, wheezing may occur. This wheezing should be controlled with medications so that the wheezing lessens and finally is no longer present. If wheezing worsens or cannot be controlled with medication, call your healthcare provider.
What can I do to treat wheezing?
When should I call my healthcare provider about my wheezing?
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