Chronic respiratory conditions including asthma and COPD
Respiratory conditions affect the airways, including the lungs as well as the passages that transfer air from the mouth and nose into the lungs. They can be long lasting (chronic) or short term (acute) and can cause ill health, disability and death.
When you breathe, your lungs take in oxygen from the air and deliver it to the bloodstream. The cells in your body need oxygen to work and grow. During a normal day, you breathe nearly 25,000 times. People with lung disease have difficulty breathing. Millions of people in the U.S. have lung disease. If all types of lung disease are lumped together, it is the number three killer in the United States.
The term lung disease refers to many disorders affecting the lungs, such as asthma, COPD, infections like influenza, pneumonia and tuberculosis, lung cancer, and many other breathing problems. Some lung diseases can lead to respiratory failure.
Lung Diseases and Conditions
Breathing is a complex process. If injury, disease, or other factors affect any part of the process, you may have trouble breathing.
For example, the fine hairs (cilia) that line your upper airways may not trap all of the germs you breathe in. These germs can cause an infection in your bronchial tubes (bronchitis) or deep in your lungs (pneumonia). These infections cause a buildup of mucus or fluid that narrows the airways and limits airflow in and out of your lungs.
If you have asthma, breathing in certain substances that you’re sensitive to can trigger your airways to narrow. This makes it hard for air to flow in and out of your lungs.
Over a long period, breathing in cigarette smoke or air pollutants can damage the airways and air sacs. This can lead to a disease called COPD (chronic obstructive pulmonary disease). COPD prevents proper airflow in and out of your lungs and can hinder gas exchange in the air sacs.
An important step to breathing is the movement of your diaphragm and other muscles in your chest, neck, and abdomen. This movement lets you inhale and exhale. Nerves that run from your brain to these muscles control their movement. Damage to these nerves in your upper spinal cord can cause breathing to stop, unless a machine is used to help you breathe. (This machine is called a ventilator or a respirator.)
A steady flow of blood in the small blood vessels that surround your air sacs is vital for gas exchange. Long periods of inactivity or surgery can cause a blood clot called a pulmonary embolism (PE) to block a lung artery. A PE can reduce or block the flow of blood in the small blood vessels and hinder gas exchange.
What Is Asthma?
Asthma is a long-term lung condition that affects a person’s breathing. People with asthma have sensitive airways in their lungs which react to triggers, causing a ‘flare-up’. In a flare-up, the muscles around the airway squeeze tight, the airways swell and become narrow and there is more mucus. These things make it harder to breathe.
Asthma by numbers
1 in 9 Australians have Asthma. That is around 2.5 million people.
10.8% of Australians have Asthma
10.4% NSW 9.6% WA
11.9% VIC 12.6% TAS
10.6% QLD 11.5% ACT
10.5% SA 8.2% NT
Asthma Mortality Rate
419 Australians died from Asthma in 2014.
142 males 277 females
141 NSW 44 WA
96 VIC 14 TAS
61 QLD 8 ACT
51 SA 4 NT
39,500 Australians are hospitalised
- 0 – 14 Boys were 1.7 times as likely to be admitted to hospital for asthma
- 15 years and older Females were 2.3 times as likely to be admitted to hospital for asthma
24% of people with Asthma have an Asthma action plan
- 0 – 14 = 41%
- 15 years and over = 20%
*Statistics provided by Asthma Foundation of Tasmania
Asthma can affect your quality of life. Come in to Rural Health Tasmania and talk with our staff about how we can help you get the most out of life.
Overview
To understand asthma, it helps to know how the airways work. The airways are tubes that carry air into and out of your lungs. People who have asthma have inflamed airways. The inflammation makes the airways swollen and very sensitive. The airways tend to react strongly to certain inhaled substances. When the airways react, the muscles around them tighten. This narrows the airways, causing less air to flow into the lungs. The swelling also can worsen, making the airways even narrower. Cells in the airways might make more mucus than usual. Mucus is a sticky, thick liquid that can further narrow the airways. This chain reaction can result in asthma symptoms. Symptoms can happen each time the airways are inflamed.
Asthma
Figure A shows the location of the lungs and airways in the body. Figure B shows a cross-section of a normal airway. Figure C shows a cross-section of an airway during asthma symptoms.
Sometimes asthma symptoms are mild and go away on their own or after minimal treatment with asthma medicine. Other times, symptoms continue to get worse.
When symptoms get more intense and/or more symptoms occur, you’re having an asthma attack. Asthma attacks also are called flareups or exacerbations (eg-zas-er-BA-shuns).
Treating symptoms when you first notice them is important. This will help prevent the symptoms from worsening and causing a severe asthma attack. Severe asthma attacks may require emergency care, and they can be fatal.
Outlook Asthma has no cure. Even when you feel fine, you still have the disease and it can flare up at any time. However, with today’s knowledge and treatments, most people who have asthma are able to manage the disease. They have few, if any, symptoms. They can live normal, active lives and sleep through the night without interruption from asthma.If you have asthma, you can take an active role in managing the disease. For successful, thorough, and ongoing treatment, build strong partnerships with your doctor and other health care providers.
What Is Bronchitis?
Bronchitis (bron-KI-tis) is a condition in which the bronchial tubes become inflamed. These tubes carry air to your lungs. (For more information about the bronchial tubes and airways, go to the Diseases and Conditions Index How the Lungs Work article.) People who have bronchitis often have a cough that brings up mucus. Mucus is a slimy substance made by the lining of the bronchial tubes. Bronchitis also may cause wheezing (a whistling or squeaky sound when you breathe), chest pain or discomfort, a low fever, and shortness of breath.
Bronchitis
Figure A shows the location of the lungs and bronchial tubes in the body. Figure B is an enlarged, detailed view of a normal bronchial tube. Figure C is an enlarged, detailed view of a bronchial tube with bronchitis. The tube is inflamed and contains more mucus than usual.
Overview
The two main types of bronchitis are acute (short term) and chronic (ongoing).
Acute Bronchitis
Infections or lung irritants cause acute bronchitis. The same viruses that cause colds and the flu are the most common cause of acute bronchitis. These viruses are spread through the air when people cough. They also are spread through physical contact (for example, on hands that have not been washed).
Sometimes bacteria cause acute bronchitis. Acute bronchitis lasts from a few days to 10 days. However, coughing may last for several weeks after the infection is gone.
Several factors increase your risk for acute bronchitis. Examples include exposure to tobacco smoke (including secondhand smoke), dust, fumes, vapors, and air pollution. Avoiding these lung irritants as much as possible can help lower your risk for acute bronchitis. Most cases of acute bronchitis go away within a few days. If you think you have acute bronchitis, see your doctor. He or she will want to rule out other, more serious health conditions that require medical care.
Chronic Bronchitis
Chronic bronchitis is an ongoing, serious condition. It occurs if the lining of the bronchial tubes is constantly irritated and inflamed, causing a long-term cough with mucus. Smoking is the main cause of chronic bronchitis. Viruses or bacteria can easily infect the irritated bronchial tubes. If this happens, the condition worsens and lasts longer. As a result, people who have chronic bronchitis have periods when symptoms get much worse than usual. Chronic bronchitis is a serious, long-term medical condition. Early diagnosis and treatment, combined with quitting smoking and avoiding secondhand smoke, can improve quality of life. The chance of complete recovery is low for people who have severe chronic bronchitis.
What Is COPD?
COPD, or chronic obstructive pulmonary (PULL-mun-ary) disease, is a progressive disease that makes it hard to breathe. “Progressive” means the disease gets worse over time. COPD can cause coughing that produces large amounts of mucus (a slimy substance), wheezing, shortness of breath, chest tightness, and other symptoms.
Cigarette smoking is the leading cause of COPD. Most people who have COPD smoke or used to smoke. Long-term exposure to other lung irritants—such as air pollution, chemical fumes, or dust—also may contribute to COPD.
Overview
To understand COPD, it helps to understand how the lungs work. The air that you breathe goes down your windpipe into tubes in your lungs called bronchial (BRONG-ke-al) tubes or airways. Within the lungs, your bronchial tubes branch into thousands of smaller, thinner tubes called bronchioles (BRONG-ke-ols). These tubes end in bunches of tiny round air sacs called alveoli (al-VEE-uhl-eye).
Small blood vessels called capillaries (KAP-ih-lare-ees) run through the walls of the air sacs. When air reaches the air sacs, oxygen passes through the air sac walls into the blood in the capillaries. At the same time, carbon dioxide (a waste gas) moves from the capillaries into the air sacs. This process is called gas exchange. The airways and air sacs are elastic (stretchy). When you breathe in, each air sac fills up with air like a small balloon. When you breathe out, the air sacs deflate and the air goes out.
In COPD, less air flows in and out of the airways because of one or more of the following:
- The airways and air sacs lose their elastic quality.
- The walls between many of the air sacs are destroyed.
- The walls of the airways become thick and inflamed.
- The airways make more mucus than usual, which can clog them.
Normal Lungs and Lungs with COPD
Figure A shows the location of the lungs and airways in the body. The inset image shows a detailed cross-section of the bronchioles and alveoli. Figure B shows lungs damaged by COPD. The inset image shows a detailed cross-section of the damaged bronchioles and alveolar walls.
“COPD” includes two main conditions—emphysema (em-fih-SE-ma) and chronic bronchitis (bron-KI-tis). (Note: The Health Topics article about bronchitis discusses both acute and chronic bronchitis.)
In emphysema, the walls between many of the air sacs are damaged. As a result, the air sacs lose their shape and become floppy. This damage also can destroy the walls of the air sacs, leading to fewer and larger air sacs instead of many tiny ones. If this happens, the amount of gas exchange in the lungs is reduced.
In chronic bronchitis, the lining of the airways is constantly irritated and inflamed. This causes the lining to thicken. Lots of thick mucus forms in the airways, making it hard to breathe.
Most people who have COPD have both emphysema and chronic bronchitis. Thus, the general term “COPD” is more accurate.
Outlook
COPD is a major cause of disability. Currently, millions of people are diagnosed with COPD. Many more people may have the disease and not even know it.
COPD develops slowly. Symptoms often worsen over time and can limit your ability to do routine activities. Severe COPD may prevent you from doing even basic activities like walking, cooking, or taking care of yourself.
Most of the time, COPD is diagnosed in middle-aged or older adults. The disease isn’t passed from person to person—you can’t catch it from someone else.
COPD has no cure yet, and doctors don’t know how to reverse the damage to the airways and lungs. However, treatments and lifestyle changes can help you feel better, stay more active, and slow the progress of the disease.
Cough
A cough is your body’s natural reflex to help clear your airways of irritants and prevent infection. Common irritants include smoke, mucus, or allergens such as pollen, mold, or dust. Some medical conditions or medicines irritate the nerve endings in your airways and cause coughing.
A cough may be acute, subacute, or chronic depending on how long it lasts. Acute coughs last less than three weeks and usually are caused by the common cold or other infections such as sinusitis or pneumonia. Subacute coughs last three to eight weeks and remain after the initial cold or respiratory infection is over. Chronic coughs last more than eight weeks and can be caused by gastroesophageal reflux disease (GERD), postnasal drip from sinus infections or allergies, or chronic lung conditions such as asthma, chronic obstructive pulmonary disease (COPD), pulmonary fibrosis, and interstitial lung diseases.
Your doctor will consider your medical history, physical exam, and test results when diagnosing and treating cough. Quitting smoking and avoiding smoke, other irritants, or certain medicines may help relieve your cough. Medicines to control coughing are usually used only for coughs that cause extreme discomfort or interfere with sleep. Talk to your doctor about how to treat your child’s cough. Pneumonia.
Pneumonia
Pneumonia is a bacterial, viral, or fungal infection of one or both sides of the lungs that causes the air sacs, or alveoli, of the lungs to fill up with fluid or pus. Symptoms can be mild or severe and may include a cough with phlegm (a slimy substance), fever, chills, and trouble breathing. Many factors affect how serious pneumonia is, such as the type of germ causing the lung infection, your age, and your overall health. Pneumonia tends to be more serious for children under the age of five, adults over the age of 65, people with certain conditions such as heart failure, diabetes, or COPD (chronic obstructive pulmonary disease), or people who have weak immune systems due to HIV/AIDS, chemotherapy (a treatment for cancer), or organ or blood and marrow stem cell transplant procedures.
To diagnose pneumonia, your doctor will review your medical history, perform a physical exam, and order diagnostic tests. This information can help your doctor determine what type of pneumonia you have. If your doctor suspects you got your infection while in a hospital, you may be diagnosed with hospital-acquired pneumonia. If you have been on a ventilator to help you breathe, you may have ventilator-associated pneumonia. The most common form of pneumonia is community-acquired pneumonia, which is when you get an infection outside of a hospital.
Treatment depends on whether bacteria, viruses, or fungi are causing your pneumonia. If bacteria are causing your pneumonia, you usually are treated at home with oral antibiotics. Most people respond quickly to treatment. If your symptoms worsen you should see a doctor right away. If you have severe symptoms or underlying health problems, you may need to be treated in a hospital. It may take several weeks to recover from pneumonia.
Explore this Health Topic to learn more about pneumonia, our role, how to improve your health and where to find more information.