Chronic obstructive pulmonary disease is a group of medical conditions that affect the lungs. Examples of these lung diseases include chronic bronchitis and emphysema.
While there are several different factors that contribute to chronic obstructive pulmonary disease (COPD), the most common cause is smoking.
One of the most common symptoms associated with COPD is coughing. This article will look at the connection between coughing and COPD, and the available treatments.
When a person has COPD, their airways are not as elastic as they once were. The lungs are like balloons that have become overfilled. Air cannot easily escape and often becomes trapped.
Sometimes the small airways are floppy, and become swollen or thickened. When the airways are blocked and a person breathes in deeply, they may cough because the air has difficulty moving through the airways.
Sometimes breathing can cause mucus that is made in the lungs to come up into the airways and a person will cough as a means to move the mucus forward and out.
Many people who develop COPD have been or are smokers. When a person smokes, the airways become irritated and may react by tightening, which can cause coughing. However, a small proportion of people with COPD have never smoked. Genetics or other environmental problems such as air pollution are the cause.
How does coughing change with COPD?
Several conditions that affect the lungs can cause coughing. An example is asthma. Both asthma and COPD cause symptoms that include coughing and shortness of breath.
However, coughing caused by asthma often results in breathing difficulties that come and go and the person may experience more significant coughing at night. A person who has COPD may find that their symptoms are often worse in the morning. They may experience coughing episodes as well as recurring respiratory infections and feel fatigued after activity. With COPD, a person’s breathing difficulties tend to be constant or can become worse during a flare-up.
COPD also damages the cilia, hair-like projections, in the lungs. Cilia help to move mucus and unwanted substances out of the lungs. When the cilia are damaged, they can’t move mucus through the lungs as well as they used to. As a result, a person with COPD may cough more.
People with COPD often have enlarged mucous glands in their lungs that make excess mucus. The combination of this extra mucus and damaged ciliary glands that struggle to move it can result in increased coughing.
COPD also causes significant inflammation of the airways, which is also likely to stimulate the cough reflex. An estimated 78 percent of people with COPD have some kind of cough most days of the week, according to research in the International Journal of Chronic Obstructive Pulmonary Disease.
A person with COPD will typically begin coughing first thing in the morning and may cough up thick mucus, which is often yellow in color. For most people, this would be a sign of an active infection, but people with COPD may experience this type of mucus and cough all the time.
COPD is a condition where a person’s breathing will be stable for a time, then they will experience periods when their condition gets worse. During these episodes, a cough may become more productive and a person may cough more frequently. A person with COPD may also find that their chest feels tighter.
How does coughing from COPD change over time?
Over time, a person with COPD will experience a more frequent and more severe cough. The coughing is usually worse in the morning.
According to an article published in the journal Cough, a severe cough is associated with greater incidences of flare-ups of COPD symptoms. Men who have COPD may experience more instances of pneumonia and find that their lung function declines faster when excess mucus production is present.
Also, the journal reported that having a constant cough severely impacted a person’s quality of life when they had COPD. Over time, coughing and shortness of breath may keep a person with COPD from completing everyday tasks, such as eating and walking.
Having certain conditions can also further contribute to a cough with COPD. These include gastroesophageal reflux disease (GERD) and a condition called occult bronchiectasis. This is an inflammation of the lung’s airways that causes increased mucus production and can also cause bleeding.
Traditionally, a cough is treated with cough suppressants. However, cough suppressants are rarely effective in treating a COPD-related cough.
According to an article in Cough, quitting smoking is one of the best ways for a person with COPD to reduce their cough. Using inhaled medications that treat airway inflammation and reduce airway narrowing may help with a cough as well.
Although there is no cure for COPD, there are ways to reduce coughing and improve other symptoms. As well as quitting smoking, other treatment examples include:
- Bronchodilators, which are medications that relax the muscles around the airways, making it easier to breathe.
- Inhaled corticosteroids to reduce the inflammation in airways that can make them smaller and more difficult to move air through.
- Antibiotics when a person has a respiratory infection to ideally prevent a recurrence of COPD and a worsening of lung function.
- Avoiding items known to irritate the lungs, such as smoke, pollution, and cold or dry air.
- Getting the flu, pneumonia, and pertussis (whooping cough) vaccinations to prevent illness.
- Using supplemental oxygen when needed. Some people may wear oxygen masks all the time or only at night to reduce breathlessness with activity.
- Employing special coughing techniques to clear mucus from the lungs.
- Participating in pulmonary rehabilitation. These are programs that can teach people with COPD new ways to breathe. These exercises and techniques can improve breathlessness and cough and help a person build up a better tolerance to physical activity.
One example of a special coughing technique is “deep coughing.” This involves taking a deep breath, holding the breath for 2 to 3 seconds, and then engaging the stomach muscles before releasing the air. This controlled deep cough method is more effective in clearing the lungs than an irregular, hacking cough according to National Jewish Health.
While these treatments may reduce symptoms associated with COPD, according to the International Journal of Chronic Obstructive Pulmonary Disease, no definitive treatment or cure for coughs that are related to COPD has been identified.
When to see a doctor
COPD is a chronic and progressive disease, meaning that the symptoms will worsen over time. While the amount of time it takes for COPD to get worse varies from person to person, there are some symptoms that a person with COPD shouldn’t ignore.
People with COPD should seek emergency medical attention if they experience any of the following:
- difficulty walking or talking because they are too short of breath
- feeling their heart beating very fast or irregularly
- seeing their fingernails turn blue- or gray-tinted
- fast and hard breathing that isn’t improved with medication
- a fever
- chest pain that is new or worsening
Over time, the affected airflow from COPD can cause heart problems that lead to right-sided heart failure. According to the Centers for Disease Control and Prevention (CDC), COPD is the fourth-leading cause of death in the United States.
In addition to cough, COPD causes other symptoms that affect a person’s breathing. Examples include:
- shortness of breath, usually during everyday activities
- frequent respiratory infections
- a blue tinge to the lips or fingernails
- becoming easily fatigued
- producing a significant amount of mucus
If a person experiences these or other symptoms, they should see their doctor. There are many medications and breathing techniques that a person can use to reduce symptoms associated with COPD.