Emphysema, Chronic Bronchitis, and Colds

If you have emphysema or chronic bronchitis, you know how miserable it feels when you catch a cold. After all, breathing is difficult enough with a chronic obstructive pulmonary disease (COPD). Not only does catching a cold worsen your ability to breathe and be active, but the cold virus increases your chance of getting a more serious respiratory tract infection. Here's what you must know to stay well.

Emphysema and chronic bronchitis are chronic (long-term) lung diseases that make it hard to breathe. Both diseases are chronic obstructive pulmonary diseases (COPD), meaning they are conditions that cause a limitation in airflow. Emphysema and chronic bronchitis can occur separately or together and are usually the result of cigarette smoking. In addition, although it happens rarely, a genetic form of emphysema can occur early in adulthood, even if you never smoked.

In the United States, COPD is vastly under diagnosed. While only 15 to 20 percent of smokers are diagnosed with COPD, experts believe the majority of smokers develop some degree of airflow obstruction.

Emphysema comes on gradually after years of exposure to irritants such as cigarette smoke. With emphysema, the tiny air sacs in the lungs become damaged. Because the tiny sacs lose their "stretch," less air gets in and out of the lungs. This causes you to feel short of breath.

With chronic bronchitis, the airways that carry air to the lungs are inflamed and produce a lot of mucus. The mucus and inflammation cause the airways to narrow or become obstructed, making it difficult to breathe. Once the airways are irritated over a long period, the lining of the airways becomes thickened. This thickening of the airways results in an irritating cough, hampered airflow, and lung scarring. The damaged airways then become a breeding place for bacterial infections such as pneumonia.

A cold is a viral respiratory illness that mainly affects your nose and throat but in some instances can affect your airways. When you have emphysema or chronic bronchitis, you already have some difficulty breathing because of the damaged airways and lungs. Catching a respiratory virus along with COPD can hinder breathing even more and can cause the following changes in your symptoms:

• An increase in phlegm
  
  
• An increase in the thickness or stickiness of the phlegm
  
  
• A change in phlegm color to yellow or green
  
  
• A presence of blood in the phlegm
  
  
• An increase in the severity of shortness of breath, cough, or wheezing
  
  
• A general feeling of ill health
  
  
• Difficulty sleeping
  
  
• Increased fatigue

Catching a cold with emphysema or chronic bronchitis may also lead to bacterial infections such as pneumonia. This occurs because of the airway obstruction and the inability to cough out infected secretions of mucus.

Sometimes, patients with COPD are hospitalized because of a respiratory infection and the worsening of their symptoms. Treatment may include inhaled medications, oxygen, and antibiotics to treat any bacterial infection. Antibiotics do not treat a cold.

To avoid more serious problems with emphysema, chronic bronchitis, and colds, it's important to always alert your doctor if your cold symptoms get worse. Don't wait until you have more serious breathing problems to contact your doctor.

First, it is important to stay on your prescribed medications for emphysema and chronic bronchitis. Then, to decide how to treat cold symptoms, it's best to talk with your doctor. You might treat the body aches and fever associated with a cold with acetaminophen or ibuprofen. In addition, you should avoid antihistamines that thicken mucus and make it even more difficult to cough up.

Most over-the-counter cold remedies are generally safe for people with emphysema and chronic bronchitis. However, decongestants raise blood pressure and some of the medications used to treat emphysema and chronic bronchitis also raise heart rate. So, use decongestants with caution. Again, ask your doctor about medications for cold symptoms.

The following guidelines can help:

• Good hygiene can decrease respiratory infections such as colds. Prevent the spread of a cold virus by making sure you and your family members wash your hands regularly.
  
  
• Check with your doctor about a pneumonia and influenza vaccine. You need a flu shot every year. One pneumonia shot is usually enough to protect you from a specific type of bacterial pneumonia.
  
  
• Avoid crowds during cold and flu season, since colds and flu can cause serious problems for people with COPD.
  
  
• Pay attention to healthy lifestyle habits by avoiding cigarette smoke and air pollutants; eating a balanced, healthy diet; and exercising to stay strong.
  
  
• Sinus infections can trigger breathing problems for those with emphysema and chronic bronchitis. Be aware of your sinus symptoms and report them immediately to your doctor to prevent worsening of breathing difficulties.

SOURCES: American Lung Association: Need Help For Treatment Decisions with COPD? American Lung Association: Chronic Obstructive Pulmonary Disease (COPD) Fact Sheet. The National Heart Lung and Blood Institute: COPD: Learn to Breathe Better. Global Initiative for Chronic Obstructive Lung Disease (GOLD): GOLD Guidelines At-A-Glance Desk Reference.

Reviewed by Michael W. Smith, MD on December 19, 2007
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