Chronic obstructive pulmonary disease, otherwise known as COPD, is a long term condition that causes inflammation and narrowing of the airways and obstructs airflow from the lungs. COPD is the umbrella term for a number of conditions that cause these breathing difficulties, mainly emphysema and chronic bronchitis. COPD commonly affects middle-aged or older people as it is often caused by exposure to pollutants and irritants over many years such as cigarette smoke.
Getting an early diagnosis of COPD is key to helping you stay fitter for longer without struggling to breathe, although there is no cure, there are effective treatments to manage the disease. For some, the symptoms may be severe but others may not be aware that they have the condition. Read on to find out more about symptoms, diagnosis, and treatments that are available for COPD.
Dr. Daniel Cichi
Our Health Care Team
"COPD is a chronic, long term condition that predominantly affects older people who have smoked for many years. Although smoking isn’t the only cause, around 9 in every 10 cases of COPD are caused by smoking. Quitting smoking is the most important thing you can do to help your condition and prevent it from reaching advanced stages. Although there is no cure, your healthcare professional can help put together a treatment plan to slow down the disease and manage the symptoms."
What is COPD?
COPD stands for chronic obstructive pulmonary disease, the name given to a group of lung diseases which cause breathing difficulties due to narrowing of the airways. The most common lung diseases are emphysema and chronic bronchitis, these diseases get progressively worse over time.
With emphysema, the air sacs in the lungs known as alveoli become damaged, and over time, they weaken and break. Alveoli are an important part of lung function, they exchange oxygen and carbon dioxide to and from the bloodstream. These tiny air sacs cover a large surface area to be able to take in large amounts of air that we breathe in, however, as emphysema destroys alveoli the surface area reduces making it difficult to take in as much oxygen.
Chronic bronchitis occurs when the lining of the bronchial tubes which carry air to and from the alveoli become inflamed and narrow making it difficult to breathe and causing a persistent cough. Chronic bronchitis causes persistent inflammation and coughing that progresses over many months and years.
What are the symptoms of COPD?
In the beginning your symptoms may not be noticeable or they may only occur when exercising or exerting yourself, but over time as the lungs get more and more damaged the symptoms become more severe if the condition is left untreated. Breathlessness, a persistent chesty cough with lots of phlegm that you can’t get rid of or cough up, wheezing, and frequent chest infections are common symptoms of COPD.
As the condition becomes more advanced other symptoms may occur such as fatigue, weight loss, chest tightness/pain, swollen ankles, feet, or legs, and you may also cough up blood although these are not common symptoms of COPD.
Any shortness of breath or a persistent cough that doesn’t seem to be clearing shouldn’t be ignored. These symptoms usually appear in the early stages and many people brush it off as getting older or being generally unfit, but this is not always the case. While these symptoms are similar to many other conditions such as asthma, you should visit your GP to get tested for COPD or find any other underlying cause of your persistent symptoms.
What causes COPD and who is most at risk of developing the disease?
The main cause of COPD is smoking, exposure to harmful chemicals over a long period of time causes damage to the lungs, and conditions such as COPD can develop. Around 9 in 10 cases of COPD are caused by direct exposure to the toxic substances in cigarette smoke. COPD can develop if you’re a cigarette smoker or if you’re exposed to second-hand smoke, i.e, you’re around people who smoke.
COPD can also develop as a result of long term exposure to other types of smoke and harmful substances. Air pollution, which most of us are exposed to, has been found to reduce lung function and increase the risk of developing COPD.
Your job may also put you at risk of developing this disease. If your job involves working with harmful substances, or if you’re exposed to fumes and dust this can damage the lungs over time and may cause respiratory conditions such as COPD. If you’re working in a high-risk job and you smoke your lungs can become significantly damaged and the risks of COPD are greater.
As well as this, some people have a tendency to develop COPD because of their genes. A genetic disorder known as alpha-1-antitrypsin (AAT) deficiency is thought to be a cause of COPD in younger people. Alpha-1-antitrypsin is a protein that protects the lungs, but in some families, there is a genetic disorder that causes a deficiency in this protein. Without this essential protein, your lungs are at risk of damage. If you have a close relative with COPD you’re more likely to develop the condition yourself.
How is COPD diagnosed?
If you have any of the symptoms mentioned earlier, particularly a persistent cough, breathlessness, or any signs of infection such as a fever, or phlegm that is green or yellow in colour, you should see your GP as soon as possible to get a diagnosis. Early diagnosis of COPD can delay the progression of the disease and reduce symptoms and the frequency of flare-ups.
Your GP will ask you some questions about your symptoms and lifestyle such as whether you smoke or if you smoked in the past, your family history, and check your general health such as height and weight. They’ll also listen to your chest using a stethoscope and may conduct a series of tests if COPD is suspected. These tests may include a chest x-ray, CT scan of your lungs, blood tests, an ECG, a peak flow test which measures your breathing, and something called a spirometry which tests your lung function and how much air you breathe in and out, as well as how much oxygen is being delivered to your bloodstream from your lungs.
If your results come back as abnormal for your age and signify COPD, your doctor will put you on a treatment plan to help slow its progression and control the symptoms.
Treatment for chronic obstructive pulmonary disease
Once you have a diagnosis, you will be put on effective treatment to manage the disease as there is no cure. As a patient of COPD, the single most important thing you can do is to quit smoking if you’re a smoker. Stopping smoking will significantly slow down the development of the disease, and although the damage to the lungs is already done and cannot be reversed, any further damage can be prevented which means you could avoid reaching the advanced stages of COPD. Take a look at our stop smoking page for advice on how to quit smoking if you’re struggling.
To ease the symptoms and make breathing easier, inhalers and tablets are used. One of the most irritating symptoms of COPD is not being able to cough up the build-up of phlegm because it is too thick and sticky, however, there are medicines known as mucolytics such as carbocisteine which thin the mucus and make it less sticky so it is easier to cough up. Oral corticosteroids may also be given during severe episodes of COPD, and antibiotics may be given if respiratory infections occur as this can worsen COPD symptoms.
If your oxygen levels are low you will be given a device which delivers oxygen to your lungs.
You may undergo a number of therapies if your COPD is more severe, this includes pulmonary rehabilitation which focuses on specialised advice, education, and counseling for people with lung problems. In this programme you will be given specialist exercise training, nutrition advice, and education about COPD for you and your family, all of this is aimed to help you manage and understand the condition.
The type of treatment you will receive depends on how severe your COPD is and what stage it is at. Your doctor can discuss the many options that are available to you.
How to cope with COPD
COPD is not only physically challenging, but it can also be mentally debilitating, particularly for those who have severe or chronic COPD. If you’re dealing with a chronic, long term condition such as COPD it’s important to take care of your emotional wellbeing as well as your physical wellbeing. Taking part in therapies that help you and your family to better understand the condition can make it easier for your loved ones to provide support when you need it most. If you’re experiencing mental health issues such as anxiety and depression as a result of dealing with your condition, there are other therapies such as talking therapies and counseling which can help you deal with these issues.
To cope with the demanding physical effects of COPD, it’s important to keep yourself as healthy as possible. Keep on top of your medication and therapies as these will help to stop your condition from getting worse, and managing the condition will prevent flare-ups which can get particularly bad for some sufferers. Eating well and keeping active will help to prevent getting any other illnesses or conditions which could worsen your COPD, although exercising may seem too difficult in your condition, it will help to improve your breathing. You can speak to your healthcare professional about what types of exercises are suited to your condition.
Other tips for coping with COPD:
- Quit smoking
- Maintain a healthy weight
- Plan your day ahead, check the weather as extreme temperatures can worsen breathing, keep your medicines handy should your symptoms flare up
- Avoid anything that could trigger a flare-up such as being around harmful substances like cigarette smoke or dust
- Practice breathing techniques to help you cope with shortness of breath
- Get vaccinated against flu or other illnesses which make you vulnerbale or could exacerbate your condition