What is Chronic Obstructive Pulmonary Disease, or COPD?
Chronic Obstructive Pulmonary Disease describes a group of lung conditions that make it difficult to empty air out of the lungs because your airways have been narrowed. Two of these lung conditions are persistent bronchitis and emphysema, which can also occur together.
- Bronchitis means the airways are inflamed and narrowed. People with bronchitis often produce sputum, or phlegm.
- Emphysema affects the air sacs at the end of the airways in your lungs. They break down and the lungs become baggy and full of holes which trap air.
These processes narrow the airways. This makes it harder to move air in and out as you breathe, and your lungs are less able to take in oxygen and get rid of carbon dioxide.
Chronic = it’s a long-term condition and does not go away
Obstructive = your airways are narrowed, so it’s harder to breathe out quickly
Pulmonary = it affects your lungs
Disease = it’s a medical condition
The airways are lined by muscle and elastic tissue. In a healthy lung, the tissue between the airways acts as packing and pulls on the airways to keep them open. With Chronic Obstructive Pulmonary Disease, the airways are narrowed because:
- the lung tissue is damaged so there is less pull on the airways
- the elastic lining of the airways flops
- the airway lining is inflamed
There are treatments to help you breathe more easily, but they can’t reverse the damage to your lungs so it’s important to get an early diagnosis.
Causes of Chronic Obstructive Pulmonary Disease
COPD usually develops because of long-term damage to your lungs from breathing in a harmful substance, usually cigarette smoke, as well as smoke from other sources and air pollution. Jobs where people are exposed to dust, fumes and chemicals can also contribute to developing COPD. You’re most likely to develop COPD if you’re over 35 and are, or have been, a smoker.
Some people are more affected than others by breathing in noxious materials. COPD does seem to run in families, so if your parents had chest problems then your own risk is higher. A rare genetic condition called alpha-1-antitrypsin deficiency makes people very susceptible to develop COPD at a young age.
Symptoms of Chronic Obstructive Pulmonary Disease
The symptoms of COPD include:
- getting short of breath easily when you do everyday things such as going for a walk or doing housework
- having a cough that lasts a long time
- wheezing in cold weather
- producing more sputum or phlegm than usual
You might get these symptoms all the time, or they might appear or get worse when you have an infection or breathe in smoke or fumes. If you have severe COPD, you can lose your appetite, lose weight and find that your ankles swell.
What’s the difference between Chronic Obstructive Pulmonary Disease and asthma?
With COPD, your airways have become narrowed permanently � inhaled medication can help to open them up to some extent.
With asthma, the narrowing of your airways comes and goes, often when you’re exposed to a trigger something that irritates your airways such as tobacco smoke, dust or pollen. Inhaled medication can open your airways fully, prevent symptoms and relieve symptoms by relaxing your airways.
So, if your breathlessness and other symptoms are much better on some days than others, or if you often wake up in the night feeling wheezy, it’s more likely you have asthma.
Diagnosing Chronic Obstructive Pulmonary Disease
Your doctor will ask if your breathlessness is brought on by anything, how your daily life is affected and other questions about your general health.
They’ll ask if you’ve smoked and if you’ve been exposed to dust, fumes or chemicals.
Your doctor can check how well your lungs work by arranging a simple test called spirometry. This involves blowing hard into a machine which measures your lung capacity and how quickly you can empty your lungs. This is called the forced expiratory volume in one second, often shortened to FEV1.
Your doctor will use spirometry to measure how narrow your airways are. But this only covers one aspect. Someone with slightly narrowed airways can be more breathless than someone with very narrow airways depending on their level of fitness and the exact way COPD has damaged their lungs.
Other tests for Chronic Obstructive Pulmonary Disease
Your doctor should arrange for you to have a blood test and a chest X-ray to rule out other causes of your symptoms. Your doctor will calculate your body mass index (BMI) to find out if you’re a healthy weight for your height. This is important because you can deal with your COPD better if you’re not underweight or overweight.
You may do more tests to give a better picture of your condition, covering:
- efficiency of lung function
- how often you have symptom flare-ups or chest infections
- how short of breath you feel during everyday activities
- whether your oxygen level is significantly lower
Who will I see?
You may be referred to see a specialist doctor or a specialist nurse to confirm the diagnosis or to work out the right treatment for you.
You may also see other health care professionals who can help you to manage your condition:
- physiotherapists to help you deal with your sputum, control your breathing and keep active
- dieticians to help you manage your weight
- occupational therapists to help make your daily living easier
Treatments for Chronic Obstructive Pulmonary Disease
Your health care professional can prescribe several types of medicine or combinations of medications to improve symptoms like breathlessness and to help prevent a flare-up. Furthermore, you can also do things to help manage your condition yourself. Keeping active and doing exercise can make a big difference many people find this helps them more than inhaled drugs.
- Don’t smoke
- Have a plan
- Non-invasive ventilation
- Lung volume reduction surgery
- Lung transplant
Finally, if you smoke, the most effective treatment for COPD is to stop. Your health care professional and pharmacist can help you find ways that make it easier for you. You’re four times as likely to quit with help from support services and medication. Have a look at the NHS Smokefree website to find out more.