What is COPD?

Chronic Obstructive Pulmonary Disease (COPD) is the medical term used to describe forms of serious lung conditions that cause the airways to narrow, become obstructive and inflamed, which in turn makes breathing difficult. 

When the term is broken down you can see how the definition gets its meaning:

Chronic refers to it being a long-term and ongoing condition that won’t go away

Obstructive refers to the fact that the airways in your lungs have narrowed and become obstructed

Pulmonary means that it’s a condition that affects your lungs

Disease reflects the fact that it’s a recognised medical condition. 

Chronic Obstructive Pulmonary Disease is a common condition. In fact, according to the World Health Organisation (WHO), there are about 251 million cases of COPD worldwide. Figures suggest that by 2030, COPD could become the third leading cause of death in the world. 

If you have Chronic Obstructive Pulmonary Disease, it gradually becomes harder to breathe. If it’s left untreated, the condition worsens and your risk of hospital admission increases. It can be life-threatening, too. Although the damage to your lungs can’t be reversed, treatment, medication and lifestyle adjustments can help you learn to manage it more effectively. 

How do you get COPD?

If you suffer from one or more of a group of lung diseases, it can lead to Chronic Obstructive Pulmonary Disease. Two of the most common conditions associated with COPD are chronic bronchitis, which inflames the airways, and emphysema, which damages the air sacs. 

  • Chronic bronchitis causes irritation and inflammation to the bronchial tubes – the tubes responsible for carrying air to and from your lungs. The tubes swell and produce a build-up of phlegm or mucus along the lining. Tiny hair-like structures in the tubes called cilia normally help move the mucus out of the airways, but the irritation from chronic bronchitis stops them. The build-up of mucus causes the tube’s opening to narrow and makes it harder to get air in and out of the lungs.  

 

  • Emphysema causes the walls of the tiny air sacs – called alveoli – to breakdown, which makes it difficult to breathe. The air sacs are located in the lower end of your lung, at the end of the bronchial tubes. They normally play a key role in transferring oxygen into your blood and filtering carbon dioxide back out. 

If you have chronic bronchitis, emphysema or both conditions, then you may be told you have COPD.  With multiple parts of the airways affected by the two lung conditions, from the bronchial tubes to the air sacs, it’s no wonder the lung damage can make it increasingly difficult to breathe. 

What is the main cause?

Chronic Obstructive Pulmonary Disease develops due to long-term damage to the lungs that causes them to become inflamed, obstructed and narrowed. Some of the main causes of COPD include:

  • Smoking or a history of smoking
  • Exposure to air pollution, secondhand smoke, dust, fumes or chemicals at work
  • Age – COPD tends to develop after the age of 35
  • A family history of chronic lung disease
  • Frequent childhood chest infection that may scar the lungs.

COPD can also be caused by a rare genetic condition called alpha-1-antitrypsin deficiency, which makes people susceptible to COPD at a younger age. 

Contrary to some assumptions, there are more factors involved in COPD than simply exposure to smoke. Not all smokers, even heavy smokers, develop COPD, and nearly one third of cases occur in people who’ve never smoked. Recent research suggests that having small airways relative to the size of the lungs could predispose people to a lower breathing capacity and an increased risk of COPD. 

What are the symptoms of COPD?

The symptoms include:

  • Getting easily breathless when you’re active, such as when working or doing housework 
  • A persistent chesty cough with phlegm
  • Frequent chest infections
  • Wheezing, especially in cold weather

The symptoms might occur all the time, or they may get worse at certain times, such as if you have an infection or breathe in secondhand smoke or fumes. 

When should you see your doctor?

If you experience persistent symptoms of COPD, especially if you feel short of breath after being active, are over 35 and have ever smoked, you should see your doctor. 

It’s not unusual to be unaware that you have COPD. Some people assume that early symptoms – such as shortness of breath – are due to age, being out of shape or asthma. Because of this, many people try to reduce their activities rather than seek medical advice. But as COPD can worsen, it’s important to get any unexpected symptoms checked out sooner rather than later. 

Your doctor will ask about the symptoms you’ve been experiencing and can arrange for you to have a simple breathing test, called spirometry. This test can help rule out other lung conditions, such as asthma (a chronic lung disease that inflames and narrows the airways). Spirometry measures your lung capacity and how quickly you can breathe air out. You may also have a chest X-ray, CT scan or blood test to rule out other conditions and diagnose COPD.  

What are the treatments?

Although there’s no outright cure for COPD, it can be managed and treated to stop further damage to your lungs and improve your symptoms. 

Your doctor may prescribe:

  • Inhaled medicines called bronchodilators, which relax the muscles around the airways
  • Steroids given via an inhaler to reduce swelling in your airways
  • Pulmonary rehabilitation, a prescribed exercise programme with a physiotherapist to help you learn to breathe more easily
  • For severe cases and if you have low blood oxygen levels, oxygen therapy via a home unit or small portable tank 
  • If other treatments don’t work and your COPD is very severe, you may be offered surgery to remove damaged pieces of your lungs or improve airflow.

In addition, there are practical steps you can take to adjust your lifestyle habits and self-manage your symptoms. These include:

  • Taking regular exercise to improve your breathing
  • Maintaining a healthy weight and eating a healthy, balanced diet
  • Practising breathing exercises to increase your lung capacity
  • Taking prescribed medication regularly
  • Avoiding potential triggers such as traffic fumes, tobacco smoke or dust
  • Quitting smoking
  • Using a damp cloth to wet dust your home and remove dust particles. 

COPD can also put you at higher risk of getting seriously ill from coronavirus (COVID-19). It’s important to follow the government guidance, avoid crowded places, wear a face covering, keep your distance and wash your hands often to reduce your risk of catching coronavirus. Having an annual flu vaccination can also help reduce your risk of catching flu. Find out more about COPD and COVID. 

How are COPD flare-ups treated?

COPD flare-ups or COPD exacerbation are occasions when symptoms worsen and become more severe. COPD exacerbation can occur due to exposure to triggers such as pollution, secondhand smoke or having an infection. 

COPD flare-ups are treated with a flare-up plan – a treatment plan drawn up by your doctor. Depending on your individual symptoms and treatment needs, your flare-up plan may include taking antibiotics or steroids to reduce your symptoms. With severe flare-ups, hospitalization may be required. 

How prevalent is COPD?

COPD is prevalent worldwide. In the US, over 16.4 million people have COPD, with millions more thought to be affected, and it’s the third leading cause of death. 

Estimates suggest three million people in the UK have COPD, and up to two million don’t have a formal diagnosis. It is the second most common lung disease in the UK, after asthma. 

The overall prevalence of COPD increases with age, particularly as cases often aren’t diagnosed until people are in their 50s and the disease has become advanced. This is because people are often unaware of the warning signs and that shortness of breath can be due to more than simply getting older. 

How serious is COPD?

COPD is serious and can be life-threatening, especially if it’s not treated and managed properly. 

There are four stages which range from mild to very severe. At the very severe stage, any normal daily activities result in extreme breathlessness and your quality of life is adversely affected.  

  • Mild COPD – your airflow is slightly limited and you will have a cough and mucus sometimes, but won’t notice it much. 
  • Moderate COPD – your airflow is worse and you’ll often feel short of breath after being active. At this stage you’re likely to notice you’re experiencing symptoms and seek help and advice from your family doctor. 
  • Severe COPD – your shortness of breath and airflow is severe. You’ll frequently experience COPD exacerbation, where your symptoms flare up. 
  • Very severe COPD – you’ll be having regular bad flare ups and your airflow is very limited. Your quality of life becomes poor due to extreme breathlessness. 

The sooner it is identified and diagnosed, the sooner treatment can be started and symptoms managed. 

Can a person with COPD get better?

There’s no overall cure for COPD and the lung damage can’t be reversed. However, a person with COPD can see an improvement in their symptoms, especially if diagnosed early, and further lung damage can be prevented. The key to getting better is finding the right treatment option to suit your stage of COPD and learning techniques to self-manage your symptoms. 

What is life expectancy with COPD?

COPD is a serious medical condition and it can become life-threatening. There are many factors involved in working out life expectancy – your doctor or medical professional will be able to advise you on your exact circumstances. 

As a guide though, research suggests that severe and very severe COPD could be associated with a loss of life-expectancy of about eight to nine years. 

 

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BMJ Best Practice – Chronic Obstructive Pulmonary Disease

British Lung Foundation – Chronic Obstructive Pulmonary Disease statistics

British Thoracic Society – COPD

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