COPD

What is COPD?

Chronic obstructive pulmonary disease (COPD) is an umbrella term for a group of lung conditions that cause long-term damage to the airways. In COPD the airways are narrowed, due to a variety of causes, so the air you breathe cannot flow freely in or out of the lungs.

Chronic = long term

Obstructive = describes the narrowing of the airways

Pulmonary = of the lungs

Disease

What are the symptoms of COPD?

COPD makes breathing increasingly difficult over time. Many people do not have noticeable symptoms until their late 40s.

Typical symptoms of COPD are::

• Increasing breathlessness
• Wheezing
• Regular production of sputum (phlegm)
• Coughing

You may also have other symptoms, such as repeated chest infections, weight loss, and tiredness or fatigue.

What causes COPD?

The main cause of COPD is smoking. In the UK, around 8 out of 10 people with COPD are either current smokers or have previously smoked.

But smoking is not the only cause of COPD. It can also be caused by:

• poor air quality
• work-related exposure to dust
• chemicals or fumes
• genetic factors

How is COPD diagnosed?

COPD diagnosis can happen in many ways, as it tends to “creep up” with worsening symptoms over time. Your doctor will likely ask you a series of questions about your family background, your general health and whether you’re a smoker. They will then examine you by listening to your chest and looking at other parts of your body (such as fingers and ankles) to rule out any other possible conditions that could be causing your symptoms.

They may also assess the severity of your breathlessness to get an idea of how much COPD is impacting your day-to-day life. Once COPD is diagnosed, the severity is defined as Mild, Moderate, Severe or Very Severe.

Your BMI may also be calculated to see if being underweight or overweight is potentially worsening your symptoms.

You may then be offered one of the following tests to understand which treatment(s) will be most effective for you and your condition:

• Additional breathing tests to decide whether you have asthma or COPD
• Functional breathing tests to see how physical activity affects your breathing
• A blood test for alpha-1 antitrypsin to find out if you have alpha-1 antitrypsin deficiency (an inherited condition that can cause COPD)
• A computerised tomography (CT) scan of your chest to get a detailed picture of the structure of your lungs
• An electrocardiogram (ECG) or echocardiogram (Echo) or both to check whether COPD has affected your heart
• Pulse oximetry to measure how much oxygen there is in your blood
• A sputum test if an infection is suspected

How is COPD treated?

If you’re a smoker, the first step in treatment is to stop smoking. Quitting smoking will slow down or prevent further damage to your lungs. If you’re in the early stages of COPD, this may be the only treatment that you need.

COPD cannot be cured, but medical treatment can improve your symptoms, stop them from getting worse, and prevent future flare-ups of symptoms.

There are several treatment options for COPD. The treatment you are given will depend on your symptoms and the severity of your COPD. The process of finding the right treatment for you can require some trial and error. This means that your treatment will be reviewed regularly, and you may have to try several treatments until you find the one that fits you best.

COPD medicines are often inhaled through an inhaler or nebuliser, allowing the medicine to go directly to the lungs and get the greatest effect with the least side effects. Other medicines include mucolytic medicines which make phlegm less thick, steroid tablets prescribed for flareups, and – if you have an flareup resulting from an infection -a prescribed course of antibiotics.

Pulmonary rehabilitation is a structured programme of physical activity and education specifically designed for people with long-term chest conditions like COPD. Pulmonary rehabilitation is one of the most effective treatments for people with COPD. It can lead to significant improvements in your quality of life and ability to exercise. It can also help to improve symptoms such as breathlessness.

Making lifestyle changes to improve COPD

A COPD diagnosis can be life-changing and distressing, but there are ways that you can help yourself following diagnosis.

If you’re a smoker, the first thing to do is stop smoking. There are many ways to help quit smoking available to you and your loved ones.

Make sure that you drink plenty of fluids, stay as active as you can, and eat healthily. If you suffer from repeated flare-ups, your care team will help you to create a self-management plan that should reduce the instances of flare-ups and help you to live a comfortable, active life.

Visit our Living with a Chest Condition section for more information about how to manage your condition at home, how to stay well and reduce your risk of developing further chest conditions.