What is COPD?

Chronic bronchitis causes inflammation and swelling of the bronchi (the airways of the lungs), which lead to their narrowing and obstruction. In emphysema, there is permanent damage to the smaller airways and air sacs (alveoli) of the lungs.

In both of these lung diseases the airways are partly obstructed making it difficult to get air in and out. Chronic bronchitis and emphysema commonly occur together ⁽¹⁾ and affect your lungs by narrowing their airways.

What causes COPD?

The main cause of COPD is smoking: the lining of the airways become inflamed and damaged. Breathing in lung irritants, such as air pollution, dust or chemicals over a long period of time, may also contribute to COPD.

Environmental pollutants, such as cadmium and silica, can increase the risk of COPD. People at risk for this type of pollution include coal miners, construction workers and metal workers. However, if you have never smoked, it is rare for you to develop COPD.

COPD can also be caused by deficiency of alpha-1 antitrypsin (AAT). AAT deficiency is a rare genetic disorder in which an imbalance of proteins in your blood leads to the destruction of the lungs ⁽²⁾. Passive smoking ⁽³⁾ can also play a role in an individual developing COPD.

Who gets COPD?

The disease mainly affects smokers and people aged over 40 years old ⁽⁴⁾. People with a family history ⁽⁵⁾ of COPD are more likely to get the disease if they smoke. Those that have had severe lung infections as a child ⁽⁶⁾ may have a greater chance of developing lung damage which can cause COPD.

What are the symptoms of COPD?

The symptoms of COPD can appear similar to asthma. However, asthma can be controlled by treatment whereas COPD causes permanent damage to the lungs.

Cough

This is usually the first symptom to develop and is synonymous with the coughing up of phlegm (sputum). Your cough can be intermittent at first and develop into a more persistent (chronic) cough

Breathlessness and wheezing

This usually occurs when you exert yourself for example during physical exercise but for sufferers affected predominantly by emphysema this can happen while you are resting

Sputum

The damaged airways make a lot more mucus than normal. This forms sputum (phlegm). Sufferers tend to cough up a lot of sputum each day

Chest infections

These are more common if you have COPD, especially with chronic bronchitis. Wheezing, coughing and breathlessness may become worse than usual if you have a chest infection. Sputum usually turns yellow or green during a chest infection

Cyanosis

This may occur if you have advanced COPD and your nails and lips may go blue due to a lack of oxygen in the blood

How is COPD diagnosed?

The following diagnoses methods are used to detect COPD:

A spirometry (breathing) test

This will be carried out by your GP to assess if your airways have become narrower. The test requires you to breath in and out of a tube connected to a machine

Chest radiography

This is an X-ray that will show any overexpansion of your lungs

CT scan

This is useful in diagnosing other lung diseases

Blood test

These can check for conditions that can make the symptoms of COPD worse

What are the treatments for COPD?

The aims of the treatment are to prevent further deterioration of the lungs, alleviate symptoms and improve the sufferer’s quality of life. COPD can not be cured at present.

Bronchodilator inhalers

this medication dilates the airways and decrease airway inflammation. These can improve symptoms of wheezing and breathlessness. Short acting and long term acting inhalers can be used depending on the severity of the condition

Steroid inhalers

this may help in addition to a bronchodilator inhaler if you suffer from severe COPD. It can help to prevent your condition flaring up

Bronchodilator tablets

these can open up your airways and may be easier to use than inhalers but you may experience some side effects

Steroid tablets

a short course may be prescribed if you have a bad attack of wheezing and breathlessness. These can reduce the extra inflammation in the airways caused by infections. These should not be taken long term due to serious side effects

Mucolytic medicines

these make your phlegm less thick and easier to cough up. It is prescribed for moderate of severe sufferers of COPD

Antibiotics

a short course of antibiotics is often prescribed if you have a chest infection

Pulmonary rehabilitation

this is a form of therapy that improves your respiratory symptoms and can include education, exercise, nutritional assessment and smoking cessation advice

Regular oxygen supplementation

this can help sufferers of severe COPD, oxygen through a mask is taken for at least 15-20 hours. This is usually only an option for non-smokers

Surgery

removing a section of lung that has become useless may be an option if it improves symptoms but this is only carried out on a small number of sufferers. A lung transplant may be carried out for some people with very severe COPD

Can COPD be prevented?

Stop smoking

If you stop smoking at an early stage of the disease, it will make a huge difference. Any damage already done to your airways cannot be reversed, but stopping smoking prevents the disease from getting much worse

Get immunised

A yearly flu jab can protect against possible flu bugs and chest infection that may then develop.

Immunisation against pneumococcus (a germ that can cause serious chest infections) is recommended. This is a one-off injection and not yearly, like the flu jab

Try to do some regular exercise

studies have shown that people with COPD who exercise regularly tend to improve their breathing, ease symptoms, and have a better quality of life

Eat a balanced diet

this can boost your immune system and fight off diseases and infections

Try to lose weight

If you are overweight carrying extra weight can make breathlessness worse

Drink lots of fluids

this will help to reduce the amount of mucus and phlegm in your throat and lungs

Use a steam inhalator or humidifier

This can help to reduce excess mucus and phlegm and can help you breath more easily

It is estimated that 30,000 people die each year in the UK from the end stages of COPD ⁽⁷⁾, but in the majority of cases COPD can be prevented by giving up smoking. Those that continue to smoke suffer a more rapid decline in lung functions than those who stop completely.

Infolink

• British Lung Foundation