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Chronic Obstructive Pulmonary Disease - COPD

A Guide to Chronic obstructive pulmonary disease (COPD), the name for a collection of
lung diseases including chronic bronchitis, emphysema and chronic obstructive airways disease.

Symptoms
Causes
Diagnosing COPD
Treating COPD

Introduction

The main symptom of COPD is an inability to breathe in and out properly. This is also referred to as airflow obstruction.

Airflow obstruction is caused by long-term damage to the lungs, usually as a result of smoking.

How common is COPD?

COPD is one of the most common respiratory diseases in the UK. It usually affects people who are over 40 years of age.

Around 900,000 people in the UK have been diagnosed with COPD, but it is thought that the actual figure is much higher. This is because many people who develop the symptoms of COPD do not seek medical attention because they often dismiss their symptoms as the result of a ‘smoker’s cough’.

A report by the British Lung Foundation that was published in 2007 estimated that in the UK there are 3.7 million people living with COPD.

COPD affects more men than women. According to the British Thoracic Society, the rate of COPD among women is increasing.

The main cause of COPD is smoking. The likelihood of developing COPD increases the more you smoke and the longer you've been smoking.



The effects of COPD

The condition builds up over a number of years, causing the airways of your lungs (bronchioles) to narrow, permanently damaging your air sacs (alveoli). As the condition progresses, breathing in and out will become increasingly difficult. You may find it hard to do normal activities, such as walking to the shops. If not enough oxygen is getting through the narrowed airways to your heart you may also be at risk of heart failure.

The symptoms of COPD can seem similar to those of asthma. Asthma can be controlled with treatment but COPD causes permanent damage to the lungs. Treatment for COPD usually involves relieving the symptoms; for example, by using an inhaler to make breathing easier.

Although COPD causes about 30,000 deaths a year in the UK, severe COPD can be prevented by making some basic changes to your lifestyle.

See the Prevention section (above) for information and advice about how to prevent COPD developing, and how to alleviate the symptoms.

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Symptoms of COPD

If you smoke, you have an increased risk of getting chronic obstructive pulmonary disease (COPD). The condition can build up over a number of years, as your lungs are gradually damaged more and more by smoking.

COPD does not usually become noticeable until after the age of 40. Symptoms include:

  • early morning ‘smoker’s cough’
  • persistent coughing
  • mucus and phlegm
  • wheezing
  • tight chest
  • difficulty breathing
  • shortness of breath
  • repeated lung and chest infections

If you have COPD, your bronchioles (airways of the lungs) become inflamed and narrowed. As your lungs’ alveoli (air sacs in the lungs) become permanently damaged, it will become increasingly difficult for you to breathe in and out.

The symptoms of COPD are often worse in the winter, and it is common to have two, or more, ‘flare-ups’ a year. A flare-up is when your symptoms are particularly bad.



Daily life

If you have COPD, you may feel anxious about your condition. This can leave you feeling depressed and isolated.

If you find it hard to get air in and out of your lungs, the amount of oxygen reaching your heart and other muscles is restricted. This can make you feel very tired. This can affect your work, ability to exercise, social life, and personal relationships. It can also have a negative impact on your sex life, as you may feel too tired to have sex or experience breathing difficulties during sex.

If you have severe COPD, simple tasks and daily activities can become increasingly difficult.

COPD and your weight

If you are having difficulties breathing, you may be using up a lot more energy than usual. You may find that feeling breathless is making it hard to eat as much as you would normally. This can lead to weight loss and muscle wasting.

Severe weight loss can result in serious complications, such as heart failure (a weakened, inefficient heart).

If you are losing a significant amount of weight, speak to your GP for advice about ways to help keep your weight up.

Not everyone with COPD loses weight. If you are overweight, try not to put weight on. Obesity can also make COPD worse and lead to health conditions, such as heart disease and diabetes.

Whether you are under or overweight, eating a healthy, well-balanced diet is essential.

When to seek medical advice

You should contact your GP if you experience the following symptoms:

  • an increasing breathlessness when exercising, or moving around
  • a persistent cough with phlegm that never seems to go away
  • frequent chest infections, particularly in winter

While there is currently no cure for COPD, the sooner the condition is diagnosed and appropriate treatment can begin, the less chance there is that you will experience severe lung damage.

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Causes of COPD

Smoking is the main cause of chronic obstructive pulmonary disease (COPD). It is responsible for around 80% of cases. The likelihood of developing the condition increases the more that you smoke and the longer you have been smoking.

Between the age of 35-45, everyone’s lung function begins to gradually decline. For smokers, this loss of lung function speeds up to around three times the normal rate.

COPD is not curable, but if you quit smoking you can slow down the effects of the condition.

Less common causes of COPD include:

  • passive smoking,
  • pollution,
  • fumes and dust, and
  • being born more susceptible to the condition.

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Diagnosing COPD

If you have chronic obstructive pulmonary disease (COPD) you will often be short of breath, have a persistent cough, and a build-up of mucus and phlegm in your throat.

The following tests can be carried out to help diagnose COPD, and also to eliminate other conditions such as asthma.

Spirometry

Spirometry is usually used to diagnose COPD. It involves breathing in and out of a tube connected to a machine, so that your GP can assess whether or not your airways have narrowed.

Chest radiography

Chest radiography is a type of X-ray that will show any hyperinflation (over expansion) of your lungs.

Computerised tomography (CT) scan

A CT scan is more sensitive than a chest radiograph (X-ray) and is particularly useful for diagnosing lung diseases.



Blood test

A full blood test may be carried out in order to check for anaemia (low iron levels in your red blood cells) that can make the symptoms of COPD worse.

A blood test may also be used to look for polycythaemia (an excess of red blood cells). If you have polycythaemia, your body may not be getting enough oxygen as a result of your lungs being damaged.

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Treating COPD

There is no cure for chronic obstructive pulmonary disease (COPD). Treatment is mainly used to relieve any symptoms that you have.

After assessing your condition, your GP may recommend a course of treatment for you, and closely monitor how well you respond to it. The effectiveness of treatment for COPD can vary considerably from person to person.

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