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Chronic obstructive pulmonary disease (COPD)Published by BUPA's health information team, healthinfo@bupa.com, November 2007. This factsheet is for people who have chronic obstructive pulmonary disease (COPD) or who would like information about it. COPD is a term used to describe a number of long-term lung conditions such as chronic bronchitis and emphysema that cause breathing difficulties. It is a long-term condition that tends to get progressively worse. Smoking is the main cause of COPD. About COPDCOPD is common, affecting at least 900,000 people in the UK. The use of the term COPD has largely replaced the previously separate conditions of chronic bronchitis and emphysema. BronchitisBronchitis means inflammation of the bronchi, the main airways that lead from your windpipe (trachea) into your lungs. Chronic bronchitis is now known as COPD. Chronic bronchitis develops if you are exposed to irritants such as tobacco smoke for a long time. The word 'chronic' refers to it being a long-term condition, rather than how severe it is. Your airways react to the irritants by becoming inflamed and producing excessive amounts of mucus - also known as phlegm or sputum. This clogs up the airways and air sacs (alveoli) that transfer oxygen from the air you breathe to your blood. Chronic bronchitis is often made worse by bacterial or viral infections that can affect the chest. It therefore tends to be worse in winter when viral infections such as colds and flu are more common. EmphysemaEmphysema is another form of lung disease which is now known as COPD. Like chronic bronchitis, in most people it's caused by smoking. The elastic supporting structure of the alveoli becomes damaged, making breathing difficult and causing shortness of breath.
SymptomsAt first COPD doesn't usually have any symptoms. The condition progresses gradually, starting with either a "phlegmy" cough or breathlessness. Initially you may only get symptoms in the winter, and they are often disregarded as a "smokers cough", or winter bronchitis. Many people developing COPD don't see their doctor at this stage, but the earlier you get treatment, the better. As the disease progresses, symptoms can vary between patients. They include:
Chest pain and coughing up blood are rare symptoms of COPD, and usually indicate the presence of other diseases as well. CausesThe biggest single cause of COPD is smoking. According to the British Thoracic Society it causes 95 percent of all COPD. About one in eight people who smoke one pack of cigarettes a day develop it; this rises to one in four people who smoke two packs a day. If you stop smoking your chances of developing COPD begin to fall. And if you already have COPD, it progresses more slowly if you stop smoking. Other risk factors include:
Pollution and allergies have also been suggested as risk factors for COPD, but the evidence isn't conclusive. DiagnosisIf your GP thinks you have COPD, he or she will ask you about the problems you have had with your chest and how long you have had them. He or she will usually examine your chest with a stethoscope, listening for noises such as wheezing or crackles. Your GP may also perform a lung test called a spirometry test. This involves you blowing into a device that measures how much and how fast you can force air out from your lungs. Different lung problems produce different results so this test helps to separate COPD from other chest conditions such as asthma. Other tests you might have include:
You may have other tests to rule out specific conditions. Here are some examples.
TreatmentAlthough there is no way to reverse the damage to your lungs, there are lots of things you can do to stop COPD from getting worse. The most important treatment is to stop smoking. Quitting smoking can slow down the progression of the condition, even if you've had it for a long time. Using nicotine replacement therapy and other stop-smoking treatments can make giving up easier. Self helpThere are other steps you can take to stop COPD getting worse and to ease your symptoms:
Pulmonary RehabilitionAsk your GP about pulmonary rehabilitation. These are programmes consisting of exercise, education about COPD, advice on nutrition and psychological support. Pulmonary rehabilition has been shown to help people with COPD. MedicinesThere are various medicines that may help to ease your symptoms. Your GP will discuss which treatment is best for you. BronchodilatorsThese treatments, commonly used for asthma, may help to relieve wheezing and breathlessness by relaxing your lungs (bronchodilation) so that air flow into them more easily. They are available as inhalers or as tablets. SteroidsSteroid treatments may help if you have more severe COPD, although they are usually only used if bronchodilators aren't effective. They are available as inhalers or as tablets. MucolyticsMucolytics break down the phlegm in your lungs, making it easier for you to cough it up. Your doctor may prescribe you a mucolytic if you have a chronic phlegm-producing cough. Research indicates that using mucolytics can reduce the number of flare-ups you have. Oxygen therapyIf the COPD becomes severe, you may develop low blood oxygen levels. Oxygen therapy can help relieve this. The oxygen is provided in large tanks for home use, or smaller, portable versions for outside the home. An oxygen concentrator - a machine that uses air to produce a supply of oxygen-rich gas - is an alternative to tanks. You inhale the oxygen through a mask or small tubes (nasal cannulae) that sit beneath your nostrils. You can only use oxygen therapy if you have given up smoking, because there is a serious fire risk. Oxygen therapy can either be long term, where you use it all the time at home, or ambulatory - when it is used for exercise or when outdoors. Portable oxygen cylinders are available for ambulatory oxygen therapy. SurgeryIf you have severe COPD your doctor may recommend surgery to remove diseased areas of the lung and allow them to function more effectively. However this is only carried in certain specific cases. Further information
Sources
Related topicsThis information was published by BUPA's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Dr James Quekett, Bsc.MB Ch.B MRCGP DRCOG DFFP, partner/principal general practitioner at Rowcroft Medical Centre, and by BUPA doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional. Publication date: November 2007. Expected review date: November 2009.
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