COPD

What is COPD?

Chronic Obstructive Pulmonary Disease, or COPD, describes a group of lung conditions that cause air flow to be blocked due to a narrowing of the airways in the lungs. People who are diagnosed with COPD have one, or both of the following conditions:

1. Emphysema which involves damage to the walls of the air sacs in the lungs and leads to less oxygen reaching the bloodstream.

2. Chronic Bronchitis is a long term inflammation of the airways.

Both types of COPD cause shortness of breath, as damage to the air sacs and airways makes it harder to move air in and out as you breathe. Some people with COPD are less able to take in oxygen and get rid of carbon dioxide. COPD is a long-term, or ‘chronic’, condition, requiring ongoing medical treatment.

Who is at risk of developing COPD?

Most COPD is diagnosed in people aged 40+, usually in those with a history of chest problems in childhood, which can be linked to a low birth weight or premature birth. Drug smoking, or inhaling cigarette smoke can also be a factor. COPD can be caused by fumes from poisonous chemicals or substances, from indoor cooking on open fires or from harmful dust, and can be caused from some work environments. A genetic condition called alpha-1 antitrypsin deficiency can increase the risk of younger people and non-smokers developing COPD, which increases sensitivity to lung damage from airborne pollutants.

What are the symptoms?

COPD develops slowly and many people may be unaware of the problem until breathing starts to become more difficult, or different to normal. This usually occurs when the lung damage becomes significant enough to impact on lung function. The main symptoms are difficultly inhaling deeply or breathing out fully, shortness of breath, frequent coughing and wheezing and producing excess phlegm, also known as ‘sputum’. People with COPD can be more vulnerable to chest infections, including pneumonia, so it is important to monitor symptoms regularly. Sometimes COPD symptoms can become significantly worse, known as an acute exacerbation, or ‘flare-up’.

What if I have some of these symptoms?

If you have any of these symptoms, speak to your GP or practice nurse. If you don’t have a GP, you can search for local GP services on the Service Finder web page. They may complete some tests such as blowing into a special tube (spirometry) that can check how well your lungs are working or take a blood sample. Click here to find out more.

How is COPD treated?

If you have been diagnosed with COPD and you smoke, the most important thing you can do to help your condition is to stop smoking. There is more about this below in the ‘What can I do to help myself?’ section.

Pulmonary rehabilitation is another effective treatment and management option, involving a combined educational and specially designed physical exercise programme. Programmes differ across the country and can be delivered in a group setting or completed individually in the comfort of your home or online. Benefits of pulmonary rehabilitation include improved muscle strength and fitness, increased knowledge about COPD and increased confidence to manage your symptoms effectively. You can find out more about pulmonary rehabilitation here.

A wide range of medical treatments are available to keep COPD symptoms under control. A common treatment is medication delivered via inhalers. ‘Preventer’ inhalers reduce inflammation in the airways. ‘Reliever’ inhalers reduce symptoms quickly if they do occur. ‘Combination’ inhalers are also available, aiming to prevent symptoms from occurring and helping to keep airways open. A machine called a ‘nebuliser’ can be also used to deliver reliever medication via a face mask in extreme cases.

Tablet medication is also available to reduce airway inflammation and help make mucus easier to cough up. For some, oxygen therapy can relieve breathlessness and improve quality of life. Some people may receive Non-Invasive Ventilation (NIV) in hospital following a flare-up and may be available to some patients at home, depending on their condition.

How does COPD affect daily life?

COPD is a progressive condition, meaning that it becomes worse over time. Increased breathlessness can affect people’s quality of life, ability to complete daily tasks and remain physically active. Some people may experience sleep disturbance or develop sleep apnoea, so it is important to maintain good sleeping habits. You can find out more on our sleep apnoea web page. Experiencing breathlessness can lead to low mood, anxiety or fear. Information about looking after your mental wellbeing can be found on the Mental Health Foundation website. Information about how to exercise safely can be found here.

What can I do to help myself?

You should take all medications as prescribed and make sure that you can use your inhaler. Your GP or Practice Nurse should check with you regularly that you know inhaler technique. If you smoke, you should try to stop and avoid inhaling other people’s smoke. Details about support to give up smoking can be found here. You can find local Stop Smoking services using the Service Finder tool. You should also keep up to date with vaccinations, particularly for flu, pneumonia and COVID-19. Diet and nutrition and managing a healthy weight are also important. Being underweight is linked to a weaker immune system, and being overweight means a higher risk of restrictive lung disease and higher risk of heart conditions and Type 2 diabetes.

If you have COPD, you should avoid things which could trigger symptoms, such as pollen, aerosols, strong fragrances, airborne pollutants or extreme temperatures.

Keeping physically active, eating well and sleeping well will also help. If you have not yet been referred for Pulmonary Rehabilitation, ask your GP or Practice Nurse about a referral. Learning to conserve energy, planning ahead and using effective breathing techniques can all help to manage breathlessness. You can find out more about managing breathlessness on the British Lung Foundation website. During cold weather try to stay as warm as possible and keep your nose and mouth covered when you go out. Avoid others who are unwell, and practice the habit of ‘hands, face, space’, which is wash your hands, cover your face and make space’ You can find out more on our Health and Wellbeing web pages.

What should I do if I feel unwell?

If you feel unwell and your breathing is affected, tell someone as soon as you can. Seek medical advice and if you have a prescription of rescue medication, take this as instructed if advised to be a medical professional. If your medication does not help to relieve symptoms, contact your GP or specialist community team.

24-hour NHS advice is available by dialling 111 or visiting https://111.nhs.uk/. In an emergency dial 999 or go straight to your nearest accident and emergency department.