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What is COPD? How is it different to asthma?
COPD (chronic obstructive pulmonary disease) is a chronic inflammatory lung disease which causes an obstruction of the airflow to the lungs that makes it hard to breathe. The main conditions responsible for causing this obstruction are emphysema and chronic bronchitis. It is one of the most common respiratory diseases in the UK, affecting around 3 million people.
What are the symptoms?
The symptoms of COPD develop over many years and are often dismissed as “smoker’s cough”. Although COPD can start to affect people over the age of 35, most are not diagnosed until they are in their 50s. Symptoms gradually worsen over time, but include:
- Difficulty breathing because your airways have narrowed, restricting air flow.
- Breathing problems after exercise.
- A persistent cough with phlegm.
- Wheezing.
- Frequent chest infections, particularly in winter.“Flare-ups”, often during winter, when symptoms get particularly bad for several days.
- Chest tightness.
- Unintentional weight loss.
- Swollen ankles.
- Tiredness and fatigue.
What causes COPD?
COPD is caused by long-term exposure to gases or particles that irritate your lungs. In 90% of cases, this is from cigarette smoke. Smoking inflames your lungs and over a long period of time they can become damaged and scarred. This can lead to the development of emphysema or chronic bronchitis, conditions that cause airway obstruction.
Emphysema cause destruction of the fragile walls and air sacs (alveoli) in your lungs. This makes the thin airways in your lungs collapse, making it hard to breath out.
Chronic bronchitis is caused by inflammation of your bronchial tubes (tubes that carry air to and from your air sacs). The tubes narrow, and your lungs produce mucus, which further blocks your airways.
If you have COPD you could have one or both of these conditions. When you breathe out, your lungs rely on the natural elasticity of both the air sacs and bronchial tubes to help push air out of your body. COPD causes your lungs lose their elasticity, making it harder to exhale.
Other causes of COPD include passive smoking and exposure to dust, fumes and air pollution. You may be particularly at risk of COPD if you work with cadmium, coal, isocyanates or grains, which generate a lot of dust during processing. People who have asthma and smoke are also more at risk of developing COPD. Some genetic factors may increase susceptibility to the disease, including a rare deficiency of alpha-1-antitrypsin, a protein that helps to protect your lungs from enzyme damage. However, this only causes COPD in about 1% of patients.
How is it treated?
There is currently no cure for COPD and you cannot reverse the damage already done to your lungs. However, with proper management, people with COPD can have a good quality of life. Getting an early diagnosis is vital to help to slow lung deterioration and reduce your symptoms, so see your GP as soon as possible if you develop symptoms. Your doctor may give you a breathing test assessment and send you for a chest x-ray to check for other lung conditions and confirm the COPD diagnosis.
Medications that may be prescribed to help improve your symptoms include:
- Bronchodilator inhaler. This works by making the muscles in your airway to relax and open up.
- Steroid inhalers, more commonly given to asthma patients, can help to reduce lung inflammation.
- Theophylline tablets, which cause airway muscles to relax, helping your airway to open up.
- Mucolytic tablets help to thin the mucus and phlegm in your throat, making it easier to cough up.
- Antibiotics may be prescribed if you suffer from chest infections.
If your breathing becomes difficult and the oxygen levels in your blood get low, your doctor may recommend oxygen therapy. There are several types of oxygen treatment and breathing aids available, depending on your specific needs.
Surgery is an option for a small number of people. Badly damaged areas of lung tissue can be removed to allow the remaining tissue to work more effectively.
COPD is a long-term condition, so you will have regular meetings with your healthcare team to monitor your progress and adjust any medications.
There are also several lifestyle changes you can do yourself to help to ease your symptoms:
- Quit smoking.
- Exercise as much as you can, even if your movement is limited. Exercising, ideally twice a day, will improve your breathing.
- Learn breathing techniques and exercises.
- Get a flu jab every year.
- Get the anti-pneumococcal vaccination - just one injection that will protect you against pneumonia.
- Avoid any products with strong fumes, such as hairspray, perfume or strong smelling cleaning products.
- Ensure you take your medication as directed, even if your symptoms improve.
- Keep a healthy weight. COPD sufferers often lose weight unintentionally, which can cause make the disease progression worse. Being overweight with COPD is also problematic as it will make you more breathless. Therefore, it is important to follow a healthy diet. If you are losing weight, make sure you eat enough calories to maintain a healthy weight.