COPD Treatment

COPD stands for Chronic Obstructive Pulmonary Disease, which means it is a long term medical condition which causes the airways of the lungs to narrow over time, leading to breathing difficulties. 

Some common symptoms of COPD are:

• increasing breathlessness – may happen during or after exercise or you may wake up feeling short of breath
• a persistent chesty cough with mucus that does not go away
• frequent chest infections
• persistent wheezing

While these symptoms are found in COPD, they are also the common symptoms found in asthma. Your doctor will be able to investigate more to help confirm what is causing your symptoms.

What are the early warning signs of COPD?

At first, the most common COPD symptom you may experience is coughing. It may start as coughing every now and then, and may progress to persistent coughing with production of mucus.

A common ‘warning sign’ symptom of COPD is feeling breathless, especially after light activity like climbing a flight of stairs. This is the point where most people seek medical help. Without any treatment, this may progress to difficulty breathing which will affect your quality of life over time.

How fast does COPD progress?

The rate at which COPD progresses over time is difficult to predict and can vary on multiple factors such as your family history, your medical history and your lifestyle choices. COPD may progress over several years with symptoms of:

• worsening cough
• Increased mucus production
• shortness of breath

If you are frequently exposed to air pollutants like dust and toxic chemicals, or if you continue to smoke, your COPD symptoms may progress faster which may lead to a poor quality of life.

What are the signs that COPD is getting worse?

COPD will affect people differently, but in most it is a progressive disease which worsens over time. COPD has been grouped into 4 stages, from mild to very severe, based on symptoms and certain lung tests for breathing difficulties.

Most people tend to seek medical help, as their symptoms of coughing with mucus production and shortness of breath begin to worsen and happen more frequently. The 4 stages are outlined below and medical professionals refer to these as the e GOLD stages of COPD. What this indicates is how severe your COPD is.

You will usually know your stage after you have had lung function tests done but the table below will give you a rough idea according to your symptoms.

Grade 0 - Not troubled by breathlessness except on strenuous exercise

Grade 1 - Short of breath when hurrying or walking up a slight hill

Grade 2 - Walks slower than contemporaries on level ground because of breathlessness, or has to stop for breath when walking at own pace

Grade 3 - Stops for breath after walking about 100 metres or after a few minutes on level ground

Grade 4 - Too breathless to leave the house, or breathless when dressing or undressing

What factors contribute to COPD flare ups (exacerbation)?

Some people may experience a sudden worsening of their COPD symptoms compared to their usual symptoms. This is also known as a COPD ‘flare up’, ‘attack’ or ‘exacerbation.’ Some factors that make you at risk of an exacerbation of you COPD are:

• smoking
• bacterial or viral infections
• poorly controlled COPD
• bad air pollution
• Allergies or hayfever

COPD flare ups can become life threatening if not treated as soon as possible, with appropriate inhalers and antibiotics (if you have a chest infection).

Is COPD the same as smokers cough

A smoker’s cough is not always the same condition as COPD, but a smoker's cough can often be a sign of COPD or other diseases such as lung cancer, pneumonia and many other conditions.

A smoker’s cough is not a diagnosis and always needs to be investigated.

COPD, may be caused by long term smoking, but there are other causes.

The symptoms are often:

• shortness of breath
• coughing
• Increased mucus production

The cough is usually worse in the morning and may improve later in the day. You may also experience other symptoms like:

• sore throat
• chest pain

If you have chest pain or sudden onset of shortness of breath please call 999. If you’ve had a cough for over 3 weeks, you should book an appointment with your doctor for further investigation.

You should book an appointment with your doctor if you are experiencing symptoms (persistent coughing and difficulty breathing), and think you may have COPD. Your doctor will examine you and carry out other investigations such as lung function tests to confirm a diagnosis of COPD. The methods used to diagnose COPD are:

• Medical history and physical examination – your doctor will ask about your symptoms and examine your chest with a stethoscope for signs of wheeze or reduced air entry
• Spirometry – this is a lung function test which checks how well your lungs are working. You will be asked to breathe into a device which will check the capacity of your lungs. Spirometry is also used to regularly check how well your COPD is controlled after treatment
• Medical imaging – a chest X-ray and CT scan may show signs of COPD, and also help to rule out other possible causes of your symptoms like lung cancer
• Blood tests will help to check for other causes of shortness of breath such as heart failure or anaemia
• Oxygen saturation – your oxygen saturation levels will be checked using a device (pulse oximeter) that fits on your finger. People with COPD usually have lower oxygen saturation levels than normal

What is the normal oxygen level for someone with COPD?

If you have COPD you will probably have lower oxygen saturation levels in your blood than normal. The normal oxygen saturation levels for people without chronic medical conditions is 95–100%.

People with COPD usually have oxygen saturations of 88–92%. If levels fall below this range, you may experience symptoms of headaches, fast heartbeats (palpitations) and confusion, because your organs are not receiving enough oxygen.

There is no cure for COPD but it can be managed with lifestyle changes and medical treatments to help improve the symptoms. COPD is managed differently, depending on which stage of COPD you have.

Lifestyle changes

Your doctor will recommend the following lifestyle changes:

• The first and most important step is to stop smoking as this can help slow down COPD progression
• Take physical exercise
• Enjoy a healthy diet
• Find out how to live with COPD and keep it controlled
• Lose unhealthy weight
• Attend follow up appointments to monitor COPD progression
• Get the yearly flu jab and ‘one off’ pneumococcal vaccine to help protect against chest infections

Medical treatments

Medications your doctor may prescribe to help improve your COPD symptoms include:

• Bronchodilator inhalers (Ventolin) work by relaxing your airways to help them open up
• Steroid inhalers (Pulmicort, Clenil Modulite) – works to reduce lung inflammation and swelling, which helps to open up the airways more
• Combination inhalers (Fostair, Seretide, Symbicort) – these contain both steroid and bronchodilator medicines in one inhaler making them more convenient to use
• Mucolytic tablets help to thin the mucus in your throat, making it easier to clear your airways
• Antibiotics – may be prescribed if you suffer from chest infections which may cause COPD flare ups

People with lung conditions like COPD are at an increased risk of severe illness from COVID-19, and need to take extra measures to protect themselves. These protective measures include:

• Limiting contact with people outside your household
• Keeping a distance of at least 2 metres from others when outside if you can
• Working from home if possible
• Wearing a face covering especially when in crowded places. You can find expert advice here on wearing face coverings safely when you have a lung condition

A COPD attack happens when you suddenly feel more out of breath than usual and cough up larger amounts of coloured mucus than you usually do. This is also known as a COPD flare up or exacerbation. It can be set off by long term exposure to bad air pollution or a bacterial or viral infection of your airways. These attacks affect people in different ways.

COPD flare ups can happen a few times a year, especially during the cold winter months. You should always seek immediate medical attention if you feel your COPD symptoms are suddenly worse than usual. Your doctor may give you steroid inhalers, tablets or antibiotics, depending on the cause of the flare up.

COPD is mainly managed with lifestyle changes and medications to improve symptoms, and keep it controlled.

What weather is best for COPD?

Poor weather conditions can set off COPD flare ups very quickly. The best weather for people living with COPD is a warm air climate with low humidity as it is easier to breathe in these conditions.

What makes COPD worse?

Other factors that can worsen COPD symptoms and cause flare ups include:

• smoking, including long term exposure to passive smoking
• long term exposure to air pollutants
• cold and dry winter seasons
• Bacterial and viral infections
• excessive exercise

Does hayfever affect COPD?

People with COPD may experience more flare ups during allergy season. Hay fever is an allergic reaction to pollen and causes the body to produce more mucus in your airways, which can cause them to become narrow, making it harder to breathe.

COPD and asthma

It is possible for people with asthma (which is usually diagnosed early in life) to also have COPD later on.

The main difference between asthma and COPD is that the airways can be restored to normal or near normal if asthma is well controlled with the right inhalers, but COPD is a progressive disease where over time the airways will become more rigid, even if you use inhalers regularly. The inhalers only help to slow the progression of COPD and manage the symptoms.

When people with asthma also develop COPD, flare ups may be life threatening and require immediate medical attention.