Chronic obstructive pulmonary disease (COPD)

About COPD 

Chronic obstructive pulmonary disease (COPD) is the name for a group of lung conditions that cause difficulty breathing. It was previously thought they were separate conditions, but now it is clear that they are linked:

• emphysema – damage to the air sacs in the lungs
• chronic bronchitis – long-term inflammation of the airways
• chronic obstructive airways disease

COPD is a common condition that mainly affects middle-aged or older adults who smoke. Many people don't realise they have it. COPD can occur in people who have never smoked, however, it is mainly caused by cigarette smoking

The breathing problems tend to get gradually worse over time. This can limit normal activities, although treatment can help keep the condition under control.

Symptoms of COPD 

The main symptoms of COPD include:

• increasing breathlessness, particularly when you're active
• a persistent chesty cough with phlegm – some people may dismiss this as just a "smoker's cough"
• frequent chest infections
• persistent wheezing

Without treatment, the symptoms usually get slowly worse. There may also be periods when they get suddenly worse, known as a flare-up or exacerbation.

Less common symptoms of COPD include:

• weight loss
• tiredness
• swollen ankles from a build-up of fluid (oedema)
• chest pain and coughing up blood – although these are usually signs of another condition, such as a chest infection or possibly lung cancer

These additional symptoms only tend to occur when COPD reaches a more advanced stage.

When to get medical advice 

See your GP if you have persistent symptoms of COPD, particularly if you're over 35 and smoke or used to smoke.

Don't ignore the symptoms. If they're caused by COPD, it's best to begin treatment as soon as possible, before your lungs become significantly damaged.

Your GP will ask about your symptoms and whether you smoke or have smoked in the past. They can organise a breathing test to help diagnose COPD and rule out other lung conditions, such as asthma.

Causes of COPD 

COPD occurs when the lungs become inflamed, damaged and the airways narrowed. The main cause is smoking.  Some cases of COPD are caused by long-term exposure to harmful fumes or dust. Some can also occur as a result of a rare genetic problem that means the lungs are more vulnerable to damage

For those who smoke, the likelihood of developing COPD increases the more you smoke and the longer you've smoked.

Treatments for COPD 

The damage to the lungs caused by COPD is permanent. However, treatment can help slow down the progression of the condition.

Treatments include:

• stopping smoking – if you have COPD and you smoke, this is the most important thing you can do
• inhalers and medications – to help make breathing easier
• pulmonary rehabilitation – a specialised programme of exercise and education
• surgery or a lung transplant – although this is only an option for a very small number of people

Outlook for COPD 

The outlook for COPD varies from person to person. The condition can't be cured or fully reversed. However, for many people treatment can help keep it under control so it doesn't severely limit their daily activities.

But for some people COPD may continue to get worse despite treatment. This eventually has a significant impact on their quality of life and can lead to life-threatening problems.

Preventing COPD 

You can significantly reduce your chances of developing COPD if you avoid smoking.

If you already smoke, stopping can help prevent further damage to your lungs before it begins to cause symptoms.

Your GP can help you to stop smoking. There is also free specialist advice available to help you quit smoking. Stop smoking support services, through GP practices and community pharmacies, are available across Northern Ireland.

• Find out more about COPD on the NHS website

More useful links

• How to use your health services
• Air pollution and health
• Air quality in Northern Ireland
• Support for chest conditions
• British Lung Foundation