What is chronic obstructive pulmonary disease and how can it be treated?

Chronic obstructive pulmonary disease (COPD) is a group of lung conditions that result in poor lung function due to a narrowing of the airways.

We recently spoke to Dr Anjani Prasad, a leading specialist in pulmonology and respiratory medicine, to find out more details about the different types of COPD, the symptoms, and how it can be diagnosed and treated.
 

What are the main types of COPD?

The two main conditions are emphysema and bronchitis and the main cause of both is related to smoking, making COPD a largely preventable disease. COPD refers to a disease characterised by long-term narrowing of the airways that make breathing more difficult when exhaling.
 

The two most common types of COPD are bronchitis and emphysema. With bronchitis, the airways become narrow and inflamed and the lungs produce sputum or phlegm. If you have emphysema, the air sacs in your lungs become baggy and damaged. Holes appear, which impair breathing.
 

How common is COPD?

• It's estimated that 1.2 million people in the UK are living with COPD.
• This number has increased considerably since 2011, when it was estimated that 835,000 were living with the condition.
• COPD is most common for those who are over 35 years of age and are a smoker, or have smoked. This makes COPD the most common lung condition after asthma.
• The main cause of COPD is smoking, although it can affect people that have never smoked.
• Approximately 90% of individuals that get COPD smoke or smoked previously.
• COPD tends to run in families so your risk may be higher if your parents also had chest conditions or COPD.
• A genetic condition known as alpha-1-antitrypsin deficiency, can increase the risk of development of COPD at a young age.

The damage that COPD causes to your lungs is irreversible, therefore early diagnosis is essential. There is no cure for COPD, but treatment options are available to help manage your symptoms.
 

Symptoms of COPD

COPD symptoms are sometimes mistaken for just a “smokers cough” but this is not the case. Diagnosis is vital in order to prevent symptoms from getting worse. Following diagnosis, patients can seek the right treatment to help manage symptoms better.
 

What are the symptoms of COPD?

• Breathlessness when doing daily tasks and even more so when active.
• A persistent, chesty cough, usually with phlegm.
• Wheezing persistently, particularly in cold weather.
• Frequent chest infections.
• Producing more phlegm, or sputum than normal.
   

Symptoms of severe COPD may include losing your appetite that may lead to tiredness and weight loss. Your ankles may become swollen from a build-up of fluids.
 

Coughing up blood could be a symptom of severe COPD. However, couging up blood can also be due to severe chest infections or possibly lung cancer. Part of the diagnosis process is ruling out other conditions.
 

Symptoms may come and go, though with COPD, symptoms are usually persistent. Symptoms can get worse depending on the weather if you have an infection or when breathing in heavy fumes or smoke. Without treatment, symptoms often get worse.
 

What causes COPD?

COPD is the result of long-term damage to the lungs. This causes them to be inflamed, narrow and damaged. The lining of your airways is made from elastic tissue and muscle. If you are suffering with COPD, they become floppy which means there is less of a “pull” on the airway to keep them open.
 

Narrow airways mean it is more difficult breathing in and out of your lungs. It directly impacts the amount of oxygen you can take in and the amount of carbon dioxide you can expel.
 

Common substances that cause COPD

Breathing in harmful substances are the cause of damage, including:

• Cigar, cigarette and pipe smoke – the most common cause of COPD
• Also, passive smoking (second hand smoke)
• Chemicals
• Dust
• Fumes
• Air pollution

However, some of us are higher risk, including:
 

• If you have a family history of chest infections or COPD.
• If you have a rare genetic condition such as alpha-1-antitrypsin deficiency as this would make your lungs more prone to damage.

The longer you have been exposed to harmful substances, through lifestyle or work choices, the more likely it is that damage has been caused. About 90% of COPD patients are smokers, or former smokers.
 

How is COPD Diagnosed?

Diagnosing COPD is required to manage your symptoms with effective treatment.

A consultation with a specialist respiratory physician who will carry out various tests, discuss your family medical history and also to help confirm the diagnosis.
 

What do tests for COPD assess?

• The overall functioning of your lungs
• Your oxygen levels
• The frequency of your infections, symptoms or flare-ups
• Shortness of your breath when doing regular activities
   

Tests that are used to diagnose COPD include:

Spirometry test

This involves blowing into a machine to measure lung capacity.

It also measures how quickly your lungs can be emptied – known as the forced expiratory volume in one second, FEV1.

• Blood tests
• Chest X-rays are done to rule out other conditions.
• BMI tests – to assess whether you're a healthy weight for your height.
   

How is COPD treated?

If you're a smoker, quitting smoking will help. Additional treatments include:

• Inhalers
• Medications
• Oxygen treatment – this may be used if you have low oxygen levels
• Non-invasive ventilation – this may be used to assist your breathing
• Pulmonary rehabilitation – education and exercise
• Lung volume reduction surgery – this may be used to enable the healthier part to function better.
• Surgery – although only for a very small proportion of sufferers with this lung disease.
   

​If you require treatment for COPD or are having any symptoms mentioned in the article, it is advisable to book an appointment with a leading pulmonology and respiratory specialist such as Dr Anjani Prasad. Visit his Top Doctors profile today for more information.