Chronic Obstructive Pulmonary Disease (COPD) is a progressive lung disease that makes breathing difficult over time. It is one of the most common respiratory conditions in the UK, affecting hundreds of thousands of people. The condition causes increasing breathlessness due to damage to the lungs and airways. The main cause is smoking, although air pollution and genetic factors can also play a role. 

However, despite its widespread impact, awareness and understanding of the condition remains insufficient among the general population and even among those at risk. It can be challenging living with the limitations that come with the disease, however early detection and treatment can help those suffering lead a more manageable life. 

This is why we’ve put together this ultimate guide, helping you understand the symptoms, diagnosis, and treatments for COPD. We’ll also provide you with the next steps if you or a loved one is affected by the disease. 

Understanding COPD

Chronic obstructive pulmonary disease (COPD) is the name for a collection of lung diseases including chronic bronchitis, emphysema and chronic obstructive airways disease. The main hallmark of COPD is that there is permanent damage done to the airway and lungs that is not reversable. 

The two main conditions of COPD are emphysema and chronic bronchitis 

In emphysema, the walls between the air sacs in the lungs are damaged. This leads to the air sacs losing their natural elasticity. Meanwhile, with bronchitis, the lining of the airways becomes irritated and inflamed. The excess mucus builds up, narrowing the airways and making breathing difficult. Most people with COPD have a combination of both conditions as the limitations to airflow are usually due to a mixture of air sac damage and swelling in the airways. 

The leading cause of COPD is tobacco smoke and is thought to be responsible for around nine in every ten cases. However, there are other risk factors to be aware of including exposure to air pollutants (including workplace dust and chemicals), genetic factors, and a history of frequent respiratory infections during childhood. 

Symptoms & Diagnosis

The main symptoms of COPD are: 

  • a cough that lasts for a long time and doesn’t go away, often referred to as a “smoker’s cough”. 
  • an increase in the amount of mucus produced, often leading to frequent clearing of the throat. 
  • difficulty breathing, especially during physical activities, which worsens over time. 
  • a whistling or rattling sound while breathing, especially noticeable while exhaling. 
  • an increased susceptibility to respiratory infections, such as colds, flu, and pneumonia. 

These symptoms tend to start slowly and get progressively worse – making daily activities increasingly difficult. However, treatment can help slow the progression. There may also be periods when they get suddenly worse, known as a flare-up or exacerbation. 

To confirm a diagnosis of COPD, a doctor will typically carry out some specific tests, with the goal of assessing lung function and determining the severity of the condition: 

  • Spirometry: this measures how much air you can inhale and how quickly you can exhale. A reduce flow indicates the obstruction characteristic of COPD. 
  • Chest X-Ray: imaging tests that helps identify emphysema and rule out other lung problems. 
  • Arterial Blood Gas Analysis: this measures how well your lungs are bringing oxygen into your blood and removing carbon dioxide. 
  • Patient History & Physical Examination: a detailed patient history, including exposure to risk factors like smoking and occupational hazards, combined with a physical examination, supports the diagnosis. 

Based on your symptoms, medical history and test results, the doctor will determine if you have COPD. If so, they will advise you on the best course of treatment based on the stage of disease. 

Treatments

There is currently no cure for chronic obstructive pulmonary disease (COPD), but there is treatment available to relieve symptoms, reduce exacerbations, improve quality of life and slow down progression. 

Lifestyle Changes 

There are various lifestyle changes which you can make to improve your condition. 

The single most important step you can take is to stop smoking, as continuing to smoke worsen COPD progression. It is also extremely beneficial to stay active and have a healthy diet. Regular exercise can improve cardiovascular health, muscle strength, and overall endurance, making it easier to stay active without becoming breathless.  

Meanwhile, a balanced diet help maintains an ideal body weight, supports immune function, and provides the energy needed for daily activities. 

Avoiding pollutants also helps with improving your condition as reducing exposure to air pollution, dust, and chemical fumes helps prevent COPD exacerbations. 

Medications 

Medications play a crucial role in managing COPD symptoms and preventing complications. The type of medication depends on the severity of the disease, the frequency of exacerbations, and the presence of side effects: 

  • Bronchodilators: these medications help relax the muscles around the airways, making breathing easier. 
  • Inhaled Corticosteroids: these can reduce airway inflammation and help prevent exacerbations in people with severe COPD. 
  • Combination Inhalers: some patients may benefit from inhalers that combine bronchodilators with inhaler corticosteroids. 
  • Antibiotics: these may be prescribed for exacerbations to treat secondary chest infections associated with flare-ups. 
  • Mucolytics: these helps thin the mucus in the airways, making it easier to cough up 

Other Treatments 

In addition to lifestyle changes and medications, other treatments may be necessary for some individuals with COPD, especially if it is severe. 

If the oxygen level in your blood is low, you may be advised to have oxygen at home through nasal tubes, or through a mask. It is not a treatment for breathlessness, but it is helpful for some patients with persistently low oxygen levels in the blood. 

There are also pulmonary rehabilitation programmes that are focused on exercise and education designed to help people with chronic lung problems. It can increase your exercise capacity, mobility and self-confidence. 

In selected cases, such as those with very severe COPD or those who have not benefited from other treatments, surgery might be an option. This can include lung volume reduction surgery or, in rare cases, a lung transplant. 

Next Steps

If you or a loved one has COPD, it’s important to focus on following the doctor’s instructions for medications, lifestyle changes, and anything else they recommend. This includes quitting smoking, developing a COPD management plan, or joining a support group. However, it’s still important to pay close attention if symptoms suddenly worsen as that may indicate an exacerbation requiring prompt treatment. 

It’s crucial to get the annual flu vaccine and the pneumonia vaccine as recommended by your doctor, as COPD patients are at high risk for complications from these illnesses. Preventing flu and pneumonia through vaccination is very important. 

At e-Surgery, we understand the challenges of COPD. Our team provides you with the support, resources, and care you need to improve your health. Whether you have questions about medication, need advice on lifestyle changes, or simply seek reassurance, you can use our ‘Ask-a-Pharmacist’ service where you can talk to a trained healthcare professional. We are always happy to help! 

Living with COPD can be challenging, but taking proactive treatment measures helps control symptoms, avoid flare-ups and enjoy a good quality of life through the self-care journey.