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Chronic Obstructive Pulmonary Disease (COPD) is a common respiratory disease which usually affects middle aged smokers or ex-smokers. People who have symptoms of COPD may find it harder to breathe because of inflammation in the airways and damage to air sacs in the lungs. Although COPD can impact your daily life it’s possible to manage your symptoms and live an active life.

What is COPD?

COPD is a name that’s given to a group of lung diseases including chronic bronchitis, emphysema and chronic obstructive airways disease. COPD can make it difficult for people to breathe easily, mainly because their airways have narrowed.

What can cause COPD?

The most common cause of COPD is smoking, which irritates and eventually scars the lungs. The people who are most likely to be diagnosed with COPD are over the age of 35,and are either heavy smokers or have been heavy smokers in the past. If you have smoked for a long time, you’re more likely to develop COPD, and your risk increases the longer you carry on smoking.

It’s also possible to develop COPD if you have severe, long-term asthma, or if you’ve been exposed to air pollution and fumes over a long period of time, perhaps in the workplace. There’s also a type of COPD that can be inherited, although this is extremely rare.

What are the symptoms of COPD?

In most cases, COPD develops when the irritation caused by smoking or pollution starts to thicken the walls of your airways and leads to more mucus being produced than normal. The air sacs are also damaged, which can cause emphysema. As the smaller airways become scarred they become narrower, making breathing harder.

The symptoms often develop slowly and most people don’t notice anything until they are in their mid to late thirties. Most aren’t diagnosed until they are over 50.

Symptoms include:

  • Breathlessness which gets worse when you’re moving around or exercising

  • Wheezing and tightness in your chest

  • A persistent cough that produces phlegm

  • Frequent chest infections.

If you have a chesty cough that won’t go away, see your doctor, especially if it’s accompanied by wheezing and breathlessness when you exert yourself. The sooner you’re diagnosed, the earlier you can start treatment and prevent serious lung damage.

Your doctor will ask you if you smoke, or have done in the past, whether you have asthma or could have been exposed to any pollution that could have caused lung damage. Then, you’ll be given a breathing test called a spirometry test. This measures the air flow in and out of your lungs, as well as the size of your lungs.

What are the stages of COPD?

  • The early symptoms of COPD include a cough that won’t go away, coughing up mucus and a tight, wheezy chest. The cough may be worse in the morning. You might also  feel a bit breathless when exerting yourself. 

  • As the disease progresses, the breathlessness gets worse, and instead of finding stairs a bit harder to manage, you could find yourself having to stop for breath every few minutes while you’re walking normally. 

  • Late stage COPD can make it difficult to even undress and dress yourself without getting out of breath. In severe COPD, some people also find that they lose their appetite, lose weight or develop swollen ankles.

What COPD treatments are there?

There is no cure for COPD but it can be managed, which is why it’s so important to diagnose the condition early. The most important thing you can do if you’ve been told that you have COPD is to give up smoking, if you still smoke.

Other lifestyle changes include:

  • A healthy diet - if you’re overweight try to get down to a healthy weight. 

  • Staying active - it’s important to stay as active as you can at a level that’s appropriate for you.

  • Pulmonary rehabilitation - a type of exercise programme that improves your muscle strength and lung fitness, and offers support and education.

  • Medication - your doctor might prescribe inhalers to relax the muscles in your airways and help you to breathe. There are also steroid inhalers that can be used to reduce swelling, and drugs that can help reduce the amount of phlegm you produce.

For severe COPD, you might be offered oxygen therapy to help you with tiredness and breathlessness. You may also be able to have surgery to replace the damaged part of your lung, or non-invasive ventilation, where a machine is used to push air into your lungs.

What is the prognosis for someone with COPD?

The prognosis depends on many things, including how early the COPD was diagnosed. Once you have a diagnosis, you’ll see your doctor regularly which means that any complications should be picked up early.

GOLD System

Some experts measure COPD in ‘stages’ of severity. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) measurement system uses a test called FEV1 (forced expiratory volume) that measures the amount of air someone can forcefully blow out to indicate how severe their COPD is.

Other experts have developed a measure of life expectancy called the BODE index, which looks at:

  • body mass

  • airflow obstruction

  • Dyspnea (breathlessness)

  • exercise capacity

Whichever way your COPD is monitored, the longer you can keep your symptoms at the lowest possible level, the better your prognosis will be.

Giving up smoking and making other lifestyle changes, plus making sure that you are regularly reviewed by your doctor and take all medicines as directed will go a long way to prevent the  disease progressing.

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