COPD

Chronic obstructive pulmonary disease (COPD) is a long-term condition that causes inflammation in the lungs, damaged lung tissue and a narrowing of the airways, making breathing difficult.

There are many different types of the condition, although little is known about what causes this variation and the best way to manage the different versions of the disease

Symptoms

The symptoms of COPD are breathlessness and chronic cough, with or without phlegm. Fatigue, anorexia and weight loss can also occur over time.  A key characteristic of the condition is periods of worsening symptoms, known as exacerbations. This can be triggered by infections or exposure to high amounts of air pollution. Symptoms of COPD get worse over time and exacerbations can speed up this decline.

People with COPD often suffer from other conditions, known as co-morbidities. These conditions may share similar risk factors, such as smoking, and they often contribute to the severity of the condition.

The most common conditions that occur alongside COPD include heart disease, anxiety and depression, osteoporosis, gastro-esophageal reflux, skeletal muscle dysfunction, anemia, lung cancer, diabetes and metabolic syndrome.

Causes

COPD is caused by factors that trigger inflammation in the lungs. These include:

This is the main risk factor for COPD. About 40-50% of lifelong smokers will develop COPD, compared with 10% of people who have never smoked.  Not all smokers will develop the condition, which suggests that genetics also play a part in making some people more susceptible than others.

Around 15-20% of COPD cases are associated with exposures to occupational dust, chemicals, vapours or other airborne pollutants in the workplace that can trigger COPD.

People with COPD are at a high risk of their symptoms worsening with high levels of outdoor air pollution. Indoor air pollution from using biomass fuels for cooking and heating is also a risk factor for the development of COPD.

Research has shown that the risk of developing COPD is associated with lower educational and income levels. Experts believe this is due to factors such as nutrition, overcrowding and air pollution.

Lung infections in early life and mothers who smoke are important risk factors for COPD.

The make-up of a person’s genes can mean they are more susceptible to developing COPD. The most researched genetic problem linked with COPD is a condition called alpha-1 antitrypsin deficiency; an inherited condition where a person lacks a protein known as alpha-1 antitrypsin.

Prevention

Identifying the risk factors, and preventing exposure to these factors, is the most important step in preventing the disease. This includes:

• Encouraging people to quit smoking
• Preventing exposure to passive smoke for unborn babies and infants
• Reducing exposure to indoor air pollution from biomass fuels in developing countries
• Preventing COPD exacerbations

Treatment

COPD is diagnosed via a spirometry test. This test involves breathing into a device called a spirometer, which measures the amount of air in the lungs and how fast a person can breathe out. If the test shows that the amount of air a person breathes out is low, it may indicate a narrowing of the airways and the early stages of COPD.

There is no known cure for COPD, but it can be effectively managed to ease the impact of the symptoms on quality of life. Management of the condition includes;

• Reducing exposure to risk factors, including smoking and air pollution
• Improving exercise ability to help relieve symptoms
• Medical treatment with bronchodilators to help prevent exacerbations
• Oxygen therapy to help ease breathlessness

People with COPD can be referred onto exercise programmes known as pulmonary rehabilitation. These focus on improving a person’s ability to exercise and providing education to help a person manage their own condition.