Chronic obstructive pulmonary disease, or COPD, is the second most common lung condition in the UK1, behind asthma. But is it as well understood or well known by the UK public? COPD Awareness Month seeks to promote awareness and understanding of the disease to help prevent it. Dr Anne Mier, a London-based respiratory specialist, introduces us to the condition.
What exactly is COPD?
Chronic obstructive pulmonary disease, or COPD, is a progressive lung disease. The term has replaced emphysema or chronic bronchitis and describes an obstructive lung disease characterised by long-term breathing problems and poor air flow.
How can I tell if I have COPD?
The main symptoms of COPD are a persistent cough with phlegm and shortness of breath, whilst other symptoms may include wheezing and persistent chest infections. The disease is progressive, which means that COPD symptoms will get gradually worse over time. Flare-ups, or exacerbations, describe episodes in which symptoms become worse for a period of time.
What causes COPD and who is a risk?
The main cause of the disease is smoke. Whilst in developing countries indoor air pollution is significant, in the UK the vast majority of cases are due to tobacco. Occupational exposure to dust or chemicals also increases risk and may account for some incidences of the disease, however, it is estimated that in 80% of cases the primary cause is cigarettes2. Outdoor air pollution from exhaust fumes is also known to have an effect, however, it is relatively insignificant when compared with the effect of smoking. In very rare cases a genetic condition can predispose people who have never smoked to the condition.
How is COPD Diagnosed?
Diagnosis is most commonly made in people over 40 with persistent symptoms of COPD. A doctor will listen to the chest using a stethoscope, may carry out a spirometry (a test which measures lung function), and may take a chest X-ray to determine if other diseases might be present. In certain scenarios, a blood test is also carried out - again, this helps to rule out other conditions.
Depending on the outcome of these tests, further tests may be done to help with the diagnosis, including a sputum sample, an oxygen saturation test, or a CT scan.
Can COPD be cured?
COPD has no cure and the damage to the lungs is irreversible. The disease will get gradually worse over time, however, the progression of the condition can be slowed with careful management.
Primarily, exposure to the underlying risk factor should be minimised, which for the vast majority of cases in the UK means stopping smoking.
Aside from that, medications and inhalers can be prescribed to ease breathing and sufferers may also undertake a pulmonary rehabilitation program. This involves a combination of exercise and education to help a patient manage the disease. For a small minority, surgery to remove affected parts of the lungs or a lung transplant may be an option.
Can COPD be prevented?
COPD is largely preventable and requires reduced exposure to the risk factors. In the majority of cases, this means stopping smoking – indeed prevention of the disease is focused on encouraging people to never start in the first place.
1 & 2 British Lung Foundation