Short of breath? You could be suffering from Chronic Obstructive Pulmonary Disease (COPD)

    20 January 2020

    What is Chronic Obstructive Pulmonary Disease?

    COPD is a long-term problem affecting the lungs. There are two main aspects to the disease. The first is that the airways have become narrowed (persistent bronchitis) by inflammation and often this causes mucus which clogs up the lungs and airways and makes breathing difficult.

    The second is that the air sacs, called alveoli, that are at the end of the lungs and where oxygen is absorbed into the blood, become damaged. They are very fragile and delicate and their walls breakdown and this means they are no longer as effective at absorbing oxygen. This is called emphysema. The combination of these two processes means that it is harder to get air into and out of the lungs. This means people with this struggle to get enough oxygen into their bodies and to get rid of the carbon dioxide when they breathe out. In asthma the airways narrow but this can be reversed – in COPD the narrowing is permanent. People with COPD will get short of breath when doing relatively easy things like going for a walk. They will also often have a persistent cough and a wheeze when it’s cold. These symptoms often get even worse when someone breathes in fumes or smoke.

    What causes COPD?

    It is usually the result of long-term damage to the lungs. The most common cause is smoking or second hand smoke, although pollution can also be a cause. Sometimes people’s jobs can also cause it – for example if they inhale lots of dust or chemicals. There is also a genetic condition alpha-1-antitryptan deficiency that makes people very susceptible to developing it.

    How is it treated?

    The damage to the lungs that causes COPD cannot be reversed. However, there are treatments that can help with the symptoms. There are several inhalers that can help improve the airflow to the lungs. These are the same for people with asthma – short acting broncho-dilators and long acting bronchodilators. If people are having difficulties, then they may be given a steroid inhaler. People might also be put on a tablet to ‘dry up’ some of the mucus, which makes breathing easier. If people have low levels of oxygen in their bodies, then this can sometimes be given at home. People wear a little tube that runs under their nostrils and delivers a steady trickle of oxygen that they can then breath in. In very severe cases, people can have surgery on their lungs to remove the very damaged parts as this allows the less damaged parts to work better. Sometimes people are also able to have a lung transplant. This is only suitable for a very small number of people though.

    COPD can be made even worse if there is a chest infection. This is called ‘acute exacerbation of COPD’ and means that people often become incredibly breathless and struggle to get enough oxygen. People with this often need to be admitted into hospital where the infection can be treated and oxygen can be given.

    What can the patient do?

    Avoiding smoking is the biggest thing. Even in those who already have it, stopping smoking and help it stabilise and stop it getting worse. Regular exercise is also important as this can help improve lung function as well as strengthening the heart. It’s important to speak to your doctor though before taking up regular exercise and ensure you don’t over do it. It’s also vital to go for regular check ups to ensure you are as fit and healthy as can be and have your flu vaccine each Autumn.