Chronic obstructive pulmonary disease: COPD
What is COPD?
Chronic obstructive pulmonary disease (COPD) is a long-term (chronic) condition that obstructs (blocks) the airways in the lungs.
Often the term COPD is used to describe chronic bronchitis and emphysema, 2 progressive lung diseases which can occur by themselves or together. The most common form of COPD is a combination of the 2 conditions.
COPD causes increasing shortness of breath, leading to impairment in the activities of daily living and a gradual loss of quality of life.
Chronic bronchitis is, as its name suggests, a chronic inflammation of the airways (bronchi) in your lungs. It is defined as a cough that is productive of sputum occurring on a daily basis for at least 3 months of 2 or more consecutive years.
Bronchitis results in the lungs producing too much of the mucus they make to keep the bronchi moist. This causes coughing and narrowing of the airways, making it more difficult for air to flow freely. As a result, you become breathless. Although many people contract acute (short-term) bronchitis at some time in their lives, chronic bronchitis lasts for months or years.
Emphysema occurs when the air sacs (alveoli) deep in your lungs become enlarged and damaged. This makes oxygen transfer from the airways to the bloodstream less efficient. Eventually the alveoli collapse which means that they don’t prop open the microscopic airways called bronchioles. This makes it extremely difficult to breathe in and out.
What causes COPD?
The vast majority of cases of emphysema and chronic bronchitis are caused by long-term smoking.
In some cases COPD can also result from occupational exposure to dust or chemical fumes. In people who smoke, air pollution can aggravate the symptoms of COPD but air pollution doesn’t appear to cause COPD in non-smokers.
There is also a rare type of emphysema known as A1AD-related emphysema, a genetic condition in which a person’s body lacks a protein called alpha1-antitrypsin. This protein normally helps protect the lungs. Smoking hastens the speed at which emphysema develops in people with alpha1-antitrypsin deficiency.
What are the symptoms of COPD?
The symptoms of COPD vary. In mild forms of chronic bronchitis and emphysema, coughing or breathlessness on exertion may be the only symptom. Mild emphysema may not even have any signs to start with. Later on in both conditions you may notice you get short of breath when doing moderate daily activities. You may have frequent coughing and recurrent chest infections or bronchitis.
In the severe stage, daily activities become more difficult with the continual shortness of breath and often bodily changes occur, such as a blue tinge to the skin from chronic bronchitis, fluid retention in the ankles and a ‘barrel-shaped’ chest from emphysema.
Indications that you are at risk of developing COPD include the following.
- Smoking for many years.
- 'Smoker's cough' in the morning.
- Bouts of asthma or bronchitis.
- When you get a cold it lasts for weeks, rather than days.
- Chronic cough or heavy phlegm.
- At least one prolonged episode of bronchitis every winter.
- A cough that feels shallow, like something is stuck inside your chest.
What can be done?
COPD is a progressive condition and unfortunately there is no cure for it. It also isn’t possible to reverse lung damage that’s already been done. However, your lung function can be improved and your symptoms can be relieved by some self-management options, as advised by your doctor, medications where necessary and special lung exercises.
By far the most important thing you can do for yourself if you have COPD is to stop smoking immediately. You may have tried to in the past, but if you have been diagnosed with COPD, it is even more important that you talk to your doctor about stopping. You will improve your cough, ease your breathlessness and you’ll also slow down further lung damage.
Last Reviewed: 29 July 2009
- 1. The Australian and New Zealand COPD Reference Site. COPD-X Guidelines [updated 2009, Apr; accessed 2009, Aug]. Available at: http://www.copdx.org.au/guidelines/confirm.asp
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