Copping on to COPD

It’s a relatively common condition, yet lots of people aren’t even aware they’ve got it. Lisa Salmon finds out more about chronic obstructive pulmonary disease (COPD)

Anyone concerned that they might be exhibiting symptoms of COPd should see a doctor
Anyone concerned that they might be exhibiting symptoms of COPd should see a doctor

IMAGINE your nose being blocked, and only being able to breathe through a straw. That's what the breathlessness caused by chronic obstructive pulmonary disease can feel like.

COPD, as it's also known, is an umbrella term used to describe a number of lung conditions, including emphysema and chronic bronchitis (emphysema affects lungs' air sacs, and chronic bronchitis affects the airways).

People with COPD will have one or more of such conditions, resulting in inflamed and narrowed airways and damaged air sacs.

It claims nearly 30,000 lives a year in the UK alone, and while it's believed that more than three million people are currently living with COPD, only around one million have actually been diagnosed.

This is possibly because many don't seek help, dismissing symptoms as a 'smoker's cough', for instance – indicating that, despite the prevalence of the condition, there remains a lack of awareness.


COPD usually starts to affect people once they're over the age of 35, although most aren't diagnosed until they're in their 50s or 60s, as breathing becomes increasingly difficult.

Symptoms include wheezing, breathlessness, a tight chest, persistent cough, and producing more phlegm than usual.

"Breathlessness is a key symptom of COPD, and it can feel quite scary," says the British Lung Foundation's chief operating officer Steven Wibberley.

"People get quite anxious about it and may even have panic attacks. Unless you've tried breathing just through a drinking straw, it's hard to appreciate just how scary it can feel to be that breathless."

A recent Manchester Metropolitan University study also found almost a quarter of COPD patients were permanently depressed, while 14 per cent developed depression during the three-year follow-up period.

Those with depression were also more likely to have worse COPD symptoms.


The main cause of COPD is smoking, and the longer and more you smoke, the more likely you are to develop the condition, as smoking irritates and inflames lungs, leaving scarring.

Over many years, this inflammation leads to permanent changes - the walls of the airways thicken, more mucus is produced, and the delicate air sacs become damaged.

Severe long-term asthma can also be associated with COPD, along with long-term exposure to air pollution, fumes and dust. It's also possible to inherit a condition that causes it, though this is very rare.


As Wibberley explains, COPD flare-ups or when symptoms exacerbate can also leave people vulnerable to infections such as pneumonia.

"It's very difficult to talk about prognosis – people might live 20 years with COPD, and die from something else," he says.

"But fundamentally, it's a progressive disease and will get worse over time."

That said, treatments are available to help manage the condition and improve quality of life, including inhalers, steroids and medications to reduce phlegm thickness.

"Stopping smoking is the single most important thing you can do if you have COPD, and we talk about it as a treatment," stresses Wibberley.

Oxygen therapy may be used to increase the amount of oxygen entering the lungs, or a non-invasive ventilation (NIV) breathing machine may be provided.

A minority of patients, whose airways are very narrow, may have surgery to remove badly damaged areas of the lung, allowing less-damaged areas to work more effectively.


Self-management also plays a vital role. This includes eating a balanced diet and maintaining a healthy weight, as good nutrition is essential to prevent infections and keep lungs healthy, and being very overweight can make breathing more difficult.

Conversely, some people with COPD might find they lose weight because eating makes them feel breathless. If this happens, experts advise eating little and often and trying softer foods, as well as nutritional drinks to ensure your body's getting what it needs.

Structured exercise, such as NHS pulmonary rehabilitation (PR) courses, has marked benefits for COPD patients, and helps reduce the likelihood of flare-ups.

"Although it sounds counter-intuitive to exercise when you're already breathless, there's plenty of evidence to show that structured exercise improves quality of life for COPD patients," says Wibberley.

"Although the lungs are damaged, it gets them fitter, and helps improve confidence."


Wibberley acknowledges that keeping positive can be very difficult – but emphasises that it can make a world of difference.

"It's not surprising that people with COPD get depressed when they struggle to carry on doing their everyday activities, and know they're only going to get worse – but if people stop smoking, do the pulmonary rehab and take the appropriate medication, they can improve their functioning ability," he says.

"Some people do get fatalistic about having COPD, but we want to challenge that and explain that there are things that people can do to help improve their quality of life."

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