Chronic obstructive pulmonary disease (COPD) is a group of lung diseases. This includes chronic bronchitis, emphysema and chronic obstructive pulmonary disease.
Patients with COPD have difficulty breathing.
COPD is usually not noticed until after the age of 35. Most people diagnosed with this disease are over the age of 50.
When to seek medical advice
Talk to your GP if:
- You get tired of breathing heavily during exercise or walking
- You have a cough with phlegm (phlegm) that never seems to go away
- You get chest infections often, especially in winter
- You have a wheezing sound while breathing
- You are a smoker, or have been a smoker and you have a persistent chest cough, especially in the morning.
- you have COPD and are having a seizure (especially more severe symptoms than usual)
Chest pain and spitting up blood (hemoptysis) are not common symptoms of COPD.
Diagnosis of COPD :
It is important that COPD is diagnosed as soon as possible.
Your GP:
- May ask about your symptoms
- May ask if you smoke, or what you used to smoke
- Listens to your chest using a stethoscope
- Takes your weight to measure your body mass index (BMI).
- Checks how well your lungs are working with a breathing test called spirometry.
- Wants to rule out other conditions with tests like x-rays or blood tests.
You may need further tests to confirm that you have COPD or to check how severe it is. These tests may include:
- An electrocardiogram (ECG) or echocardiogram to check the condition of your heart
- Peak flow tests to check how fast you can exhale, and to rule out asthma
- A blood oxygen level test using a pulse oximeter (looks like a peg attached to your finger) to see if extra oxygen will help.
- A blood test to check if you have a genetic predisposition to COPD (alpha-1-antitrypsin deficiency)
- Computerized tomography (CT) scan to look for any changes in the lungs
- More detailed tests than spirometry (you may be referred to hospital for these).
- Sputum sample to test for infection
Chronic Acute Anti-Lung Disease Treatment :
There is currently no cure for COPD, but the sooner treatment is started, the lower the risk of complications and attacks. Lung damage that has already occurred cannot be reversed. But you can slow down COPD and feel better with treatment, especially by quitting smoking.
NHS Scotland recommends that you get the coronavirus (COVID-19) vaccine, the flu vaccine and the pneumococcal vaccine whenever they are offered.
Treatment for COPD usually involves relieving symptoms with medication. For example, using an inhaler to make breathing easier. Pulmonary rehabilitation can also help increase your ability to exercise.
Surgery is an option for only a few COPD patients and a lung transplant is an option for those under 60 years of age.
1. Quit Smoking :
The easiest way for COPD patients to improve their health is to quit smoking.
Quitting smoking in the early stages of the disease makes a big difference. Any damage already done to the respiratory tract is irreversible. But quitting smoking can slow the progression of the disease.
2. Inhalers
If an inhaler has been prescribed for you, your healthcare professional can show you how to use it.
3. Short acting bronchodilator inhalers :
Short-acting bronchodilator inhalers deliver a small dose of medicine directly into your lungs. It relaxes the muscles in your airways and opens them up.
There are 2 types of short-acting bronchodilator inhalers:
1. Beta-2 agonist inhalers, such as salbutamol and terbutaline
2. Antimuscarinic inhalers, such as ipratropium
When you experience shortness of breath, an inhaler should be used to relieve symptoms.
4. Long-acting Broncho Dilator Inhalers :
If a short-acting bronchodilator inhaler does not help your symptoms, your GP may prescribe a long-acting bronchodilator inhaler. It works in the same way as a short-acting bronchodilator inhaler, but each dose lasts for at least 12 hours.
There are 2 types of long-acting bronchodilator inhalers:
· beta-2 agonist inhalers, such as salmeterol, formoterol, vilanterol and indacaterol
· antimuscarinic inhalers, such as tiotropium, glycopyrronium and aclidinium
You’ll usually be given a combination of these.
5. Steroid inhalers
Steroid inhalers, also called corticosteroid inhalers, can help to reduce the frequency of exacerbations or flare ups in some people with COPD.
6. Used inhalers
There is no recycling scheme available for used inhalers. You should return all your used or expired inhalers to your community pharmacy for safe disposal. Spacers should be replaced each year if used regularly. Old spacers go into the household bin.
7. Medicines
You may be prescribed medicines such as:
-
- mucolytic tablets or capsules to make your phlegm easier to cough up – these are good for people with lots of thick phlegm or who have frequent or bad flare-ups
- antibiotics if you have a chest infection
- steroid tablets if you have a bad flare-up
8. Other types of treatment
Other types of treatment include:
-
- nebulised medication (for severe cases where inhalers have not worked) – a large dose of medicine is taken through a mouthpiece or a face mask
- oxygen therapy (if your oxygen levels are low) – taking oxygen through tubes in your nose or through a mask
- non-invasive ventilation (NIV) – helps you breathe using a portable machine connected to a mask covering the nose or face
- pulmonary rehabilitation programmes – exercise and education to help people with chronic lung problems, you can ask your healthcare professional if this is available
What causes COPD?
Causes of COPD include:
-
- genetics (COPD-G)
- abnormal lung development, early life events, premature birth, low birth weight, neonatal ventilation (COPD-D)
- smoking including in utero (from before birth), passive smoking, vaping, cannabis (COPD-C)
- pollution from outdoor air, wildfire smoke, occupational hazards, household pollution (COPD-P)
- infections (COPD-I)
- unknown cause (COPD-U)
The main cause of COPD is smoking. The more you smoke, and the longer you’ve been smoking, the more likely you are to develop COPD. This is because smoking irritates and inflames the lungs, and prevents them functioning normally, which results in scarring. Passive (second-hand) smoke can also cause COPD.
Over many years, the inflammation leads to permanent changes in the lung. The walls of the airways thicken and more phlegm is produced. Damage to the delicate walls of the air sacs in the lungs causes emphysema and the lungs lose their normal elasticity. The smaller airways also become scarred and narrowed. These changes cause the symptoms of breathlessness, cough and phlegm associated with COPD.