Finding Hope with COPD

Breath is the finest gift of nature. Be grateful for this wonderful gift.

Amit Ray

On World COPD Day (20th November), there are 1.2 million people in the UK living with it.

What is COPD?

The British Lung Foundation has a great way of describing Chronic Pulmonary Obstructuve Disease (COPD):

  • Chronic = it’s a long-term condition and does not go away
  • Obstructive = your airways are narrowed, so it’s harder to breathe out quickly and air gets trapped in your chest
  • Pulmonary = it affects your lungs
  • Disease = it’s a medical condition.

COPD describes a group of lung conditions that make it difficult to empty air out of the lungs because the airways have become narrowed. Two of these lung conditions are long-term (or chronic) bronchitis and emphysema, which can often occur together:

  • Bronchitis means the airways are inflamed and narrowed. People with bronchitis often produce sputum, or phlegm.
  • Emphysema affects the tiny air sacs at the end of the airways in your lungs, where oxygen is taken up into your bloodstream. They break down and the lungs become baggy and full of bigger holes, which trap air.

These conditions narrow the airways. It is then harder to move air in and out as you breathe and your lungs are less able to take in oxygen and get rid of carbon dioxide. The airways are lined by muscle and elastic tissue. In a healthy lung, the springy tissue between the airways acts as packing and pulls on the airways to keep them open. With COPD, the airways are narrowed because:

  • The lung tissue is damaged so there is less pull on the airways
  • Mucus blocks part of the airway
  • The airway lining becomes inflamed and swollen.

What causes COPD?

COPD is usually associated with long-term exposure to harmful substances such as cigarette smoke. Things that can increase your risk of developing COPD include:

Smoking: Smoking is the main cause of COPD and is thought to be responsible for around 90% of cases. The harmful chemicals in smoke can damage the lining of the lungs and airways. Stopping smoking can help prevent COPD from getting worse. Some research also suggests that being exposed to other people's cigarette smoke (passive smoking) may increase your risk of COPD.

Fumes and dust at work: Exposure to certain types of dust and chemicals at work may damage the lungs and increase your risk of COPD. Substances that have been linked to COPD include:

  • Cadmium dust and fumes
  • Grain and flour dust
  • Silica dust
  • Welding fumes
  • Isocyanates
  • Coal dust.

The risk of COPD is even higher if you breathe in dust or fumes in the workplace and you smoke.

Air pollution: Exposure to air pollution over a long period can affect how well the lungs work and some research suggests it could increase your risk of COPD.

Genetics: You're more likely to develop COPD if you smoke and have a close relative with the condition, which suggests some people's genes might make them more vulnerable to the condition.
Around 1% of people with COPD have a genetic tendency to develop the condition, called alpha-1-antitrypsin deficiency. Alpha-1-antitrypsin is a substance that protects your lungs. Without it, the lungs are more vulnerable to damage. People who have an alpha-1-antitrypsin deficiency usually develop COPD at a younger age – particularly if they smoke.

Speak to your GP or occupational health provider if you have any concerns.

What re the symptoms of COPD?

The main symptoms of COPD are:

  • Increasing breathlessness, particularly when you're active
  • A persistent chesty cough with phlegm – some people may dismiss this as just a "smoker's cough"
  • Frequent chest infections
  • Persistent wheezing.

Without treatment, the symptoms usually get progressively worse. There may also be periods when they get suddenly worse, known as a flare-up or exacerbation.

See a GP if you have persistent symptoms of COPD, particularly if you're over 35 and smoke or used to smoke. Do not ignore the symptoms. If they're caused by COPD, it's best to start treatment as soon as possible, before your lungs become significantly damaged. Your GP will ask about your symptoms and whether you smoke or have smoked in the past. They can organise a breathing test to help diagnose COPD and rule out other lung conditions, such as asthma.

What are the treatments for COPD?

The core care for COPD is:

  • Having treatment and support to stop smoking
    Having a flu jab every year and a one-off pneumonia vaccination
  • An exercise programme called pulmonary rehabilitation if your breathlessness stops you doing things
  • Gaving your own self-management plan
  • Identifying and managing your other health problems, because most people with COPD also have other long-term conditions
  • Taking medicine or combinations of medications to improve breathlessness and help prevent flare-ups.

She even ran the London Marathon!

Watch Sarah's story