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COPD information

 

Chronic Obstruction Pulmonary Disease (COPD) is a long-term lung condition characterised by breathlessness, coughing, and increased mucus. This leads to blocked airways (bronchioles) and damaged air sacs (alveoli).

Lets break COPD down…

Chronic = long term (does not go away)
Obstructive = a blockage in the airways (can include things like swelling, mucous, scarring)
Pulmonary = relating to the lungs
Disease = a particular abnormal condition that negatively affects the structure or function of all or part of any body part, organ or system and is usually associated with specific signs and symptoms.

COPD is an umbrella term which includes:
• Chronic Bronchitis
• Emphysema
• Co-existing asthma and COPD (previously known as asthma/COPD overlap

COPD is progressive and irreversible. However, with good management and support, people can live long and healthy lives.

The main causes of COPD are smoking, exposure to air pollution, or genetic factors like alpha-1-antitrypsin deficiency (emphysema)

Chronic Bronchitis – The presence of mucous, swelling and long-term productive cough for three months during two consecutive years when other lung or heart causes for these symptoms have been excluded. 

  • The airways in our lungs carry oxygen to the bases of our lungs where its swapped for carbon-dioxide (a waste product). This is known as gas exchange. The airways are swollen and filled with excess mucous make it difficult for oxygen to be inhaled and carbon-dioxide to be exhaled. This leads to coughing and shortness of breath.

Emphysema – Abnormal, permanent enlargement of the air sacs (alveoli) at the bases of the lungs, accompanied by destruction of their walls and loss of elasticity. 

  • Imagine your air sacs (located at the end of our airways) are a bunch of grapes. Instead of having several separate grapes, you instead have one large grape. The air sacs are more stiff due to the loss of elasticity and there is less room for oxygen, making gas exchange less effective and why people feel breathless.

Illustration courtesy of healthflexhhs.com

 

 

In New Zealand, around 14% of adults aged over 40 years live with COPD. It is a big reason people end up in hospital so early detection, diagnosis, treatment and support is important.

If you think you or someone you care for might have COPD, it’s important to see your doctor as soon as possible. Going through the process of getting a diagnosis will tell you whether your symptoms are being caused by COPD or something else. A diagnosis will help you to manage your condition and understand how to reduce or prevent symptoms such as cough, sputum production, chest tightness and breathlessness. It will also help you learn how to stay well and live a long and healthy life.

COPD symptoms tend to start slowly and can get worse over a few years, so many people may have COPD but don’t yet know they have it.

COPD symptoms are often progressive (get worse), persistent (continue), brought on by exercise and worrying. Some people experience all or only a couple of symptoms. The most common symptoms are:

  • Cough
  • Sputum/phlegm production
  • Shortness of breath/breathlessness
  • Recurrent chest infections

At your appointment your doctor will ask you questions about you and your family’s medical history. They will also ask for details about your symptoms (symptoms may include wheeze, cough, mucous production, shortness of breath and chest infections) such as:

  • What symptoms you are experiencing and for how long you have been experiencing them
  • When symptoms occur
  • If there is a family history of COPD (especially emphysema and/or an alpha-1 antitrypsin deficiency)
  • Smoking/vaping history (including second hand or passive smoking)
  • What you do or did do for work
  • What dangerous particles you may have been exposed to in your life and the length of the exposure
  • If you have a history of asthma (including if this has been well controlled or not)
  • Family history of alpha-1 anti-trypsin deficiency

Your doctor will listen to your lungs with a stethoscope and may order tests for you including:

  • Blood tests
  • Chest x-ray
  • CT scan
  • Spirometry

Signs and symptoms of COPD can take a long time to show and become obvious. In the early stages, people often blame their symptoms on smoking, aging or being unfit/out of shape. This can be unhelpful because it delays people seeking help and getting a diagnosis. People with COPD can have the condition for several years and not know about it.

COPD symptoms usually include:

  • A daily cough that produces mucous/phlegm
  • Excess mucous in your throat and lungs in the morning
  • Shortness of breath/breathlessness
  • Lack of energy
  • Frequent chest infections

Because COPD is irreversible and progressive, symptoms tend to worsen over time.

 

 

Smoking tobacco/cigarettes is the most common cause of COPD. Most smokers will get changes in their airways due to the harmful pollutants contained in cigarettes. About half of all smokers will have some airflow problems.

Other causes include:

  • long-term exposure to vapours, gases, dust, or fumes, indoor and outdoor air pollution
  • inhaled drugs, and second-hand smoke.
  • It’s not clear if smoking cannabis causes COPD like tobacco does, but it often leads to bronchitis symptoms.
  • There’s now long-term evidence that vaping (use of e-cigarettes) can cause COPD, even in non-smokers. Recent studies show a 1.5 times higher risk of COPD in people who vape. (The impact of electronic cigarette use on chronic obstructive pulmonary disease: A systematic review and meta-analysis – Respiratory Medicine)
  • For young patients (especially under 40), consider alpha-1 antitrypsin deficiency. This genetic defect lowers the main anti-protease in lung tissue, making the lung prone to damage from neutrophil elastase and other natural proteases released in response to smoking.

Some people get COPD without smoking or obvious exposures. COPD can also happen in people with other lung diseases like asthma. Poor lung growth in young adults raises the risk of COPD later in life. It’s not sure if COPD from poor lung growth or asthma is the same as COPD from smoking.

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