COPD: what is it?
COPD, or chronic obstructive pulmonary disease is a long-term lung condition that causes breathing difficulties. It usually occurs in those over 35 in response to damage from smoking. The more you smoke and the longer you smoke, the more likely you are to develop COPD.
Unfortunately this condition cannot be cured or reversed and it tends to get progressively worse over time. Symptoms and flare-ups can be managed with inhalers, medications and breathing techniques to exercise the lungs. Further damage can be reduced by stopping smoking.
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What happens to the lungs?
COPD is a combination of inflammation, mucus production and lack of elasticity in the lung tissue. People sometimes refer to COPD by the subcategories: emphysema and chronic bronchitis. Airways tubes – the bronchioles – can get inflamed and swollen, causing the tubes to narrow, and this usually gives the wheezy symptoms of bronchitis. Along with this, you may produce more mucus, blocking the airways and causing a thick chesty cough.
The airways tubes lead to tiny air sacs, like balloons – in emphysema these air sacs get less elastic, so they are harder to inflate (think of how tough it is to start blowing up a balloon), and join together which allows less exchange of oxygen to the blood stream and tissues. This makes you feel out of breath.
Some may have more of one sub-category than the other, but most have a combination of both and treatment is much the same, according to symptoms and flare-ups.
When should I suspect COPD?
Many people don’t realise they have COPD, and as symptoms come on gradually, and they often dismiss them as a smoker’s cough or lack of fitness. If you are a smoker or ex-smoker and have a persistent cough where you bring up thick sputum, if you feel wheezy or short of breath with minimal exercise, and if you suffer frequent chest infections, these are all reasons to book a routine appointment with your doctor.
If you are a smoker with a cough that persists beyond three weeks, you are coughing up blood, and you may also have weight loss, you should book an urgent appointment with your doctor as this could need urgent investigations.
How is it diagnosed?
Your doctor will assess your symptoms, take your vital signs and listen to your chest and heart. They will likely order further tests, which may include lung function tests, a peak flow diary, trial of an inhaler and symptom diary, or they may order a chest X-ray.
Lung function tests are usually conducted by your doctor or practice nurse at your surgery. You blow into a tube and a machine records how well your lungs are working. COPD gives a distinctive pattern, compared to other lung conditions like asthma.
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