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Chronic obstructive pulmonary disease (COPD) is the collective term for some lung diseases that make breathing difficult.

What is it?
COPD is the overall term used to describe a variety of illnesses, including chronic bronchitis, emphysema and chronic obstructive airways disease. People with COPD have permanently damaged lungs and find it difficult to breathe most of the time.

Who’s affected?
COPD usually affects people over the age of 40. It’s the sixth most common cause of death in England and Wales, causing more than 30,000 deaths a year.

What causes COPD?
Smoking is to blame for COPD in the majority of cases. Smoke from cigarettes causes inflammation in the lungs and destroys the elasticity that allows the lungs to expand and contract as we breathe.

It also damages the alveoli, the tiny air sacs at the end of the airways from which oxygen is absorbed into the bloodstream.

Other causes include occupational exposure to dusts, indoor pollution from wood-burning and coal-burning stoves, air pollution and certain inherited diseases. For example, a minority of people have a rare inherited form of emphysema caused by a lack of the protein known as alpha-1-antitrypsin.

What happens?
The diseases collectively known as COPD – chronic bronchitis, emphysema and chronic obstructive airways disease – are now understood to be aspects of the same problem: a narrowing of the airways, which obstructs the flow of air in and out of the lungs, making it difficult to breathe.
In chronic bronchitis, for example, excess mucus is made in the airways so people have a lot of phlegm and cough all the time. This mucus also narrows the airways.

In emphysema, the air sacs are left over-inflated when their elastic fibres are destroyed. Small holes also develop in their walls, leaving them unable to work properly.

What are the symptoms?
The damage to the lungs that results in COPD is gradual, which is why most people are over 40 by the time symptoms begin.

An early morning cough, often called a smoker’s cough, is common and produces a lot of phlegm. Wheezing, chest tightness and difficulty breathing are often noticed first. People may find themselves short of breath when doing very little or even when they’re just sitting down.

These symptoms are usually worse in winter, with recurrent lung infections adding to the problem.

COPD impairs quality of life, by preventing people with the condition from socialising and enjoying their hobbies. It also makes many feel frustrated and angry about not being able to do the things they want to.

What’s the treatment?
It’s not possible to cure COPD, but the damage can be slowed. By far the best way to do this is to stop smoking. It’s also vital to avoid other people’s smoke.

Exercising as much as you’re able to helps keep the lungs (and heart) strong and builds self-confidence. Pulmonary rehabilitation programmes help improve symptoms and increase exercise capacity. Physiotherapy helps to clear mucus from the lungs and most people with COPD are taught exercises they can do every day to help themselves.

Medicines that make the airways wider so it’s easier to breathe can be given through an inhaler or as tablets. Steam inhalation and humidifying rooms can also help breathing by loosening mucus. Medication is available that helps to thin mucus so it’s easier to cough up.

When lung infections arise, it’s important they’re treated quickly with antibiotics. Recurrent or severe chest infections often need hospital treatment. When COPD is very severe, oxygen can be used at home.

It’s vital that people with COPD are vaccinated against flu every year (usually in autumn) and against the most common cause of pneumonia, the pneumococcus bacteria, when advised.

Eating a healthy diet and drinking enough liquid is essential.

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