COPD

What is COPD?

COPD is the general term used for a range of chronic and debilitating respiratory illnesses that affect the lungs and airways, making it harder to breathe.

Common examples of COPD are chronic bronchitis and emphysema, which are characterised by difficulty in breathing, lung or airflow restrictions and coughing. But there can be a range of other symptoms that vary in severity and differ from person to person.

COPD is a progressive condition which tends to get worse over time. Treatment can help to slow down COPD worsening, and limit symptoms like inflammation and tightening of the airways.

Who gets COPD?

Whilst it can be caused or made worse by a range of factors, smoking is the leading cause of COPD.

But there’s also increasing evidence to suggest that air pollution is also a major cause, especially in developing countries – where an estimated 25-45% of people with COPD have no history of smoking.^[1] Genetics can also contribute, and those with the genetic condition Alpha-1 antitrypsin deficiency are at greater risk of developing COPD – a condition thought to be more common than diagnosis figures suggest. ^[2] Asthma, upper airways cough syndrome, and gastro-oesophageal reflux disease (GORD) are other possible causes.

How common is COPD?

COPD is quite common worldwide. Historically, it’s been more widespread in men than women – according to one analysis of figures that covered 2004 to 2015, the overall prevalence in men aged 30 years or more was estimated to be around 15.7%, compared to 9.9% in women. ^[3] It’s been theorised that this was because men were more likely to be smokers.

But recent figures suggest that globally, the condition is more common in women than in men (56% vs 44%). It’s not known exactly why, but one study found that a higher prevalence in women in self-reported data sets (maybe suggesting that women are more likely to go and seek advice and diagnosis for symptoms than men.) ^[4]

What causes COPD?

COPD is mainly caused by exposure to harmful particles and gases, which leads to difficulty breathing. It’s a chronic inflammation of the airways, lung tissue, alveoli and blood vessels, which narrows the airways. This can cause the overproduction of thick mucus, the loss of alveoli (tiny air sacs in the lungs that help exchange oxygen and CO2) and high blood pressure. It can also lead to other chronic lung problems if it’s not treated.

What are the symptoms of COPD?

Symptoms of COPD can vary from person to person. But the main symptoms many people get include:

• persistent cough
• shortness of breath
• production of sputum (thick mucus)
• wheezing

Other common symptoms may include:

• weight-loss
• feeling very tired
• barrel chest (where your chest looks like you’re breathing in all the time)
• distant breath sounds
• poor air movement
• coarse crackles

Less common symptoms can also include:

• headache
• muscle loss
• pursed-lip breathing
• tachypnoea (abnormally rapid breathing)
• low extremity swelling, such as in your ankles
• cyanosis (bluish skin or lips)
• loud P2 (loud heart sounds)
• hepatojugular reflux (distension of the neck veins)
• hepatosplenomegaly (swollen liver and spleen)
• clubbing (abnormal changes in the areas under and around the fingernails and toenails)

Can COPD lead to other problems?

Without effective treatment and lifestyle changes, COPD becomes a degenerative condition: when it flares up, it’s sometimes called exacerbation of chronic obstructive pulmonary disease (ECOPD). It’s also been linked to other related diseases such as lung cancer, recurrent pneumonia, respiratory failure, and anemia.

People suffering with COPD are also more likely to catch common colds, influenza, and pneumonia. It’s currently estimated to be the third-leading cause of death in the world, ^[1] and responsible for 6% of all world deaths. ^[2]

Quitting smoking and reducing exposure to lung irritants instantly decreases the risk of infections and other conditions. It’s also recommended that everyone who has COPD has a pneumonia vaccination, as well as an annual flu shot, to reduce their risk of infection.