What is chronic obstructive pulmonary disease (COPD) ?

Chronic obstructive pulmonary disease (COPD) is the name given to a group of conditions that affect your lungs and cause problems with your breathing.

At our hospitals, we understand how deeply the symptoms of COPD impact your daily life.

However, thanks to our expert lung diagnostics and tailored treatment plans, we can help get your condition under control and work to improve your symptoms.

Types of COPD

COPD is an umbrella term for a group of conditions that cause breathing difficulties due to long-term lung damage. The most common forms of COPD include:

  • chronic bronchitis (inflammation of the airways of the lungs, called bronchi)
  • emphysema (damage to the smaller airways and air sacs of the lungs, called alveoli)

Both conditions restrict airflow in and out of your lungs because they narrow your airways.

COPD is a common condition that has two main risk factors: smoking and air pollution.

While some people might not even realise they have COPD, the breathing problems it is associated with can worsen over time. However, these can often be kept under control by using the right form of treatment.

1.4 million people in the UK are currently living with diagnosed COPD, with the same amount of people living with the condition undiagnosed. This is due to the dismissal of COPD symptoms as other conditions like ‘smoker’s cough,’ which leads many people to not seek medical help.

Emphysema and bronchitis are the two most common forms of COPD.

Symptoms of COPD

The symptoms of COPD can often be mistaken for other health conditions. However, if you experience any changes to your breathing, you should seek medical advice.

The main symptoms of COPD include:

  • increased breathlessness when exercising or exerting yourself
  • a persistent cough with phlegm
  • frequent chest infections, particularly in winter
  • wheezing

It can take years for your lungs to become damaged enough to cause problems or experience flare-ups (instances when your symptoms suddenly get worse). This is why most people diagnosed with COPD are aged 60 and over.

There are some less common symptoms of COPD too, such as:

  • tiredness
  • weight loss
  • swollen ankles caused by oedema (build-up of fluid)
  • chest pain
  • coughing up blood

These symptoms tend to develop over time when your COPD has become more advanced.

What causes COPD?

The main cause of COPD is damage to your lungs, often caused by smoking.

Tobacco smoke irritates your airways and destroys your lung’s stretchy fibres. Therefore, the more often you smoke, and the longer you continue the habit, the higher your risk of COPD development will be.

However, up to 20% of people with COPD are affected by non-smoking-related causes. COPD can also be caused by breathing in:

  • air pollution
  • fumes
  • dust

In rare cases, COPD can be caused by an inherited disorder. You may be more likely to develop COPD if you smoke and have a close relative with the condition.

Risk factors of COPD

Smoking and air pollution are the most common causes of COPD. This means that you are at a higher risk of developing it if you smoke or inhale air pollution regularly.

Being exposed to dust, fumes, or chemicals (such as in a place of work) can also increase your risk of COPD, as can having childhood asthma.

Air pollution can also be found in your home. Burning wood or coal for cooking or heating purposes, for example, can increase your risk of exposure.

Diagnosing COPD

COPD is usually diagnosed through a combination of different diagnostic tests. First, your medical history will be looked at to determine if you have any environmental or lifestyle factors that could increase your risk of COPD. Your doctor will also use a stethoscope to listen to your chest.

Next, diagnostic tests will be carried out. These tests can include:

  • a physical examination
  • a blood test (conditions such as anaemia can cause breathlessness and need to be ruled out)
  • chest X-ray
  • breathing tests such as spirometry

A spirometer is a machine that you breathe into, and it records two measurements — one is the volume of air you breathe out in one second and the other is the total amount of air you breathe in. The readings can then be compared to the normal range for your age to determine if your airways are potentially obstructed.

COPD treatment

While COPD is not curable, you can manage your symptoms and reduce their severity. Treatment for COPD can help control your symptoms, minimise complications and support you in leading an active life.

If you smoke, the first step is to stop. Your doctor can provide you with nicotine replacement products and medications to reduce your cravings to support you while quitting. Giving up smoking also reduces the rate of lung function decline.

If your COPD is in its initial stages and your symptoms are mild, you might not require treatment. However, if you smoke, you will be advised to stop. This can help slow the rate of your condition and prevent further damage to your lungs.

Treatment for symptoms of COPD will usually involve a range of medications, oxygen therapy and pulmonary rehabilitation (exercise and education programme designed for people with lung disease who experience symptoms of breathlessness). If you have a severe form of emphysema, you may need lung volume reduction surgery or even a lung transplant.

RejuvenAir® metered cryospray procedure

At Royal Brompton and Harefield hospitals, we offer RejuvenAir® — a 30-minute treatment for COPD with chronic bronchitis. This minimally invasive procedure delivers liquid nitrogen spray directly to the affected airways through a flexible camera passed into the mouth.

This freezes and destroys the diseased cells lining the airways to reduce inflammation and promote healthy cell regrowth. RejuvenAir® therefore works to treat the cause of COPD with chronic bronchitis allowing for an improved quality of life.

RejuvenAir probe

dNerva targeted lung denervation procedure

We also offer dNerva targeted lung denervation to treat symptoms of COPD. This 90-minute treatment is carried out under general anaesthetic and uses an electrode to disrupt the communication between your vagus nerve in the lungs and your brain. By changing this communication network, your COPD symptoms can be reduced, and you could see an improvement in your lung function.

Our expert team are highly experienced in the diagnosis and treatment of COPD. We can provide you with long-term relief from symptoms of COPD thanks to our accurate diagnostic tools and innovative treatments.

Diagrams of bronchioli before and after Nuvaira treatment

An illustration showing how dNerva targeted lung denervation can improve a patient's condition.

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