What is COPD?

Chronic obstructive pulmonary disease (COPD) refers to a group of long-term lung conditions that make it difficult to breathe and get worse over time. It includes:

• emphysema
• chronic bronchitis
• chronic asthma

In emphysema, there is damage to the air sacs in your lungs. Air becomes trapped inside, making it hard to breathe in.

In chronic bronchitis, the lining of your airways is irritated and produces a lot of mucus.

In chronic asthma, the walls of your small airways become tight, making it hard for air to get in and out.

COPD affects about 1 in 20 Australians aged 45 and over — including 1 in 10 Aboriginal and/or Torres Strait Islander people. It is one of the leading causes of death in Australia.

Is asthma the same as COPD?

Asthma and COPD both involve blockage of your airways, but they are different.

For most people with asthma, medicines can widen your airways and help your breathing get back to normal. However, if you have chronic asthma (a type of asthma where medicines don’t work as well to help your breathing go back to normal), this is considered part of COPD.

There is also a condition called ‘asthma-COPD overlap’. This is where someone has symptoms of both asthma and COPD. It usually causes worse symptoms than either condition on its own and needs different treatment.

What are the symptoms of COPD?

If you are in the earliest stages of COPD, you may not have any symptoms.

When symptoms appear, they may include:

• feeling breathless
• a persistent cough
• producing a lot of phlegm (mucus)
• tiredness
• chest infections that occur more often and take longer to get better

Symptoms come on gradually. At first, you might think you are just unfit or getting older. As time goes on, symptoms get worse and interfere more with your daily activities.

What causes COPD?

The most common cause of COPD is smoking. One in every 4 or 5 people who smoke will develop COPD. You are still at risk if you have smoked in the past.

Other causes include:

• passive smoking — especially if your parents smoked when you were young
• exposure to pollution, fumes and dust
• lung problems in childhood
• asthma
• a rare genetic condition called alpha-1 antitrypsin deficiency

When should I see my doctor?

See your doctor if you notice you are getting short of breath with less effort.

It’s a good idea to see your doctor to check your lungs if you are over 35 years old and you have ever smoked or been exposed to fumes and dust at work.

Ask your doctor or pharmacist for help if you want to quit smoking.

If you have COPD, see your doctor immediately if you have symptoms of an exacerbation, such as:

• shortness of breath or cough that is worse than usual
• more phlegm than usual
• getting tired more easily
• fever
• swelling of your legs

Call triple zero (000) and ask for an ambulance if you:

• are so short of breath that you have difficulty talking, walking or sleeping
• feel confused or sleepy
• have blue lips or nails
• feel an unusual heartbeat

How is COPD diagnosed?

Your doctor will ask you about your symptoms, ask if you have ever smoked and what environment you work in.

They will ask you to do a breathing test called spirometry. This involves blowing hard into a tube, taking an inhaler medicine and blowing into the tube again. This measures how much air and how fast you can breathe. It shows if you have COPD.

Your doctor might ask you to have an x-ray of your chest, blood tests or other tests of your lungs.

How is COPD treated?

There is no cure for COPD, but there are treatments that can help you feel better and slow down the worsening of your symptoms. It is very important that you take the treatments exactly as your doctor prescribes, to slow down the progression of your COPD.

Lifestyle changes

The most important thing is to quit smoking, if you smoke. Talk to your doctor about treatments that can help you quit. If your partner smokes, ask them if they would consider quitting, or smoking outside.

You can keep healthy by:

• getting regular exercise
• eating a healthy diet
• getting enough sleep
• maintaining a healthy weight
• having an annual influenza vaccination
• having a pneumococcal vaccination — ask your doctor how many doses are recommended for you

Medicines

You will probably be prescribed medicines via an inhaler to help you breathe. These medicines open up your airways, or reduce inflammation inside them.

You might have an inhaler to use every day, and another inhaler to use when you feel short of breath. As your symptoms get worse, you might need an inhaler that contains a combination of medicines.

You may need antibiotics if you have a chest infection.

Pulmonary rehabilitation

It’s helpful to participate in a pulmonary rehabilitation program. This is an exercise and education program that can help you breathe and cope with everyday tasks more easily.

It includes:

• exercises to increase your physical abilities
• techniques to clear your airways, breathe effectively and save your energy
• information about using your medicine correctly
• emotional support

Managing exacerbations

It’s important to see your doctor if your symptoms flare up. They may prescribe:

• inhaled medicines
• steroid tablets
• antibiotics

You may need to go to hospital for treatment.

Severe COPD

If your COPD is severe, you may need to breathe oxygen from a portable tank at home. Rarely, you may be offered surgery.

Can COPD be prevented?

You can prevent COPD by:

• avoiding smoking
• being physically active
• using personal protective equipment at work

What are the complications of COPD?

COPD can lead to a range of complications, including:

• pulmonary hypertension
• heart failure and ischaemic heart disease
• osteoporosis and fractures
• anxiety and depression
• lung cancer
• gastro-oesophageal reflux
• type 2 diabetes