COPD/ Respiratory

Chronic Obstructive Pulmonary Disease

Chronic obstructive pulmonary disease, or COPD, describes a group of lung conditions that make it difficult to empty air out of the lungs because the airways have become narrowed.

What does COPD stand for?

Chronic = it’s a long-term condition and does not go away

Obstructive = your airways are narrowed, so it’s harder to breathe out quickly and air gets trapped in your chest

Pulmonary = it affects your lungs

Disease = it’s a medical condition

Two of these lung conditions are long-term (or chronic) bronchitis and emphysema, which can often occur together.

• Bronchitis means the airways are inflamed and narrowed. People with bronchitis often produce sputum, or phlegm.
• Emphysema affects the tiny air sacs at the end of the airways in your lungs, where oxygen is taken up into your bloodstream. They break down and the lungs become baggy and full of bigger holes which trap air.

These conditions narrow the airways. This makes it harder to move air in and out as you breathe, and your lungs are less able to take in oxygen and get rid of carbon dioxide.

The airways are lined by muscle and elastic tissue. In a healthy lung, the springy tissue between the airways acts as packing and pulls on the airways to keep them open.

With COPD, the airways are narrowed because:

• the lung tissue is damaged so there is less pull on the airways
• mucus blocks part of the airway
• the airway lining becomes inflamed and swollen

There are treatments to help you breathe more easily and help you keep active, so it’s important to get an early diagnosis.

With COPD, the airways are narrowed because:

• the lung tissue is damaged so there is less pull on the airways
• mucus blocks part of the airway
• the airway lining becomes inflamed and swollen

There are treatments help you breathe more easily and help you keep active, so it’s important to get an early diagnosis.

What causes COPD?

COPD usually develops because of long-term damage to your lungs from breathing in a harmful substance, usually cigarette smoke, as well as smoke from other sources and air pollution. Jobs where people are exposed to dust, fumes and chemicals can also contribute to developing COPD.

You’re most likely to develop COPD if you’re over 35 and are, or have been, a smoker or had chest problems as a child.

Some people are more affected than others by breathing in noxious materials. COPD does seem to run in families, so if your parents had chest problems then your own risk is higher.

A rare genetic condition called alpha-1-antitrypsin deficiency makes people very susceptible to developing COPD at a young age.

What's the difference between COPD and asthma?

With COPD, your airways have become narrowed permanently – inhaled medication can help to open them up to some extent. With asthma, the narrowing of your airways comes and goes, often when you’re exposed to a trigger – something that irritates your airways – such as dust, pollen or tobacco smoke. Inhaled medication can open your airways fully, prevent symptoms and relieve symptoms by relaxing your airways.

So, if your breathlessness and other symptoms are much better on some days than others, or if you often wake up in the night feeling wheezy, it may be that you have asthma.

Because the symptoms are similar and because people who have asthma as children can develop COPD in later life, it is sometimes difficult to distinguish the two conditions. Some people have both COPD and asthma.

What are the symptoms of COPD?

Symptoms include:

• getting short of breath easily when you do everyday things such as going for a walk or doing housework
• having a cough that lasts a long time
• wheezing in cold weather
• producing more sputum or phlegm than usual

You might get these symptoms all the time, or they might appear or get worse when you have an infection or breathe in smoke or fumes.

If you have COPD that has a severe impact on your breathing, you can lose your appetite, lose weight and find that your ankles swell.

For more information go to: https://www.blf.org.uk/support-for-you/copd/what-is-copd

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Asthma

Asthma is a long-term condition that affects the airways carrying air in and out of your lungs. It usually causes symptoms such as coughing, wheezing and breathlessness. If you come into contact with one of your asthma triggers, it can make your symptoms worse and even bring on an asthma attack.  

How do my airways react to triggers?

If you have asthma you have ‘sensitive’ airways that are inflamed and ready to react when they come into contact with something they don't like.

If you come into contact with one of your asthma triggers it causes your airways to react in three ways:

1. The muscles around the walls of the airways tighten so that the airways become narrower.
2. The lining of the airways becomes inflamed and starts to swell.
3. Sticky mucus or phlegm sometimes builds up, which can narrow the airways even more.

These reactions in the airways make it difficult to breathe and lead to asthma symptoms, such as chest tightness, wheezing, or coughing. It can also lead to an asthma attack.

Who gets asthma?

In the UK, around 5.4 million people are currently receiving treatment for asthma. That's one in every 12 adults and one in every 11 children.

Asthma affects more boys than girls. Asthma in adults is more common in women than men.

It tends to run in families, especially when there's also a history of allergies and/or smoking.

Is asthma the same for everyone? 

Everyone with asthma has their own personal set of triggers and symptoms. You can have a certain ‘type’ of asthma too. For example, occupational asthma is caused by triggers in your workplace. Around 4% of people with asthma have a type of asthma called severe asthma, which needs specialist treatment because the usual medicines don’t keep symptoms under control.

Will I always have asthma?

Asthma is a lifelong condition; most people who have asthma will always have asthma. But if you’ve been diagnosed with asthma as a child, your asthma might improve or disappear completely as you get older, particularly if the asthma was mild.  

Even if asthma goes away it can come back later in life, perhaps because you’ve come into contact with new triggers in your job, or you’ve moved to an area with more air pollution for example. Hormonal changes such as pregnancy and menopause can also bring it on again.

But the good news is that even though asthma doesn’t go away there are lots of safe and effective treatments available to help you stay symptom-free.

If you’ve tried taking all the usual treatments in the right way, but you’re still having symptoms, your GP can refer you to a specialist to see if you have severe asthma. This kind of asthma only affects around 4% of all people with asthma. An asthma specialist can help you find the right treatments for you, for example monoclonal antibodies.

Can asthma get worse at different times in my life?

There are certain stages in your life that might affect your asthma. For example, some women find that being pregnant can make asthma either better or worse and hormonal changes, at puberty, menopause or during the menstrual cycle might have an impact too.

There are lots of other life changes that might temporarily affect your asthma symptoms. Stress, for example, whether from a relationship breakdown or family illness, can make symptoms worse.

Having frequent asthma attacks can also make asthma worse over time. Asthma attacks can cause scarring in your airways which makes them narrower. This is sometimes called ‘airway remodelling’.

If your airways are scarred and narrow, you’re more likely to have worse symptoms more often. 

How can I stop my asthma getting worse over time? 

The best way to stop your asthma getting worse over time is to stick to a good routine of taking your preventer medicines as prescribed. And if you notice your symptoms are getting worse, see your GP or asthma nurse as soon as possible so they can review your treatment.

You can also cut your risk of frequent asthma attacks, and your asthma getting worse, by stopping smoking. Having an asthma review at least once a year, gives you a chance to talk through any symptoms or new triggers. You can check you’re on the right medicine and that you’re using your inhaler in the right way to get the most benefits.

You can also talk to your GP or asthma nurse about whether you need a higher dose or an ‘add-on’ treatment to help with symptoms.

For more information go to: https://www.asthma.org.uk/advice/understanding-asthma/what-is-asthma/