Chronic Obstructive Pulmonary Disease (COPD)

The main symptoms of COPD are:

• increasing breathlessness when you do everyday things such as going for a walk or doing housework
• a persistent chesty cough with phlegm – some people may dismiss this as just a “smoker’s cough”
• frequent chest infections
• persistent wheezing, particularly 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.

Without treatment, the symptoms usually get progressively worse. There may also be periods when they get suddenly worse, known as a flare-up or exacerbation.

Find out more about the symptoms of 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.

The likelihood of developing COPD increases the more you smoke and the longer you’ve smoked.

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.

Find out more about the causes of COPD

You should consult your GP if you have persistent symptoms suggestive of COPD, particularly if you’re over 35 and smoke or used to smoke.

Do not ignore the symptoms. If they’re caused by COPD, it’s best to start treatment as soon as possible, before your lungs become significantly damaged.

Your GP will ask about your symptoms and whether you smoke or have smoked in the past. They can organise a breathing test to help diagnose COPD and rule out other lung conditions, such as asthma.

Find out more about how COPD is diagnosed.

The damage to the lungs caused by COPD is permanent, but treatment can help slow down the progression of the condition.

Treatments include:

• stopping smoking – if you have COPD and you smoke, this is the most important thing you can do. Local support is available
• inhalers and medicines – to help make breathing easier. Videos showing you how to best use your inhalers can be found here
• having a flu jab every year and a one-off pneumonia vaccination
• pulmonary rehabilitation – a specialised programme of exercise and education
• Oxygen therapy can be useful as a treatment for people with low oxygen levels however, for most people with COPD breathlessness is caused by difficulty moving air in and out as you breathe, rather than by a low oxygen level.
• surgery or a lung transplant – although this is only an option for a very small number of people

Find out more about how COPD is treated and living with COPD.

COPD is largely a preventable condition. You can significantly reduce your chances of developing it if you avoid smoking.

If you already smoke, stopping can help prevent further damage to your lungs before it starts to cause troublesome symptoms.

If you think you need help to stop smoking, you can contact NHS Smokefree for free advice and support. You may also want to talk to a GP about the stop smoking treatments available.

Find out more about stopping smoking and where to find a stop smoking service near you.

You can do a lot to help manage your condition yourself. Knowing all you can about your condition, your symptoms, your medications and how to cope with flare-ups will make your day-to-day life easier. Keeping active and doing exercise can make a big difference – many people find this helps them more than inhaled drugs.

Managing exacerbations or flare ups

Flare up, or self-management plans help you know what to do when things get worse. Your GP or practice nurse can help you with this and may provide you with a ‘rescue pack’ of drugs (antibiotics and steroids) that you keep at home. The plan should outline when and how to use these and when you should contact a medical professional.

Keeping active

If you have COPD, being active and exercising can help you to improve your breathing, fitness and quality of life. Don’t avoid activities that make you breathless: you’ll get less fit and out of breath more easily. Regular exercise can help reverse this by strengthening your muscles. Exercise also benefits your heart and blood pressure and makes you less likely to develop conditions such as diabetes and osteoporosis (fragile bone disease). There are many ways to be active – find one that you might enjoy.

Some ideas for getting active can be found here

The best way to learn how to exercise at the right level for you is to take part in pulmonary rehabilitation (PR). Ask your doctor to refer you if your ability to exercise is affected by your breathing difficulties.

There is strong evidence that people with COPD benefit from PR and exercise more generally. Remember again that it is not harmful to make yourself breathless.

Controlling your breathing

There are techniques and positions that can help you cope when you get out of breath and feel more in control of your breathing.

Some people with COPD who joined a singing group said singing helped them to manage their symptoms better.

Find out more and find a group near you

If you practise breathing techniques and use them every day, they’ll help you when you’re active or if you suddenly feel short of breath. Try different breathing techniques to find what helps you. There are also positions that can help you to practise breathing control or to control your breathing when you get breathless. Talk to your respiratory physiotherapist or nurse to find out what works for you.

Top tips to manage your breathlessness

• Use a towelling robe after showering or bathing, as you’ll use less energy than drying off with a towel.
• Using a handheld battery-powered fan to blow air onto your face can help you to feel less breathless.
• Plan your day in advance to make sure you have plenty of opportunities to rest.
• Find simple ways to cook, clean and do other chores. You could use a small table or cart with wheels to move things around your home, and a pole or tongs with long handles to reach things.
• Put items that you use frequently in easy-to-reach places.
• Keep your clothes loose, and wear clothes and shoes that are easy to put on and take off.
  Using a wheeled walking frame can make it easier to get around if you are short of breath.

Eating well and keeping a healthy weight

It’s important to eat a balanced diet and maintain a healthy weight. Your doctor or nurse can help you to work out what your healthy weight should be and can refer you to a dietician or local scheme to help you if necessary.

If you’re overweight, it will be harder for you to breathe and move around.

If you’re losing too much weight because eating makes you feel breathless, or you find it difficult to shop and prepare meals, try to eat little and often.

Ask your doctor or nurse about nutritional supplements

Read more information on eating well, maintaining a healthy weight and how your diet can affect your symptoms.

Take care of your emotional wellbeing

Living with a long-term condition can affect many aspects of your life. Physical symptoms such as breathlessness and coughing, feeling more tired and being less active can mean you feel stressed, anxious or depressed.

The risk of anxiety and depression is greater in people with a variety of chronic medical conditions including COPD.

Many people who have experienced anxiety and depression make a full recovery. They are both very normal reactions to living with COPD. Talk to your health care professional about medications and counselling.

Don’t bottle things up – talking to someone you trust, including your health care professional, can help.

It’s very important to stay active and sociable, and to learn more about COPD. This will help you to understand and cope better with your condition. You might want to get involved with a local group to meet others going through a similar experience.

Support groups for people living with a lung condition and their families are a great way to get more information and make new friends.

The outlook for COPD varies from person to person. The condition cannot be cured or reversed, but for many people, treatment can help keep it under control, so it does not severely limit their daily activities.

In some people, COPD may continue to get worse despite treatment, eventually having a significant impact on their quality of life and leading to life-threatening problems.