Chronic obstructive pulmonary disease (COPD) – how to manage it

Signs of COPD can come on gradually – learn how to spot them plus discover what can control symptoms to help you manage the condition. 

Symptoms of COPD

What are the different types?

What causes it and who’s most affected?

When to see a doctor

How is COPD diagnosed?

What are the treatments?

How to manage COPD with self-care

A long-lasting cough (sometimes dismissed as ‘smoker’s cough’) and breathlessness are symptoms of COPD, and spotting signs early is vital. Find out how plus what treatments can help – from medication to self-care.

Finding it hard to breathe and a chesty, mucus-filled cough that won’t go away are 2 of the debilitating symptoms of chronic obstructive pulmonary disease (COPD) – the name given to a set of inflammatory lung diseases that cause breathing problems. 

COPD happens when parts of the lungs and the airways become inflamed and damaged, restricting airflow. 

Over time, these symptoms can get worse and stop you from living life to the full. Although there is no cure for COPD it’s possible to manage the condition with good care. 


## Symptoms of COPD

You might not realize you have chronic obstructive pulmonary disease (COPD) at first because the signs often come on gradually during mid-life, but the most common of them include: 

- feeling short of breath – it could happen when you exercise, when you have sex, or it might wake you up in the night
- an ongoing chesty cough – you might bring up white, green, or yellow phlegm (mucus)
- wheezing
- a tight chest
- repeated chest infections. 

Other symptoms of COPD can develop as the disease progresses, which can affect your home and work life, including:

- losing weight without meaning to
- feeling tired 
- swollen ankles, feet, or legs ([oedema](https://www.livehealthily.com/health-library/conditions/oedema))
- chest pain and coughing up blood.

You may also notice flare-ups (known as exacerbations) – these are specific times when your symptoms get suddenly worse, such as during the colder days of winter. 

Get help with this

## What are the different types?

Chronic obstructive pulmonary disease (COPD) is an umbrella term used to describe chronic lung diseases – 2 of the most common of these include:

- __emphysema__ – when the air sacs (alveoli) at the bottom of your lungs become damaged 
- __[chronic bronchitis](https://www.livehealthily.com/health-library/conditions/bronchitis)__ – long-term inflammation affecting your airways. 

## What causes it and who’s most affected?

There are a few different causes of chronic obstructive pulmonary disease (COPD), but smoking cigarettes is number 1. In fact, smoking accounts for 70% of all COPD cases in most of the world. 

The harmful chemicals in tobacco damage the lining of your airways and your lungs, which become inflamed and may produce more mucus, making breathing difficult.

But smoking isn’t the only risk factor. Others include: 

- __being exposed to dust__ – such as coal dust and silica dust, fumes, and other chemicals, including in your workplace environment
- __air pollution__ – such as traffic fumes, but more research is needed to confirm a link.

You may be more likely to develop COPD due to:

- __genetics__ – if someone in your close family also has COPD 
- __a rare genetic condition__ – alpha-1-antitrypsin deficiency can cause COPD at a younger age than is typical
- __having [asthma](https://www.livehealthily.com/health-library/conditions/asthma)__ – it’s thought to be a risk factor for COPD, especially when combined with smoking.

## When to see a doctor

You should see a doctor right away if you have ongoing symptoms of chronic obstructive pulmonary disease (COPD) – particularly if you are over 35 years old and you smoke, or used to. 

Seeking help early for COPD can help reduce the damage to your lungs, so don’t put off making an appointment.

Seek urgent medical help if you notice a rapid shortness of breath.


## How is COPD diagnosed?

Your doctor will ask you questions about your chronic obstructive pulmonary disease (COPD) symptoms, your medical history, and family history plus explore causes, for example if you smoke or have in the past. They might also ask if you’re regularly exposed to fumes, chemicals or lung irritants. 

Then, they’ll listen to your chest and check your breathing with a stethoscope. You may need further tests, such as: 

- __spirometry__ – to reveal how well your lungs are working by measuring the amount of air you breathe out
- __chest X-ray__ – to spot problems in the lungs as a result of COPD
- __blood tests__ – may be done to check for alpha-1-antitrypsin deficiency, which puts you more at risk of developing COPD.

Other tests you may be referred for include arterial blood gas analysis – to check oxygen and carbon dioxide levels in the blood; an electrocardiogram (ECG) – to measure the electrical activity of your heart; and a CT scan to help identify lung problems. 


## What are the treatments?

Chronic obstructive pulmonary disease (COPD) can’t be cured, but getting the right care can manage symptoms and help slow the progression of the condition. 

The first step is to stop smoking. This may be difficult so talk to your doctor about a plan for quitting.

Other treatment options will vary depending on the severity of your symptoms and condition. This may involve: 

- __short-acting bronchodilators__ – usually the first line of treatment in inhaler form – they help widen your airways and make breathing easier. You can use these 4 times a day
- __long-acting bronchodilators__ – often prescribed if you have regular COPD symptoms or experience flare-ups, and are used once or twice a day
- __steroid inhalers__ – used if long-acting bronchodilators don’t work. They can help reduce inflammation in your airways. Or steroid tablets may help
- __antibiotics__ – prescribed if you have signs of a bacterial chest infections
- __pulmonary rehabilitation__ – a special program with a combination of breathing techniques and exercise training with specialists
- __oxygen therapy__ – given through  nasal tubes or a mask if levels of oxygen in your blood are low.

Surgery, such as a bullectomy to help the lungs function better,  is only recommended if your condition is severe and other treatments haven’t worked. 


## How to manage COPD with self-care

Alongside taking medicines as instructed, it’s important to look after yourself. Try to:

- __quit smoking__ – it can help slow down and reduce further damage to your lungs – plus protect others from breathing in your smoke 
- __exercise often__ – keeping active can help improve your symptoms. Know your limits and don’t push yourself too hard
- __keep a healthy weight__ – the heavier you are, the more breathless you’re likely to feel. So focus on eating healthily and staying active
- __connect with friends and family__ – maintain important relationships and be open about how you’re feeling 
- __get vaccinated__ – respiratory infections are more serious if you have COPD, so get your shots against the [flu](/health-library/conditions/flu), [COVID-19](/health-library/conditions/coronavirus-covid19) and [pneumonia](/health-library/conditions/pneumonia)
- __monitor the weather__ – it can make your symptoms worse. Check local forecasts online to keep track of weather patterns and plan accordingly
- __avoid breathing in harmful irritants__ – avoid dusty places, fumes, and smoke, which can cause flare-ups
- __try breathing techniques__ – practices like deep breathing can be helpful when you feel breathless
- __join support groups__ – connecting with others with the same experiences can be motivating. Try [Living with COPD Community on Inspire](https://www.inspire.com/groups/american-lung-association-copd/), [Better Breathers Club](https://www.lung.org/help-support/better-breathers-club), [Asthma + Lung UK](https://www.asthmaandlung.org.uk/groups-support/copd-online-support-group), and the [Lung Conditions Community Forum](https://healthunlocked.com/asthmalunguk-lung) on HealthUnlocked.


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References

Amelia Glean

Jo Wheatley

Dr Emily Blount

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