COPD

What is COPD?

Chronic obstructive pulmonary disease (COPD) is a chronic respiratory condition in which the lungs and airways undergo progressive damage, making it difficult for air to flow out of the lungs and causing breathing to require much greater effort.

COPD includes two conditions that may occur together, although their severity varies from person to person: chronic bronchitis and emphysema. Chronic bronchitis is the persistent inflammation of the airways, which hinders both the entry and exit of air. Emphysema, on the other hand, damages the alveoli, the tiny air sacs located at the end of the bronchi where oxygen passes into the bloodstream. When the alveoli become damaged, the lungs lose their ability to oxygenate the body effectively. Together, both conditions make it increasingly difficult to breathe normally.

Symptoms of COPD

Symptoms of COPD usually develop gradually and typically appear from middle age onwards. In many cases, they do not become noticeable until significant lung damage has already occurred.

• Shortness of breath (dyspnoea), especially during physical activity. As the disease progresses, it may occur even when carrying out simple tasks or while at rest.
• Persistent cough, often accompanied by mucus or phlegm (also known as sputum, which is brought up when coughing). For many people, this is one of the earliest symptoms.
• Wheezing, a whistling sound heard in the chest when breathing.
• A feeling of tightness in the chest.
• Fatigue or lack of energy, which can make everyday activities more difficult.

People with COPD may also experience exacerbations or flare-ups, which are episodes in which symptoms suddenly worsen for several days. These episodes are often associated with respiratory infections or exposure to air pollutants and irritants.

Having COPD also increases the risk of developing other conditions, including lung infections (influenza and pneumonia), lung cancer, heart disease, osteoporosis and mental health problems.

Risk factors

In most cases, COPD is linked to long-term exposure to toxic substances or irritants that damage the lungs. In high-income countries, the main risk factor is smoking, including both active and passive smoking, as well as air pollution and occupational exposure to dust or chemicals. In many low- and middle-income countries, however, exposure to smoke from wood, coal or other household fuels is also highly relevant.

Other factors can affect normal lung development from the very beginning of life, including exposure to pollutants during foetal development, premature birth and severe respiratory infections in childhood. As a result, people whose lungs have developed abnormally may also develop COPD in adulthood.

In a small number of cases, COPD is caused by an inherited genetic condition known as alpha-1 antitrypsin deficiency, which increases susceptibility to lung damage.

Diagnosis of COPD

The spirometry test is the key test used to diagnose COPD, as it helps identify abnormalities in lung function. It is a simple, quick and painless procedure that measures both the amount of air a person can inhale and exhale and the speed at which air is expelled from the lungs.

During the test, which usually takes around 10 minutes, the patient is asked to fill their lungs completely and then blow out all the air as quickly and forcefully as possible into a device called a spirometer. The results are available immediately.