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You are in: Home > Chest Information > Chest Conditions > Chronic Obstructive Pulmonary Disease >

Chronic Obstructive Pulmonary Disease (COPD)

• What is COPD?
• Symptoms of COPD
• Acute exacerbations
• Causes of COPD
• Smoking and COPD

What is COPD?

Chronic obstructive pulmonary disease, shortened to COPD, is an umbrella term for a group of conditions which cause long–term damage to the airways.

In COPD the airways are narrowed, due to a variety of causes, so the air breathed in cannot flow freely in or out of the lungs.

C hronic: means it has been present for a long time

O bstructive: a narrowing of the airways, causing blockage

P ulmonary: another way to describe the respiratory system

D isease: refers to illness

COPD includes:

• Chronic bronchitis: the lining of the bronchi are irritated and inflamed and produce excess mucus which blocks the airways.
• Emphysema: damages the alveoli and the lung's ability to transfer oxygen into the bloodstream.
• Lung damage which is caused by chronic asthma. Usually the airways return to normal between asthma attacks. Sometimes, however, the chronic inflammation can cause a permanent obstruction to the airways.

If you have COPD you may have symptoms of all of the above conditions.

COPD affects over 100,000 people in Scotland. Many more are living with symptoms but are not yet diagnosed. There is no cure; COPD usually worsens over time. However, there are treatments available which can ease symptoms and there is a lot that you can do to help yourself and prevent further damage to your airways.

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Symptoms of COPD

The are four main symptoms:

• Coughing
• Regular production of sputum (phlegm)
• Breathlessness
• Wheezing

You may also have other symptoms such as repeated chest infections, weight loss and tiredness (fatigue).

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Acute exacerbations

Sometimes your condition can suddenly deteriorate to such an extent that admission to hospital is vital and emergency treatment is needed. This is often referred to as an acute exacerbation.

To try to avoid acute exacerbations it is important that you let your doctor / nurse know about sudden worsening of symptoms and changes in your sputum as soon as possible.

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Causes of COPD

With COPD your airways are damaged, usually through constant irritation.

The most common reason for airways being irritated and damaged is smoking.

Other factors which may cause COPD, or make your symptoms worse, include:

• Working in an occupation / conditions that creates dust
• Poor living environment and / or air quality, e.g. smog
• Chronic asthma
• Genetic factors, e.g. occasionally a deficiency in Alpha–1–antitrypsin can cause COPD (Alpha–1–antitrypsin is a protein that protects your lungs.)

When your airways are irritated they become swollen and inflamed.

The muscles in the airway walls tighten to try to stop the irritation getting further into your lungs.

The mucus glands produce more mucus to trap any debris and act as a protective mechanism to cushion the lining of your airways. The cilia have to work harder to move the debris and extra mucus up towards your throat to be expectorated (coughed up). The cilia also become damaged and are less able to carry out this function.

Cross–section of a normal airway		Cross–section of a damaged airway

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Smoking and COPD

When you smoke the irritation to your airways usually continues over a long period of time. After a while your airways remain swollen and inflamed and don't return to their normal state.

The muscle in the lining of your airways loses its tone (due to constant irritation and coughing) and no longer performs as it should, which means that your airways become floppy.

The mucus glands continue to pour out excess mucus, so the cilia get gummed up from all the excess mucus and stop working. So, instead of your lungs being able to clear themselves, the mucus falls deeper into your lungs and becomes more and more difficult to clear.

As well as your airways, the alveoli (or air sacs) are also affected by smoking. Smoking causes enzymes in the structure of the alveoli to start damaging themselves.

You may notice:

• That you become more breathless or start to wheeze when breathing out, particularly on exertion. This can get worse if you don't stop smoking.

• You cough more and produce more sputum. The excess mucus pooling in the lungs is a good environment for bacteria to grow (like a stagnant pond) and you may have frequent chest infections.

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