COPD

COPD is a group of conditions that includes chronic bronchitis and emphysema. Both conditions make it difficult to breathe because the airways become clogged with mucus. Emphysema causes the air sacs in the lungs to enlarge and rupture, making it harder to move oxygen into the bloodstream.

The symptoms of COPD develop slowly over time, and people often don’t realise they have the condition until it becomes hard to do everyday activities such as walking up stairs. The underlying cause of the disease is usually long-term exposure to dusty or polluted air, though other factors that increase your chance of developing it include smoking (particularly inhaling secondhand smoke), age, and a genetic disorder called alpha-1 antitrypsin deficiency.

If you think you have COPD, it is important to see your GP or practice nurse as early as possible because treatment can reduce the progression of symptoms and prevent flare-ups. They will ask you about your family history and your symptoms and do a physical exam, which may include listening to your chest and taking your pulse. They may also order imaging tests, such as a chest x-ray or a CT scan, to get a closer look at your lungs and blood vessels. They may also order a blood test to measure your levels of oxygen and carbon dioxide.

When your symptoms become more severe, you may have more frequent flare-ups and your phlegm may be discoloured and thicker. You may also find it harder to breathe, even while resting, and you may need help with daily tasks like washing or dressing. If your doctor feels that you are not getting enough oxygen with medication, they may recommend a supplemental oxygen tank.

Our pulmonary specialists (pulmonologists) at NYU Langone offer different types of medication to ease your symptoms and prevent them from worsening. These are known as bronchodilators, and they work by relaxing the muscles around your airways. You can take them in pill form or in a mist inhaled into the lungs using an inhaler. Some are fast-acting and offer “rescue” relief from symptoms, while others are taken regularly to prevent symptoms or reduce flare-ups. They are often combined with corticosteroids, which reduce inflammation in the lungs.

Some people with severe COPD who cannot be managed with medication may need surgery to remove the large air spaces (bullae) that build up in the lungs. This can improve breathing, but it is only recommended for a small number of people and is performed under general anaesthetic in hospital.

There is no cure for COPD, and the damage to your lungs can’t be reversed. But you can slow the progress of the condition by stopping smoking, improving your diet and getting plenty of exercise, taking your medications as prescribed, avoiding respiratory infections, and undergoing pulmonary rehabilitation to increase the amount of activity you can do without becoming short of breath. You will also need to have ongoing medical checks and join a support group.