COPD - What Are The Signs, Symptoms And Risk Factors?

COPD is a progressive lung disease caused by a variety of factors. Learn what the symptoms, risk factors and treatments are for COPD

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Chronic obstructive pulmonary disease (COPD). From coughing to excess mucus. What are the symptoms and risk factors when it comes to this condition?

As a group of progressive lung diseases affecting the narrowing of the airways, COPD, also known as Chronic obstructive pulmonary disease, affects roughly 1.2 million people in the UK.

An estimated 2% of the population – 4.5% of all people aged over 40 – live with COPD, making it the second most common lung disease in the whole of the UK.

Scarily, this condition seems to be on the rise. With the number of diagnosis’ increasing by 27% in the last decade alone. This means a jump in number, from under 1,600 people diagnosed to nearly 2,000 per every 100,000. 

What is COPD?

To look at whether or not you may have this condition and ways in which to help manage this in your day to day life, it’s crucial to understand exactly what it is…

The British Lung Foundation describes COPD as:

“Chronic obstructive pulmonary disease, or COPD, is a group of lung conditions including bronchitis and emphysema. They make it difficult to empty air out of the lungs because your airways have been narrowed.”

COPD encompasses a group of lung conditions, including:

‘chronic bronchitis’ and ’emphysema.’ 

Such conditions used to be more frequently known in individual terms but are now included within the umbrella diagnosis of COPD.

Both chronic bronchitis and emphysema can occur in unison but the two conditions are different in nature:

Bronchitis means the airways are inflamed and narrowed. People with bronchitis often produce sputum, or phlegm. Definitions include “chronic or recurrent excessive mucous secretion in the bronchial tree,

Emphysema affects the air sacs – also known as alveoli – in your lungs. Located at the end of the airways, these air sacs become so stretched out, that your lungs end up increasing in size, therefore becoming baggy. This make it harder to move air in and out.

THIS diagram helps to visualise both conditions.

Refractory (non-reversible) asthma also falls under the COPD umbrella category. 

It is a specific type of asthma that doesn’t respond well to common asthma medications. When an asthma attack takes place, the bronchial airways tighten and swell. 

Whilst medications can help in the reversal process by opening the airways up, this is not the case with refractory asthma. There are ongoing studies looking into alternatives to help with this type of asthma.

A pretty clever and easier way to remember what COPD stands for is to consider the below:

  • Chronic  this means that the disease is long-term and does not disappear
  • Obstructive = it narrows your airways, making breathing out much more difficult
  • Pulmonary = affecting the lungs
  • Disease = medical condition

What are the symptoms of COPD?

If you or someone you know is experiencing symptoms of COPD, it can be easy to ignore these or put them down to another condition.

This can be due to the many other health conditions with similar signs and symptoms. 

Because of this, many people fail to spot the early warning signs and can therefore go without help for longer than they need to.

So what are the early symptoms of COPD?

  • A persistent cough

One of the very first warning signs of COPD is a cough that just won’t go away. Known more frequently by healthcare professionals as a chronic cough, if yours has been going on for longer than normal, get to your GP to investigate further.

Coughing is a useful tool for your body, as it helps to protect your airways from air pollutants and any other inhaled irritants, such as cigarette smoke. By helping to remove phlegm – also known as mucus – from your passages, this means your lungs are working in a normally responsive way. However, if your cough is becoming chronic, this could well be an indication that your lungs aren’t functioning normally.

  1. Shortness of Breath

As an extremely common symptom of COPD, shortness of breath, or as its medically known – ‘dyspnea’ –  can be caused by both chronic bronchitis and emphysema.

Due to the damage created by the above conditions, people with COPD have damage to their lungs, making it much harder to breathe.

  1. Excess Mucus

Chronic bronchitis can cause the lungs of a person with COPD to produce more mucus than usual. This is a way for your lungs to keep air pollutants and irritants away.

If a person’s lungs produce too much mucus, it can trigger a cough (as above) as a way to help clear out the excess, This, in turn, makes breathing an easier task.

This symptom combined with a chronic cough is one of the symptoms that will help your GP to diagnose COPD. A change in your mucus can also cause an exacerbation, also known as a flare-up.

  1. General Fatigue

This is another symptom that could well be the result of various other health conditions. But it is one that is extremely common when it comes to COPD.

The levels of fatigue vary from those diagnosed with COPD but with some people, tired just doesn’t cover it. As COPD reduces airflow into your lungs, this lack of oxygen can cause you to feel extremely tired and fatigued.

Diagnosing COPD

When it comes to COPD diagnosis, it can be commonplace to consider the use of Peak flow meters, as a way to measure breathing capacity. These can be an excellent tool for monitoring asthma, however studies show that these can be of limited value in COPD diagnosis’, largely as the readings may underestimate the extent of lung impairment. 

*Enter the… Spirometry*

A valuable tool in the diagnosis of COPD, a spirometry measures the total amount of air you can breathe out from your lungs and how fast you can blow it out. You will be asked to take a very deep breath and blow out as fast as you can into a mouthpiece until no more air comes out.

A spirometry can help to assess if inhaled medication or inhalers can open up your airways by reversibility testing. During this test, your health care professional will ask you to use your inhaler or other relevant medication, wait a few minutes, and then repeat the test. 

Studies have shown the introduction of such a tool to be considerably helpful when diagnosing COPD.

The National Institute for Health and Care Excellence (NICE) and all international guidelines recommend the use of spirometry to confirm the diagnosis and assess the level of severity in COPD.

Risk Factors

There are various risk factors associated with COPD, with the most common cause being tobacco smoke. It’s important to note that this also includes second­hand or passive smoke inhalation. Up to 25% of smokers will eventually go on to develop COPD.

Other risk factors can include:

  • Indoor air pollution (such as dust, smoke or fumes)
  • Outdoor air pollution (such as pollen)
  • Strong odours
  • Frequent lower respiratory infections, particularly during childhood.
  • Age – Under 1% of people who have COPD are under 40, with over 80% of diagnoses made in people over 60.
  • Location – More than 90% of COPD deaths occur in low­ and middle­-income countries, where effective strategies for prevention and control are not always implemented or accessible.

Previously COPD was also found to be more common in men, however because of comparably high levels of tobacco smoking among women in high-­income countries in conjunction with the higher risk of exposure to indoor air pollution for women in lower­-income countries, the disease is now more on an even general keel, affecting both men and women equally.