What is COPD?

Chronic obstructive pulmonary disease (COPD) is a long-term lung condition that causes shortness of breath and gets worse with time. The 2 most common conditions that make up COPD are:

• emphysema
• chronic bronchitis

In emphysema, there is damage to the alveoli (air sacs) in your lungs. Air becomes trapped inside, making it hard to breathe in.

In chronic bronchitis, the lining of your airways is irritated and produces a lot of mucus, causing a chronic cough and difficulty breathing.

COPD affects many Australians, particularly older Australians. Aboriginal and Torres Strait Islander people have higher rates of COPD than the rest of the Australian population. COPD is one of the leading causes of death in Australia.

Is asthma the same as COPD?

Asthma and COPD both involve blockage of your airways, but they are different.

For most people with asthma, medicines can help widen the airways and help your breathing return to normal. In COPD, medicines are less effective at returning your breathing to normal. Some people with asthma who have had significant exposure to cigarette smoke can also have features of COPD. It's also possible to have both, though they are different conditions.

There is some discussion about a condition called asthma-COPD overlap syndrome, where someone has features of both asthma and COPD. It usually causes more severe symptoms than either condition on its own and needs different treatment. Whether asthma-COPD overlap syndrome is a distinct condition is still debated among researchers.

What are the symptoms of COPD?

In the early stages of COPD, you may not have any symptoms.

When symptoms appear, they may include:

• feeling breathless
• a persistent cough
• producing a lot of phlegm (mucus)
• tiredness
• chest infections that occur more often and take longer to get better

Symptoms come on gradually. At first, you might think you are just unfit or getting older. As time goes on, symptoms get worse and interfere more with your daily activities.

At times, your symptoms may get worse suddenly. This is known as an ‘exacerbation' (or ‘attack') of COPD. Exacerbations are often triggered by respiratory infections (like a cold or flu).

What causes COPD?

The most common cause of COPD is smoking. One in every 4 or 5 people who smoke will develop COPD. You are still at risk if you have smoked in the past, even if you don't smoke anymore.

Other causes include:

• passive smoking — especially if your parents smoked when you were young or you were exposed to smoking in the womb
• exposure to pollution, fumes and dust
• lung problems or frequent lung infections in childhood
• infections such as tuberculosis (TB)
• asthma
• a rare genetic condition called alpha-1 antitrypsin deficiency

Jobs that can put you at a higher risk of developing COPD include:

• construction work
• mining
• manufacturing and factory work
• farming and agricultural work
• firefighting
• cleaning work, with exposure to harsh chemicals

When should I see my doctor?

See your doctor if you notice you are getting short of breath with less effort.

It's a good idea to see your doctor to check your lungs if you are over 35 years old and you have ever smoked or been exposed to fumes or dust at work.

Ask your doctor or pharmacist for help if you want to quit smoking.

If you have COPD, see your doctor immediately if you have symptoms of an exacerbation or a complication, such as:

• shortness of breath or cough that is worse than usual
• more phlegm than usual
• getting tired more easily
• fever
• swelling of your legs or the veins in your neck

Call triple zero (000) and ask for an ambulance if you:

• are so short of breath that you have difficulty talking, walking or sleeping
• feel confused or sleepy
• have blue lips or nails
• notice a change in your heartbeat, such as it being faster than usual or irregular

How is COPD diagnosed?

Your doctor will ask about your symptoms, whether you have ever smoked and about your work environment.

They may refer you for a breathing test called spirometry. This involves blowing hard into a tube, taking an inhaler medicine and blowing into the tube again. This test measures how much air and how fast you can breathe. It shows if you have COPD.

Your doctor might also refer you for an x-ray or CT of your chest, blood tests or other lung function tests.

How is COPD treated?

There is no cure for COPD, but there are treatments that can help you feel better and slow down the worsening of your symptoms. Following your doctor's advice closely can significantly slow the progression of your COPD.

Stopping smoking

The single most important thing to limit lung damage and slow disease progression in someone with COPD is stopping smoking if they do smoke.

If you want to quit smoking, call Quitline on 13 78 48.

You can also talk to your doctor about treatments and services that can help you quit. If your housemate or partner smokes, ask them if they would consider quitting or smoking outside.

Medicines

COPD is treated with prescription medicines that are inhaled via an inhaler device. These medicines help open up your airways or reduce inflammation inside them.

Your doctor might prescribe an inhaler to use every day, and another inhaler to use when you feel short of breath. As your symptoms get worse, you might need an inhaler that contains a combination of medicines.

It is important that you know how to use an inhaler correctly and that you always use it as prescribed, even if you are feeling better.

You may need antibiotics if you have a chest infection.

If you aren't sure when or how to use your prescribed medicines, speak to your doctor or pharmacist.

Managing exacerbations

It's important to see your doctor if your symptoms flare up. They may prescribe additional medicines such as:

• inhaled medicines
• steroid tablets
• antibiotics

If your symptoms are severe, you may need to go to hospital for treatment.

Severe COPD

If your COPD is severe, you may be offered supplemental oxygen to use at home, in the form of a portable oxygen concentrator or tank. This can help ease your breathing.

Rarely, you may be offered surgery.

Living with COPD

Living with COPD can be challenging, but there are things you can do to maximise your health and wellbeing.

Lifestyle changes

As well as stopping smoking, you can keep healthy by:

• getting regular exercise
• eating a healthy diet
• getting enough sleep
• maintaining a healthy weight
• having an annual influenza vaccination
• having a pneumococcal vaccination — ask your doctor how many doses are recommended for you
• making sure all of your regular vaccinations are up to date

Pulmonary rehabilitation

Some people find it helpful to participate in a pulmonary rehabilitation (lung rehab) program. This is an exercise and education program that can teach you to live with COPD more easily.

It includes:

• learning exercises to increase your physical abilities
• learning techniques to clear your airways, breathe effectively and save your energy
• getting information about using your medicine correctly
• emotional support

Can COPD be prevented?

You can reduce your chance of developing COPD by:

• avoiding smoking
• being physically active
• using personal protective equipment at work

What are the complications of COPD?

COPD can lead to a range of complications, including:

• pulmonary hypertension
• heart failure
• osteoporosis and fractures
• anxiety and depression
• lung cancer

Following your doctor's advice and taking your medicines as directed will slow down the progression of your symptoms and reduce the chance of complications.

Resources and support

Visit Lung Foundation Australia for more information and to access a Respiratory Care Nurse service for support.

If you want to quit smoking, call Quitline on 13 78 48.

Do you prefer to read in languages other than English?

Visit Health Translations for information in many community languages about quitting smoking and protecting your lungs at work.

If you want to quit smoking, call Quitline on 13 78 48. If you prefer to speak in a language other than English, ask for an interpreter, and Quitline will call you back as soon as an interpreter for your language becomes available.

Looking for information for Aboriginal and/or Torres Strait Islander people?

Check out information about COPD for Aboriginal and/or Torres Strait Islander people.

When you want to talk about quitting smoking, call Quitline on 13 78 48 and ask to speak with a counsellor for Aboriginal and/or Torres Strait Islander Communities.