Chronic obstructive pulmonary disease (COPD) is a long-term lung condition that narrows the airways and damages the air sacs, making it hard to breathe out. It includes chronic bronchitis and emphysema. COPD develops slowly over many years and cannot be cured, but treatment and lifestyle changes can control symptoms, reduce flare-ups and help people stay active.
Key facts
- COPD is one of the leading causes of death worldwide.
- Tobacco smoking is the main cause in wealthy countries.
- In Nigeria and other low- and middle-income countries, smoke from cooking with firewood, charcoal and kerosene is a major cause, especially for women.
- COPD is diagnosed with a simple breathing test called spirometry.
- Stopping smoking is the most effective way to slow the disease.
Causes and risk factors
- Smoking cigarettes, and exposure to second-hand smoke
- Household air pollution from cooking or heating with solid fuels in poorly ventilated spaces
- Workplace dust, fumes and chemicals
- Outdoor air pollution
- Repeated lung infections in childhood, and past tuberculosis
- Poorly controlled asthma over many years
- Alpha-1 antitrypsin deficiency, a rare inherited condition
Symptoms
- Shortness of breath, first during activity and later at rest
- A long-lasting cough, often with phlegm
- Wheezing
- Chest tightness
- Frequent chest infections
- Tiredness, and in advanced disease weight loss and ankle swelling
Flare-ups (exacerbations)
A flare-up is when symptoms suddenly get worse for several days, often triggered by a chest infection or air pollution. Flare-ups can be serious and may need hospital treatment.
Diagnosis
- Spirometry: you blow as hard and fast as you can into a machine that measures how much air you can breathe out and how quickly. It confirms COPD and shows how severe it is.
- Chest X-ray to rule out other conditions such as TB or lung cancer
- Blood tests to check for anaemia and, sometimes, alpha-1 antitrypsin deficiency
- Oxygen levels measured with a finger clip (pulse oximeter)
Treatment
Stop smoking
Quitting at any stage slows lung damage. Ask a health worker about support and nicotine replacement.
Inhalers
- Short-acting reliever inhalers (such as salbutamol) ease breathlessness quickly.
- Long-acting bronchodilators (LABA and LAMA) keep airways open for 12 to 24 hours.
- Inhaled steroids may be added for people with frequent flare-ups.
Good inhaler technique matters. Ask a nurse or pharmacist to check how you use yours.
Pulmonary rehabilitation
A supervised programme of exercise and education that improves breathing, strength and confidence.
Other treatments
- Vaccines against flu and pneumococcal infection to prevent chest infections
- Steroid tablets and antibiotics for flare-ups, when prescribed
- Long-term oxygen therapy for people with low oxygen levels
- Surgery or procedures for a small number of people with severe emphysema
Living with COPD
- Stay as active as you can. Walking every day helps.
- Use cleaner cooking fuels such as gas or electricity if possible, or cook outdoors or in a well-ventilated space.
- Learn breathing techniques such as pursed-lip breathing.
- Eat well and keep a healthy weight.
- Have a written plan agreed with your health worker for what to do in a flare-up.
When to see a doctor
See a doctor if you have a cough that lasts more than a few weeks, or you get breathless more easily than before. Seek emergency care if you are very breathless at rest, your lips or fingertips turn blue, you feel confused or drowsy, or you have chest pain.
Frequently asked questions
Is COPD the same as asthma?
No. Asthma often starts in childhood and airway narrowing is largely reversible with treatment. In COPD, the damage is long-lasting and mostly not reversible, though some people have features of both.
Can non-smokers get COPD?
Yes. Cooking smoke, workplace dust and air pollution cause many cases in people who have never smoked.
Related guides
Sources
- World Health Organization: COPD fact sheet
- NHS: Chronic obstructive pulmonary disease
- National Heart, Lung, and Blood Institute (NIH): COPD
