Chronic obstructive pulmonary disease

• Pulmonary: Of or relating to the lungs.
• Respiratory: Relating to or affecting breathing or the lungs.
• Emphysema: A diagnosed medical condition in which the air sacs of the lungs are damaged and enlarged, causing breathlessness.
• Bronchitis: A diagnosed medical condition in which the mucus membrane in the bronchial tubes (upper area of the lungs) become inflamed.
• Sputum: A mixture of saliva and mucus which is coughed up from the lungs, typically as a result of an infection or another lung condition.
• Lung function test: the name for a group of tests that measure breathing and how well the lungs are functioning.

Some of the causes and risk factors of COPD include:

• smoking – this is the most significant risk factor. Around 20 to 25 per cent of smokers will develop COPD. Ex-smokers remain at risk and should be aware of the symptoms.
• exposure to lung irritants such as dust from grain or wood.
• severe air pollution can cause COPD or make the condition worse in smokers.
• genes – a rare genetic disorder known as alpha-1-antitrypsin deficiency can cause emphysema, even if no other risk factors are present.

Diagnosis must be made by a medical professional.

Emphysema produces breathlessness, which is typically both progressive and predictable; it progresses year on year with continued smoking, but it is 'the same' from day-to-day. The same amount of exertion will produce the same amount of breathlessness. In bed at night is typically the best time for emphysema sufferers.

Asthma, however, is typically variable from day-to-day and is commonly worse at night and can occur at rest. Emphysema breathlessness is relieved by rest, asthma is not.

Chronic bronchitis is characterised by a cough and phlegm. Bronchiectasis has the same symptoms, but has structural damage to bronchial tubes, visible on a CT scan of the lungs and is not necessarily related to smoking.

Wheezing is a noise on breathing out and can occur with all these diseases, as well as asthma.

Smokers are much more likely than non-smokers to suffer chest infections, for instance 'the cold that goes to the chest', as well as sinus infections.

Pneumonia is a more serious chest infection and is also much more likely in smokers.

The symptoms include:

• breathlessness on exertion
• in severe cases, breathlessness even when at rest
• wheezing
• coughing
• coughing up sputum
• fatigue
• increased susceptibility to chest infections.

If you suspect you or a family member has COPD

Many people mistake their increased breathlessness and coughing as a normal part of ageing. In the early stages of the disease, you may not notice the symptoms.

COPD can develop for years without noticeable shortness of breath. You begin to see the symptoms in the more developed stages of the disease so it's important to talk to your doctor as soon as you notice any symptoms.

If you have symptoms or are at risk of developing COPD, make an appointment with your GP for a consultation and a lung function test.

If you do not have any symptoms but are ready to quit smoking, make an extended appointment with you GP to discuss the process of quitting.

There is no cure for COPD, and the damaged airways don’t regenerate. However, there are things you can do to slow progress of the disease, improve your symptoms, stay out of hospital, and live longer.

The best 'treatment' for COPD is prevention. If you are a smoker, consider talking to your GP about quitting. COPD sets in slowly over many years and can often go undetected while you are smoking.

If you have already been diagnosed with COPD, it is never too late to quit. Quitting smoking will provide the most beneficial step in slowing the progress of the disease as well as overall management and reduction of your symptoms.

COPD cannot be treated or cured once you have been diagnosed, it can only be managed through a combination of medical and lifestyle changes to avoid flare-ups and to help you live more comfortably.

How can it be managed?

Effective management of established COPD is based on a partnership between you, your carer and/or family, and your health care team. While there is no cure for COPD, there are a number of management options which can be used to help you live a more comfortable life. It is important that you create and follow a COPD management plan which in partnership with your health care team. This plan will help you to:

• understand your medications, their side effects, and how to use them appropriately
• monitor your symptoms and take appropriate actions to avoid exacerbations
• make suitable changes to your lifestyle to support healthier and happier living
• identify when you need to seek additional medical attention.

Management options can include:

• Medical interventions:
  • pulmonary rehabilitation: This is a supervised exercise and information program which is valuable for many chronic lung conditions. It has been proven to reduce symptoms and their severity as well as reduce your chance of being hospitalised for COPD. It also helps to increase fitness which improves your cardio-vascular function and builds strength in muscles crucial to improve your breathing.
  • bronchodilator medication to open the airways
  • corticosteroid medication to help with exacerbations, along with antibiotics
  • treatment for chest infections such as antibiotics
  • annual flu vaccine
  • some surgical or stent interventions for some people with very advanced disease, such as lung volume reduction and lung transplant
  • oxygen therapy: oxygen does not relieve or lessen symptoms. Instead it is used to prevent or reverse the potential of heart failure which is a secondary risk for people with COPD. Symptoms of heart failure often show as excessive swelling in the ankles in people with advanced COPD.
  • ongoing monitoring by a medical professional
• Lifestyle changes
  • quitting smoking
  • being as physically active as possible and avoiding being sedentary
  • eating healthily
  • keep adequately hydrated
  • avoid smoky or dusty environments
  • manage stress, anxiety, and depression
  • join a support group to learn how others with similar conditions manage their health, and to gain mental, emotional, and social support.

If left untreated

You can prevent the development or significantly reduce your risk of developing COPD by quitting smoking and living a healthy, active lifestyle. If you are at risk of COPD due to occupational exposure to lung irritants, talk to your employer or Worksafe about the most appropriate personal protective equipment for your circumstances.