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COPD: what is it?

Written by Healthwords's team of doctors and pharmacists based in UK | Updated: 23.02.2023 | 3 min read

Chronic obstructive pulmonary disease, or COPD, is a long-term lung condition that causes breathing difficulties. It usually occurs in those over 35 in response to damage from smoking. The more you smoke, and the longer you smoke, the more likely you are to develop COPD.

Unfortunately, this condition cannot be cured or reversed and it tends to get progressively worse over time. Symptoms and flare-ups can be managed with inhalers, medications, and breathing techniques to exercise the lungs. Further damage can be reduced by stopping smoking.

What happens to the lungs?

COPD is a combination of inflammation, mucus production, and lack of elasticity in the lung tissue. People sometimes refer to COPD by the subcategories: emphysema and chronic bronchitis. Airway tubes – the bronchioles – can get inflamed and swollen, causing the tubes to narrow, which usually gives the wheezy bronchitis symptoms. Along with this, you may produce more mucus, blocking the airways and causing a thick chesty cough.

The airway tubes lead to tiny air sacs, like balloons – in emphysema these air sacs get less elastic, so they are harder to inflate (think of how tough it is to start blowing up a balloon) and join together, which allows less exchange of oxygen to the bloodstream and tissues. This makes you feel out of breath.

Some may have more of one sub-category than the other, but most have a combination of both, and treatment is much the same, according to symptoms and flare-ups.

When should I suspect COPD?

Many people don’t realize they have COPD, and as symptoms come on gradually, they often dismiss them as a smoker’s cough or lack of fitness. If you are a smoker or ex-smoker and have a persistent cough where you bring up thick sputum, if you feel wheezy or short of breath with minimal exercise, and if you suffer frequent chest infections, these are all reasons to book a routine appointment with your doctor.

If you are a smoker with a cough that persists beyond three weeks, you are coughing up blood, and you may also have weight loss, you should book an urgent appointment with your doctor as this could need urgent investigations.

How is it diagnosed?

Your doctor will assess your symptoms, take your vital signs and listen to your chest and heart. They will likely order further tests, which may include lung function tests, a peak flow diary, the trial of an inhaler, and a symptom diary, or they may order a chest X-ray.

Lung function tests are usually conducted by your doctor or practice nurse. You blow into a tube, and a machine records how well your lungs are working. COPD gives a distinctive pattern compared to other lung conditions like asthma.

Does COPD only occur in smokers?

Smokers or ex-smokers account for most cases of COPD. Passive smoking may also cause it, if you’ve had prolonged exposure either at home or through your job.

Your job may expose you to other harmful chemicals, such as asbestos, welding fumes, silica, coal dust or grain and flour dust. These can cause COPD as they can damage the lungs in the same way as smoking over long-term exposure. If you smoke, too, these irritants can combine to be even more damaging to your lungs, increasing your chance of COPD and accelerating the process of damage.

You may develop COPD if you have a rare genetic condition called alpha-1 antitrypsin deficiency. You may have a family history of this; it usually develops at a younger age and it’s not smoking-related.

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