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Chronic obstructive pulmonary disease (COPD)

WebMD Medical Reference
Medically Reviewed by Dr Rob Hicks

What is COPD?

Chronic obstructive pulmonary disease, or COPD, is a term for a number of respiratory conditions – including chronic bronchitis and emphysema – that cause difficulty breathing and long-term damage to the lungs.

In COPD, the airways to the lungs become inflamed and narrowed (as in chronic bronchitis), or the air sacs in your lungs may be damaged (as in emphysema), affecting the person's ability to breathe. There may be permanent scarring on the lungs.

There may be no marked changes in the condition for several months, but it is generally a progressive disease that becomes worse in the long-term. Flare-ups, attacks or worsening of symptoms are more common during the winter months, making it harder to breathe and making the person cough more. During severe attacks a person may need hospital treatment.

COPD is most often caused by smoking cigarettes, and the more you smoke and the longer you smoke, the greater the likelihood there will be of developing the condition. However, COPD can sometimes be caused by long-term asthma, or long-term exposure to fumes, dust or air pollution. In rare cases it is caused by a genetic disorder such as alpha-1 antitrypsin deficiency.

According to the National Institute for Health and Care Excellence (NICE), an estimated 3 million people living in the UK have COPD, but only 900,000 of these people have been diagnosed with the condition, with the remaining 2 million-plus people remaining undiagnosed. People with COPD are normally in their fifties before a diagnosis of the condition is made.

What are the symptoms of COPD?

They symptoms of COPD tend to develop over a number of years rather than appearing suddenly, and they are not usually apparent before the age of 35. Someone with COPD may experience several symptoms that interfere with daily life. These include:

  • Breathlessness during activities or exercise
  • A persistent cough that doesn't clear up – it can be mistaken for a "smoker's cough"
  • Regular coughing up of phlegm
  • Frequent bronchitis in winter
  • Wheezing

A person with COPD may also experience weight loss, tiredness, fatigue, swollen ankles, and anxiety or depression.

A person with the symptoms of COPD should seek medical advice for a diagnosis and to rule out any other conditions.

How is COPD diagnosed?

Because there is no specific test for diagnosing COPD, doctors have to rely on their judgement based on a combination of several factors, which include:

  • The patient's medical history
  • A physical examination, using a stethoscope to listen to the chest
  • A spirometry test, which measures the amount of air flowing in and out of the lungs, to confirm the presence of airflow obstruction

Your doctor will ask a number of questions to establish your symptoms, and these may also include certain questions – such as if you have chest pain – to rule out COPD and raise the possibility of a different diagnosis.

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