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Home / Asthma / Chronic obstructive pulmonary disease (COPD)

Chronic obstructive pulmonary disease (COPD)

Chronic obstructive pulmonary disease (COPD) is a lung condition that impacts your breathing and quality of life. It is often caused by long-term exposure to cigarette smoke.

Continue reading to explore the causes, symptoms, diagnosis, and treatment options for COPD.

What is COPD?

COPD is an umbrella term for lung conditions such as:

  • emphysema – this involves damage to the air sacs in the lungs, making it harder to breathe
  • chronic bronchitis – this condition involves long-term inflammation and narrowing of the airways

COPD is a very common condition. According to the World Health Organization WHO), it is the third leading cause of death Trusted source World Health Organization (WHO) Government Source International Public Health Information Go to source worldwide. COPD mainly affects middle-aged or older adults who smoke or have smoked.

While there is no cure, many treatments are available which can help slow down the progression and control the symptoms of this condition.

What causes COPD?

Tobacco smoking is the leading cause of COPD and is responsible for 40% to 70% of cases. Other risk factors are indoor and outdoor air pollution, and exposure to dust, chemicals, and fumes at work.


Smoking is thought to be responsible for 9 in 10 cases Trusted source NHS Government Source Go to source of COPD. The harmful substances in cigarette smoke can damage the lining of the lungs and airways, especially with repeated exposure. Inhaling passive smoke (also known as ‘second-hand smoke’) may also increase your risk of COPD.

Fumes and dust

Exposure to air pollution and certain dust and chemicals at work may damage your lungs and increase your risk of COPD.

Substances that can cause COPD include:

  • grain and flour dust
  • silica dust
  • welding fumes
  • coal dust

Working in certain occupations may also increase your chance of getting COPD. This includes fields such as:

  • agriculture
  • mining
  • construction
  • petrol
Graphic showing some causes of COPD


You may be more likely to develop COPD if you smoke and have a family history of this condition. This is because some genes make people more vulnerable to developing COPD.

What are the symptoms of COPD?

The main symptoms of COPD are:

  • shortness of breath
  • difficulty breathing
  • a chronic cough (with phlegm)
  • frequent respiratory infections
  • wheezing

Without treatment, the symptoms usually get worse with time.

If COPD becomes severe and advanced, you may experience less common symptoms such as:

  • weight loss
  • tiredness
  • ankle swelling (from fluid build-up)
  • reduced exercise tolerance

What are the different COPD stages?

There are usually 4 stages of COPD:

Stage 1 (mild)

Symptoms at this stage often go unnoticed and you may not have symptoms all the time. You may start coughing more and producing more phlegm. You may also be out of breath after you exercise.

Stage 2 (moderate)

Symptoms in this stage are the same as during stage 1 however, they last longer and are harder to ignore. You may also find it harder to do your normal daily activities without feeling out of breath. The cough becomes chronic and repetitive, phlegm is harder to cough up and can start disrupting your sleep.

Stage 3 (severe)

At this stage, you will likely experience symptoms most of the time and may have more flare-ups or chest infections. Your quality of life worsens and you may get tired even after you rest. You may also find it hard to walk upstairs or short distances without feeling out of breath.

Stage 4 (very severe or ‘end-stage’)

Your symptoms get worse and become more persistent and breathing becomes an effort. Your overall health worsens and you may experience sudden weight loss.

How is COPD diagnosed?

Many people can mistake different breathing-related conditions for COPD. Conditions that cause similar symptoms include asthma, bronchiectasis, and heart failure.

Your doctor may be able to make a COPD diagnosis by:

  • asking about your symptoms
  • asking about your risk factors, such as a family history of lung conditions or exposure to dust and fumes
  • asking if you smoke or previously smoked
  • examining your chest and listening to your breathing
  • calculating your body mass index (BMI)

Doctors diagnose COPD by performing a simple breathing test called spirometry. In this test, you will breathe into a spirometer machine after inhaling a medicine which helps open your airways. This test helps diagnose any lung conditions by measuring how much air you can breathe out in one forced breath.

Sometimes you may need to have a chest X-ray to help exclude other causes. Your doctor may also suggest doing a blood test to check for genetic problems that increase your risk of COPD.

How can COPD be prevented?

Avoiding smoking is the main way you can prevent COPD. If you already smoke, stopping can help prevent further damage to your airways and lungs. You can talk to one of our doctors about the treatments available to stop smoking.

If you have household members who smoke, encourage them to quit. This will benefit both you and them.

Use protective gear if you work in an industry where you are exposed to dust and toxic fumes. This should also be done if you are in areas with air pollution.

What COPD treatments are available?

COPD causes permanent damage to your lungs, while there is no cure, treatment can help slow down the progression and control the symptoms. Treatments include:


If COPD is causing breathing problems, your doctor may prescribe an inhaler for you. Inhalers are devices that deliver medicine directly into your lungs. There are many different types of inhalers used to treat COPD.


These medicines work by relaxing the smooth muscles in your airways, causing them to widen which makes breathing easier.

There are 2 types of beta-2-agonists:

Short-acting beta-agonists (SABAs) Long-acting beta-agonists (LABAs)
These give you immediate relief of symptoms (within 15 minutes) and have effects that last for 4–6 hours. These are slower to start working, but last longer (for 12 or more hours).
SABAs include salbutamol and terbutaline and are present in inhalers such as Ventolin, Salamol and Bricanyl. LABAs include salmeterol, formoterol, indacaterol and olodaterol. They are present together with steroids in inhalers such as Symbicort, Seretide, Onbrez Breezhaler and more.

These widen the airways by blocking the effect of acetylcholine, which causes the smooth muscle to relax.

The two types are:

Short-acting muscarinic antagonist (SAMA) Long-acting muscarinic antagonists (LAMAs)
These can be used for short-term relief in mild COPD. They work within 30–60 minutes and the effects last for 3–6 hours. These work similarly to SAMAs but the effects last longer.
SAMAs such as ipratropium are found in brands like Atrovent. LAMAs include tiotropium, aclidinium, glycopyrronium, and umeclidinium.
Steroid inhalers and tablets

Your doctor may prescribe these medicines if you still get breathless despite using a long-acting inhaler, or if you have frequent flare-ups. Inhaled corticosteroids (ICS) work by decreasing inflammation, swelling, and the amount of mucus made inside the airways.

Steroid inhalers are not used on their own, but rather as part of combination therapy.

If you experience a flare-up, your doctor may prescribe a short course of an oral corticosteroid.



This medicine widens the airways, which makes it easier to breathe. It is not used as much as there are now more effective treatments, such as inhalers. However, when it is used it must be monitored closely with blood tests due to its risks, side effects, and interactions.


Patients with COPD have a long-lasting chesty cough and produce lots of thick phlegm. In this case, your doctor may prescribe medicines to thin the mucus and make it less sticky and easier to cough up. These include medicines such as carbocisteine or acetylcysteine.


These may be prescribed if you have signs of an infection. This is because people with COPD are likely to experience frequent chest infections, which can cause serious problems.

What other therapies are available?

Pulmonary rehabilitation

This is a treatment programme which teaches people how to manage COPD symptoms to improve their quality of life. It can help improve COPD symptoms, the ability to exercise, and both emotional and mental well-being.

Plans may include:

  • advice on conserving energy
  • techniques to manage breathlessness
  • physical exercise training
  • COPD education
  • support

Oxygen therapy

This is an option for people with long-term or severe COPD if blood oxygen levels are low. Oxygen therapy can be given at home through nasal tubes or a mask.

If your blood oxygen levels are normal while you're resting but drop when you are active or exercise, your doctor may recommend having some form of oxygen therapy.

Nebulised therapy

This is when a machine is used to turn liquid medicine into a mist that you can breathe in. This mist is inhaled through a mouthpiece or a face mask.

Surgery or a lung transplant

Surgery is usually the last step in the management of severe COPD. Usually, doctors use it for patients whose symptoms are not controlled with medicines alone.

The 3 types of surgery include:

  • bullectomy – removal of the enlarged, damaged air sacs in the lungs.
  • lung volume reduction surgery – removal of the damaged areas of the lung to allow the healthier parts to work better.
  • lung transplant – removal and replacement of a damaged or diseased lung with a healthy lung from a donor

These procedures may involve many risks which will be explained to you by your doctor.

Can I buy treatment for COPD online?

You can order treatment for COPD online from euroClinix. All you need to do is complete a quick and easy online consultation form before you order.

This will allow our doctors to check your symptoms and medical history and decide on the correct treatment plan for you. All orders will then be shipped to your chosen address with discreet packaging.

Medically reviewed by Dr. Plauto Filho Written by our editorial team Last reviewed 21-02-2024

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