Understanding COPD: Symptoms, Diagnosis | For UK residents, from Chiesi.

COPD explained

COPD stands for Chronic Obstructive Pulmonary Disease, which means¹

Chronic - it's long-term
Obstructive - your airways have become narrower, slightly blocking, or obstructing, the flow of air as you breathe out
Pulmonary - it affects your lungs
Disease - it's a medical condition

The term COPD is used to describe a group of lung conditions that make it difficult to empty the air out of your lungs. This happens when lung tissue has been damaged, making the airways narrower. Mucus can also partially block airways, and the lining of the airways can become swollen and inflamed.¹All of these things make it harder for air to move in and out as you breathe, and your lungs are less able to take in oxygen and get rid of carbon dioxide.¹

What causes COPD?

COPD is usually caused by breathing in harmful substances over a long period of time, in particular, cigarette smoke. But it can also be caused by air pollution or working in jobs with lots of dust, fumes or chemicals.¹

While COPD can’t be cured, it’s possible to manage it and live well with the condition. On these pages you’ll find lots of guidance and advice to help you.

If you’re ever unsure of anything to do with your COPD, please always contact your doctor, nurse, pharmacist or other healthcare professional involved in your care.

What symptoms might I experience with COPD?

COPD is a long-term condition that develops slowly over many years. Most people do not notice any symptoms until they reach their late 40s or 50s.²

Common symptoms of COPD include:²

Shortness of breath – to begin with you might only notice an increase in breathlessness when you’re exercising, or sometimes you may wake up at night feeling short of breath
Chesty cough – a cough with phlegm (mucus) that doesn’t go away
Chest infections – you might notice you’re getting these more often
Persistent wheezing – a whistling sound when you breathe

Although the symptoms usually get gradually worse over time, it is helpful to remember that the right medication can help slow things down.²

You can find more information on the different stages of COPD here.

What are flare-ups?

You may experience times when your symptoms suddenly get worse and don’t get better after a few days. This is called an ‘exacerbation’ or a ‘flare-up’.³

Signs of a flare-up:³

Feeling a lot more breathless than usual
Coughing more
Producing more phlegm (mucus)
Your phlegm (mucus) changes colour or gets stickier

Your chest feels tight or heavy

You have a pain that spreads to your arms, back, neck and jaw

You feel or are being sick

What causes a flare-up?

Flare-ups can be triggered by an infection, so if you get a cold it is good to pay attention to your symptoms and look out for any changes. It’s also useful to keep an eye on the weather forecast as extreme cold or hot, humid weather can make breathing more difficult.^3,4

While there is no controlling the weather, other things you can do to reduce your risk of having a flare-up include avoiding dusty places, car fumes, hairspray and air freshener sprays or plug-ins.⁴

For information on what to do if you are experiencing a flare-up, see When should I use my Rescue Pack?

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What’s the difference between COPD and asthma?

You may be thinking that these symptoms sound the same as those for asthma, and you’d be right. In fact, it can be hard sometimes for your medical team to know whether you have COPD or asthma. Also, you may already have asthma, but go on to develop COPD.¹

The key difference is that, with COPD, your airways have become permanently narrowed. Your medication will help open them up a bit, but not fully. In asthma the narrowing comes and goes, and treatment can open the airways fully.¹

However, whether you are experiencing COPD or asthma it is important that you speak to your medical team to get a diagnosis and the right treatment for you. Keep track of your symptoms and whether they get worse at certain times, and make a note in your discussion list to remember to discuss them at your next appointment.

How is COPD diagnosed?

If you have been experiencing the symptoms of COPD, your medical team will ask you a few questions and send you for some tests. These are simple to do and are an important part of making sure you get the right treatment.

To start with, a healthcare professional will take a general medical background and ask about your symptoms. Questions might include:^5,6

Do you cough?
Do you have a lot of phlegm (mucus)?
Does anything trigger your breathlessness?
Do you smoke or have you ever smoked?
What do (or did) you do for work, and have you been exposed to dust, fumes or chemicals regularly?
Did you have chest problems as a child, or does anyone in your family have lung problems?
Is your daily life affected by your symptoms?

Before your appointment it will be useful to think about these questions and write down some notes, so you don’t have to remember everything on the day.

Testing for COPD

To find out if your symptoms are caused by COPD and not something else, like an infection or asthma, you will need to have a few different tests.⁶

Spirometry

This is a simple test that will quickly show if your airways are blocked (obstructed). It measures the total amount of air you can blow out, and how quickly you can empty your lungs.^5,7

You will be given a medicine to help open your airways, before blowing as hard and fast as you can into a machine. To make sure the reading is correct you may need to do it several times.^5,6

Before deciding if your airways are obstructed because you have COPD, it is important that other causes are ruled out.

Chest x-ray

Symptoms similar to COPD can be caused by a chest infection or lung cancer. A chest x-ray will help identify whether you could have these other conditions and make sure you get the right treatment if necessary.⁶

Blood test

Like the chest x-ray, blood tests will help check for other causes of your symptoms, such as having low iron levels (anaemia) and a high level of red blood cells (erythrocytosis).⁶

Other tests

There are many other measurements or tests you might have before your medical team gives an exact diagnosis or to check the stage of your COPD.⁶

These may include:⁶

A peak flow test: a different way to measure how fast you can blow air out of your lungs and will help rule out asthma as the cause of your symptoms
A CT scan: this takes detailed images of your lungs
Blood oxygen test: to see if you are getting enough oxygen into your blood
A phlegm sample: to check if you have a chest infection

To get the correct treatment it is important to have the correct diagnosis. If you have any questions about your tests and the results, use your discussion list to remind you to ask at your next appointment.

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Healthcare professionals you may meet

When you have a chronic condition such as COPD, you can feel as if there are so many people involved in your care that you don’t know who is responsible for what. You may also find that at different stages of your care you will have appointments with different healthcare professionals. This is normal, and don’t worry if you don’t see your doctor at every appointment.

Understanding the role of each healthcare professional might help you to feel more confident in the care you are getting:

Doctor: your doctor, at your local practice, will be one of your main points of contact when helping you with the diagnosis and general management of your COPD. Your doctor can also refer you to other healthcare professionals for more specialist care if you need it.

COPD nurse: a specialist nurse can give you advice to support you, which may help with reducing symptoms and improving your quality of life. For example, a COPD nurse could help you with advice to reduce or stop smoking, increase your physical activity, and manage your pulmonary rehabilitation (if appropriate).

Pharmacist: your pharmacist can advise on relief from symptoms including your cough. They will also be able to help with repeat prescriptions so you don’t accidentally run out of your medication.

Pulmonologist: you might be referred by your doctor to see a pulmonologist who is a specialist that treats diseases involving the respiratory system. They will help confirm your diagnosis of COPD, administer tests to check your lung function, and be instrumental in helping to decide the best treatment path for you.

Respiratory specialist: this is simply a healthcare professional who specialises in the respiratory system, such as a COPD nurse or a pulmonologist.

Want to discuss this topic in your next appointment?

References

Asthma + Lung UK. What is COPD? Available at: https://www.asthmaandlung.org.uk/conditions/copd-chronic-obstructive-pulmonary-disease/what-copd
NHS. Chronic obstructive pulmonary disease. Symptoms. Available at: https://www.nhs.uk/conditions/chronic-obstructive-pulmonary-disease-copd/symptoms/
Asthma + Lung UK. Managing COPD flare-ups. Available at: https://www.asthmaandlung.org.uk/conditions/copd-chronic-obstructive-pulmonary-disease/managing-copd-flare-ups
NHS. Living with chronic obstructive pulmonary disease. Available at: https://www.nhs.uk/conditions/chronic-obstructive-pulmonary-disease-copd/living-with/
Asthma + Lung UK. How is COPD diagnosed? Available at: https://www.asthmaandlung.org.uk/conditions/copd-chronic-obstructive-pulmonary-disease/how-copd-diagnosed
NHS. COPD diagnosis. Available at: https://www.nhs.uk/conditions/chronic-obstructive-pulmonary-disease-copd/diagnosis/
Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global strategy for the diagnosis, management and prevention of COPD. Available at: https://goldcopd.org/2023-gold-report-2/

Introduction to COPD.

COPD explained

What causes COPD?

What symptoms might I experience with COPD?

Want to discuss this topic in your next appointment?

What are flare-ups?

IMPORTANT:

Your chest feels tight or heavy

You have a pain that spreads to your arms, back, neck and jaw

You feel or are being sick

What causes a flare-up?

What’s the difference between COPD and asthma?

How is COPD diagnosed?

Testing for COPD

Spirometry

Chest x-ray

Blood test

Other tests

Healthcare professionals you may meet

Want to discuss this topic in your next appointment?

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