COPD – Chronic obstructive pulmonary disease

Published by Bupa’s Health Information Team, October 2011.

This factsheet is for people who have chronic obstructive pulmonary disease (COPD), or who would like information about it including the symptoms, causes and treatments.

COPD describes a number of long-term lung conditions that cause breathing difficulties.

Animation – how COPD develops

About COPD

It’s estimated that three million people in the UK are affected by COPD and it’s more common as you get older. COPD is a life-threatening lung disease that tends to get progressively worse and is most commonly caused by smoking.

A chronic illness is one that lasts a long time, sometimes for the rest of the affected person’s life. When describing an illness, the term ‘chronic’ refers to how long a person has it, not to how serious a condition is.

The term COPD has replaced the previously separate conditions of chronic bronchitis and emphysema.

  • Chronic bronchitis is inflammation of your bronchi – the main airways that lead from your windpipe (trachea) to your lungs. This inflammation can produce excess mucus that may block your airways and make you cough.
  • Emphysema damages the structure of your alveoli – these are tiny air sacs where oxygen passes into your blood. When the alveoli lose their elasticity this reduces the support of the airways, causing them to narrow.

The effects of COPD mean less oxygen passes into your blood.

Illustration showing the changes to the bronchioles and alveoli in COPD

Symptoms of COPD

At first, you may not notice any symptoms of COPD. The condition progresses gradually, starting with either a ‘phlegmy’ cough or breathlessness. Many people don’t see their GP at this early stage, but the earlier you get advice and treatment the better.

As COPD progresses symptoms can vary but may also include:

  • chronic cough
  • breathlessness with physical exertion
  • regularly coughing up phlegm
  • weight loss
  • tiredness and fatigue
  • waking up at night as a result of breathlessness
  • swollen ankles

You may find your symptoms are worse in the winter months.

It’s rare to get chest pains or cough up blood if you have COPD – if this happens, you may either have a different disease or another disease as well as COPD.

These symptoms aren’t always caused by COPD but if you have them, see your GP.

Causes of COPD

The biggest single cause of COPD is smoking. If you stop smoking, your chances of developing COPD begin to fall. If you already have COPD, stopping smoking can lead to an improvement of your symptoms and mean it progresses more slowly.

You’re also more likely to get COPD:

  • if your job exposes you to certain dusts or fumes
  • from environmental factors, such as air pollution
  • from inherited problems – an inherited shortage of a protein called alpha antitrypsin that helps protect your lungs from the effects of smoking may increase your risk, but less than one in 100 people with COPD have this
  • if you have a weakened immune system, for example HIV/AIDS

Diagnosis of COPD

Your GP will ask about your symptoms and examine you. He or she may also ask you about your medical history. If your GP thinks you have COPD, he or she will ask you about the problems you have with your chest and how long you have had them. He or she will usually examine your chest with a stethoscope, listening for noises such as wheezing and crackles.

It’s likely your GP will also perform a lung test called a spirometry test. He or she will ask you to blow into a device that measures how much and how fast you can force air out from your lungs. Different lung problems produce different results so this helps to separate COPD from other chest conditions, such as asthma. See our common questions for more information.

Other tests you may have are listed below.

  • A chest X-ray to see if your lungs show signs of COPD, and to exclude other lung diseases.
  • A blood test to look for anaemia or signs of infection.
  • A CT (computed tomography) scan to produce a three-dimensional image of your lungs.
  • An ECG (electrocardiogram) to measure the electrical impulses from your heart to check if you have heart and/or lung disease.
  • An echocardiogram to see how well your heart is working.
  • A pulse oximeter to monitor the amount of oxygen in your blood to see if you need oxygen therapy.
  • An antitrypsin deficiency test – you may need this if your COPD developed when you were 40 or younger, or if you don’t smoke.

Treatment of COPD

There isn’t a cure or a way to reverse the damage to your lungs, but there are things you can do to stop COPD from getting worse. The most important treatment is to stop smoking. Giving up smoking can relieve your symptoms and slow down the progression of COPD, even if you have had it for a long time. Speak to your GP about ways to give up smoking.


There are other steps you can take to stop COPD getting worse and to ease your symptoms. Some examples are listed below.

  • Keep up your fluid levels by drinking enough water and use steam or a humidifier to help keep your airways moist – this can help to reduce the thickness of mucus and phlegm that are produced.
  • Exercise to keep moving and eat a healthy diet to help your heart and lungs.
  • Have a flu vaccination each year, as COPD makes you particularly vulnerable to the complications of flu, such as pneumonia (bacterial infection of the lungs).
  • Have a vaccination for the Streptococcus pneumoniae bacterium that causes pneumonia.

Pulmonary rehabilitation

Ask your GP about pulmonary rehabilitation. These are programmes consisting of exercise, education about COPD, advice on nutrition and psychological support. They aim to help reduce your symptoms and make it easier for you to do everyday activities.


There are various medicines that may help to ease your symptoms or control flare-ups. Discuss with your GP which medicine is best for you.


These medicines are commonly used for asthma and COPD. They widen your airways so air flows through them more easily and relieve wheezing and breathlessness. They are available as short-acting or long-acting inhalers or tablets.


Steroid treatments may help if you have more severe COPD. Steroids work by reducing inflammation of the airways. They are available as inhalers or tablets. You may be prescribed a short course of tablets for one or two weeks when you have a flare-up, or some people may be given a steroid inhaler to take regularly.


Mucolytics break down the phlegm and mucus produced, making it easier for you to cough it up. Your GP may prescribe you a mucolytic if you have a chronic phlegm-producing cough.

Oxygen therapy

If your COPD becomes severe, you may develop low blood oxygen levels. Oxygen therapy can help relieve this. You inhale oxygen through a mask or small tubes (nasal cannulae) that sit beneath your nostrils.

The oxygen is provided in large tanks for home use or in smaller, portable versions for outside the home. An oxygen concentrator – a machine that uses air to produce a supply of oxygen-rich gas – is an alternative to tanks.

It’s particularly important to give up smoking if you have oxygen therapy for COPD because there is a serious fire risk. Oxygen therapy can either be short-term, long-term (when you use it all the time at home) or ambulatory (when you use it for exercise or when you’re outdoors).


If you have severe COPD, your GP may recommend surgery to remove diseased areas of your lungs. This can help your lungs to function better. However, it’s only carried out in certain circumstances – speak to your GP for more advice.

Prevention of COPD

You have the best chance of preventing COPD if you don’t smoke.

If your job exposes you to dust or fumes, it’s important to take care at work and use any relevant protective equipment, such as face masks, to help prevent you from inhaling any harmful substances.


For answers to frequently asked questions on this topic, see FAQs.

For sources and links to further information, see Resources.

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  • This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition. The content is intended only for general information and does not replace the need for personal advice from a qualified health professional. For more details on how we produce our content and its sources, visit the about our health information page.

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  • Publication date: October 2011

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