Chronic obstructive pulmonary disease

What is it?

Chronic obstructive pulmonary disease is the name for a group of lung diseases that cause difficulty breathing, including emphysema (damage to the air sacs) and chronic bronchitis (NHS). The WHO defines it as a common lung disease that limits airflow and causes breathing problems.

According to the WHO: the third leading cause of death worldwide with 3.4 million deaths in 2023 (about 6% of the world's deaths), and nearly 90% of the disease's deaths under age 70 occur in low- and middle-income countries.

Causes

Smoking is the most important cause (NHS). The WHO states that tobacco is responsible for more than 70% of cases in high-income countries and for 30 to 40% of them in low- and middle-income countries.

Other factors according to the WHO: occupational exposure to dust, fumes and chemicals, household air pollution from biofuels or coal, poor fetal growth, prematurity, respiratory infections in childhood and childhood asthma, and alpha-1 antitrypsin deficiency (a rare inherited condition).

Symptoms

Shortness of breath on exertion, a persistent cough with phlegm (often dismissed as “smoker's cough”), frequent chest infections, and persistent wheeze (NHS). The WHO also lists tiredness. Symptoms gradually worsen and may be interrupted by sudden exacerbations that usually last several days.

How is it diagnosed?

Diagnosis is confirmed by spirometry, a lung function test (WHO). The NHS lists breathing tests arranged by the doctor to confirm the disease and rule out other diseases such as asthma.

Treatment

The treatment categories usually used are listed here; this is not a prescription. The doctor chooses the plan according to each person's condition; do not change any medicine or dose without a specialist.

The disease cannot be cured but can be controlled (WHO). Options include: inhaled bronchodilators, which are the core treatment, inhaled corticosteroids, oxygen therapy in severe cases, pulmonary rehabilitation, surgery in selected cases, and antibiotics and corticosteroid tablets during exacerbations. The NHS describes quitting smoking as the most important step, and mentions lung transplant rarely.

Complications

The WHO lists associated risks: lung infections, lung cancer, heart problems, muscle weakness, osteoporosis, and depression and anxiety.

Prevention

Quitting smoking or vaping is the most important, along with avoiding second-hand smoke, physical activity, the annual influenza vaccine and the pneumonia and COVID-19 vaccines, and avoiding indoor air pollution (WHO).

Common questions