“Smoker’s cough” or something else? GP, Alice Fitzgibbon discusses Chronic Obstructive Pulmonary Disease (COPD)
This month’s article is about a condition known as Chronic Obstructive Pulmonary Disease (COPD). COPD is the name used to describe several conditions that cause breathing difficulties due to lung damage. Most commonly, this lung damage is caused by smoking.
COPD is a very common condition, and many people can have it without realising. It often gets worse slowly over time and can be treated but, as the lung damage is irreversible, cannot be cured.
Tobacco smoke contains nicotine, carbon monoxide, tar and toxic chemicals such as benzene, arsenic and formaldehyde. Nicotine, while extremely addictive, is not the harmful component of tobacco. That is why nicotine replacement can be used to help people quit smoking. The carbon monoxide, tar and other toxic chemicals found in cigarettes and other tobacco products are what cause damage in the lungs.
These chemicals cause irritation and damage the tiny airways. This causes narrowing of the tubes and the lungs cannot work as well. The function of the lungs is to allow us to breathe in oxygen, and breathe out of carbon dioxide, which the body produces naturally. If the lungs are damaged, it stops us getting as much oxygen as our bodies need to work well. This can put extra strain on the heart.
The chemicals inhaled from smoking also damage the lungs in a way that stops our body’s protective mechanisms from working. Our airways are lined with tiny hairs called cilia. Cilia help us clear any dirt and dust we inhale, and also move along any mucous we produce – helping us to cough it up. When they are damaged, the dirt and dust settles in the airways and this can cause more irritation and lead to lung infections.
COPD generally affects people who smoke. It can also happen to non-smokers who have a rare genetic condition. Some other cases can be due to long term exposure to harmful dust particles or certain fumes. The symptoms of COPD are:
- feeling increasingly short of breath, particularly when being active
- a constant chesty cough with phlegm
- recurrent chest infections
- wheezing
As a GP, I like to see anyone with a persistent cough especially those who smoke. We know that persistent cough can be sign of lung cancer and, of course, we want to get people checked out for this as early as possible. Some signs of COPD might be seen on a chest X-ray, but often other breathing tests, called spirometry, can be used to help make a diagnosis.
As mentioned before, COPD can be treated to allow the symptoms to be controlled, but it cannot be cured as the damage is already done. Stopping smoking is the best thing that can be done to help in COPD as it prevents any further damage from happening. By contacting your GP practice, local pharmacy or the NHS Smokefree webpage, you should be able to find out about help to stop smoking in your area. If you want to stop, the support is available.
The main treatment of COPD is inhaled medication. There are many different inhalers depending on how severe symptoms are. In COPD, people can have sudden flare ups of their symptoms – this is called an exacerbation. If this happens, tablet forms of medications such as steroids and antibiotics may be needed. In some areas, patients may be offered a place on a pulmonary rehabilitation course- this is a specialised programme of exercise and education to help manage COPD as a long term health condition.
In some cases, COPD can continue to progress despite treatment. This can have a big impact on patient’s quality of life if they have severe breathing difficulty. In some cases, oxygen therapy might be needed. End stage COPD is a life limiting condition.
Smoking is implicated in many health conditions. Reducing tobacco use and preferably stopping it altogether leads to many health and financial benefits for patients. If you have concerns about the health of your lungs, symptoms that could be cancer or want to stop smoking, then please see your GP to discuss further.
For more information on Chronic Obstructive Pulmonary Disease (COPD) from the NHS visit https://www.nhs.uk/conditions/chronic-obstructive-pulmonary-disease-copd/symptoms/
For more advice on giving up smoking from the NHS visit https://www.nhs.uk/better-health/quit-smoking/
