Chronic Obstructive Pulmonary Disease (COPD) – more than just a smoker’s cough. | 5 min read

Chronic obstructive pulmonary disease (COPD) is a common, life-threatening lung disease that restricts airflow and causes breathing difficulties, often resulting from damage to the airways and lungs. It is now considered to be a multi-system disease with effects that extend beyond the lung to affect other organs. It is one of the fastest growing causes of death worldwide.

How smoking affects your lungs and leads to COPD

COPD is often caused by smoking cigarettes. And it’s not just smokers who are at risk – even breathing in second hand smoke can be harmful. Normally, your lungs are flexible organs that help you breathe by exchanging oxygen and carbon dioxide. They’re designed to stretch and relax easily with each breath. Cigarette smoke contains many harmful chemicals. When you smoke, these toxins enter your lungs and cause damage over time.

Changes in smokers’ lungs include:

1. Inflammation: Smoking causes your lungs to become inflamed or swollen.
2. Excess mucus: Your lungs produce more mucus than usual.
3. Loss of elasticity: The airways in your lungs become damaged and less stretchy.
4. Breathing difficulties: Because the lungs lose their stretchiness, they tend to collapse more easily when you breathe out. This makes breathing harder.
5. Impaired gas exchange: The tiny air sacs (alveoli) and blood vessels in your lungs, which are crucial for exchanging oxygen and carbon dioxide, also get damaged.

All these changes add up to make breathing difficult. Your lungs can’t do their job as well as they should, which is what happens in COPD. Protecting your lungs from smoke – both firsthand and second hand – is crucial for maintaining healthy breathing.

COPD is not just one illness, but a group of lung diseases. The two most common types are emphysema and chronic bronchitis. These conditions make it hard to breathe and get worse over time. If a person with COPD continues to smoke, the disease typically worsens faster. People with COPD often experience flare-ups or “exacerbations.” These are periods when symptoms suddenly get worse, often due to recurrent lung infections.

Surprising causes of COPD

While many people think COPD is just a smoker’s disease, that’s not the whole story. In fact, in South Africa, almost half of COPD cases come from causes other than cigarette smoking. Here are some other factors that can lead to COPD:

• Having had tuberculosis (TB) in the past
• Using marijuana
• Exposure to dust or fumes at work, especially in mining
• Genetic factors
• Living in areas with high air pollution
• HIV infection
• Using fuels like wood or coal for cooking (called biomass fuels)

In South Africa, nearly half of all COPD cases are caused by factors other than cigarette smoking. This means that even if you’ve never smoked, you could still be at risk for COPD.

Symptoms of COPD

Common symptoms of COPD include:

• shortness of breath especially on exertion
• chronic cough with mucus production
• wheezing
• recurrent chest infections, and
• weight loss.

Even after recovering from TB, some people find they’re still short of breath. This persistent breathing difficulty can develop into COPD. Other conditions also related to smoking include cancers of several organs, osteoporosis, depression and ischaemic heart disease. COPD may put extra strain on your heart. This can lead to heart failure, where your heart struggles to pump blood effectively.

COPD or asthma?

COPD is often mistaken for asthma because both can cause wheezing. But not all wheezing is asthma. If you’re having breathing problems, it’s crucial to get a professional diagnosis. To figure out if you have COPD, your doctor might:

1. Test how well your lungs work i.e. pulmonary function tests
2. Take images of your lungs (like X-rays or scans)
3. Determine how severe your condition is.

Why early diagnosis matters:

• Getting the right diagnosis means getting the right treatment.
• Too often, people only seek help when their condition is advanced and harder to treat.
• It’s much better to catch and treat COPD early.

The power of prevention:

• The best approach is to prevent COPD before it starts.
• This means protecting your lungs from harmful substances like smoke and air pollution.
• Regular check-ups can help catch potential problems early.

Treating COPD: Your path to better breathing

If you smoke and have COPD, the most powerful thing you can do is quit smoking. Here’s why:

• Your sense of taste and smell improve
• Your lungs work better
• You’ll feel less short of breath
• Your lungs become better at fighting off infections

Quitting isn’t easy, but you’re not alone. The key to quitting is your own determination while medications and counselling can help support your efforts.

Other COPD treatments

1. Inhalers

• Special inhalers can help you breathe easier
• They can also help prevent chest infections
• Unlike in asthma, steroid inhalers aren’t as important for early-stage COPD. Your doctor will let you know if and when you need them

2. Protecting your lungs

• Preventing chest infections is crucial – they can cause more damage to your lungs
• Two key ways to do this:
• a) Using your inhalers as prescribed
• b) Getting a flu shot every year

If you’re having trouble breathing, don’t just chalk it up to getting older or being out of shape. Talk to a doctor about COPD. With the right care, you can breathe easier and live better!