Chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease (COPD) is the general name for a collection of diseases which affect the lungs, including chronic bronchitis, emphysema and chronic obstructive airways disease. Often people with COPD have both emphysema and chronic bronchitis. People with COPD have trouble breathing in and out (airflow obstruction) and their lungs become inflamed due to irritation (usually by cigarette smoke).

It is not fully understood why or how COPD develops, but smoking is by far the most common cause of the condition because cigarette smoke inflames and damages the delicate lining of the airways.

In Cornwall and the Isles of Scilly there are over 8,000 people that are living with COPD. This extends to nearly 900,000 people across the UK, but most people are not diagnosed and around three million people in the UK may have the condition. The older you are the more likely you are to develop COPD. The average age at which COPD is diagnosed in the UK is 67, usually after many years of less severe symptoms.

Over many years the inflammation leads to permanent changes in the lung. These changes cause airflow obstruction, where the flow of air into and out of the body is impaired. The airflow is reduced because the walls of the airways get thicker in response to the inflammation and more mucus is produced. Damage to the delicate walls of the air sacs in the lungs means the lungs lose their normal elasticity, and it becomes much harder work to breathe, especially on exertion.

It is the changes in the lungs that lead to the symptoms of COPD: breathlessness, cough and phlegm. Although any damage that has already occurred to your lungs cannot be reversed, you can prevent COPD from developing or getting worse by making changes to the way you live.

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Understanding asthma

Asthma is a long-term condition in which over-sensitive airways become narrow and inflamed, making it difficult to breathe in and out normally. Its cause is not completely understood, but asthma is one of a group of allergic conditions, including eczema and hayfever, which often occur together.

You are more likely to develop asthma if:

• You smoke
• You have another allergic disease, such as eczema or hay fever
• A close relative has asthma, eczema, hay fever or allergic conjunctivitis
• You were born prematurely or with a low birth weight
• You had bronchiolitis as a child
• You were exposed to tobacco smoke as a child

Asthma is usually experienced as an episode. There are periods of time when you have asthma symptoms, but in between you are generally well, even for periods of many years. The severity and duration of symptoms vary and are difficult to predict.

Talk to your doctor or nurse about how severe your asthma is and the long-term outlook.

• If your asthma is mild to moderate, your asthma may improve over time, and many adults even become symptom-free.
• Even in severe cases, some adults with asthma may experience improvement, depending on the degree of obstruction in the lungs and the timeliness and effectiveness of treatment.

In about one in 10 people with severe, persistent asthma, the structure of the walls of the airways changes, which leads to progressive problems in lung function.

Asthma is a serious condition, but one that can be well-controlled in most people.

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