Chronic obstructive pulmonary disease (COPD) is a long-lasting lung disease where the small airways in the lungs are damaged, making it harder for air to get in and out.

COPD is called obstructive because it limits the flow of air into and out of your lungs. Reasons for this include:

• your lungs produce more mucus than normal, blocking your airways
  
• your lungs and airways lose their elasticity (ability to stretch)
  
• the walls of your airways become thickened and inflamed
  
• parts of your lungs are damaged or destroyed.
  

Emphysema and bronchitis are older names for this condition.

People with COPD usually have one or more of these symptoms:

• feeling short of breath
  
• a cough that lasts a long time (more than 3 months)
  
• a cough with mucus most days
  
• wheezing (a whistling sound when you breathe)
  
• chest tightness.
  

The most common symptom of COPD is feeling short of breath. Simple everyday activities, like walking short distances or climbing up a few stairs, can cause someone with COPD to feel short of breath. As the disease gets worse, breathing can become difficult even at rest.

Feeling short of breath is not a normal sign of ageing and ignoring it could delay a diagnosis and treatment. Talk to your health professional if you are short of breath when doing simple chores and activities.

COPD exacerbations (a flare-up of symptoms) are common complications of COPD.

The signs and symptoms of an exacerbation are a worsening of many of your usual symptoms of COPD.

Having a flare-up can increase your loss of lung function as well as increasing the likelihood of you having another flare-up, especially if your disease is mild.

If you have COPD, you should be familiar with your medicines so that you know what steps to take at the first signs of an exacerbation.

Ask your health professional to help you develop a COPD Action Plan to help manage your condition, avoid triggers and keep you out of hospital.

The most common cause of COPD is long-term cigarette smoking. The more you smoke, the greater your risk of developing COPD.

Other causes of COPD include:

• Second-hand smoke. Some non-smokers can develop COPD from being exposed to second-hand smoke, often at home or at work.
  
• Workplace exposure to dusts and chemicals. Certain chemicals and dust (such as coal dust) can contribute to the development of COPD.
  
• Genetics. An uncommon inherited genetic disorder, alpha1-antitrypsin deficiency, is known to cause COPD. This disorder can be diagnosed by a blood test.
  
• Frequent lung infections as a child. Evidence suggests that frequent lung infections as a child, especially before 2 years of age, can increase the risk of developing COPD as an adult.
  

Not everyone who smokes develops COPD, and non-smokers can also get COPD. In some cases, the cause is unknown.

COPD develops over time. In most cases, COPD is diagnosed in people aged over 35 to 40 years old.

A diagnosis of COPD is confirmed by spirometry, a test that measures the amount of air you are able to blow out of your lungs and how fast you can do it. The test uses a device called a spirometer.

If doing simple daily tasks makes you feel short of breath, ask your health professional about getting a spirometry test.

If you are referred for a spirometry test, you need to prepare correctly to help make sure the results are accurate. 

You may also be required to have other tests, such as an exercise stress test, or blood tests. A chest X-ray is not used to diagnose COPD but will help to show if there is any damage to your lungs.

There is no cure for COPD, but medicines and treatments are available to help relieve your symptoms and prevent flare-ups (exacerbations).

If you have COPD and you smoke, quitting smoking is the best thing you can do to feel better.

Other things that can help you to breathe more easily and improve your quality of life are:

• medicines and inhalers to help make breathing easier and prevent exacerbations
  
• pulmonary rehabilitation, a specialised program of exercise and education that will help improve your symptoms and reduce your risk of going to hospital
  
• regular vaccinations against influenza and pneumococcal infections
  
• oxygen therapy if you have advanced lung disease.
  

Your health professional may also recommend exercise training, breathing exercises or chest physiotherapy. Surgery is an option for only a very small number of people.

Ask your health professional to help you to develop a COPD Action Plan to help manage your condition, avoid triggers and keep you out of hospital.

Find out more about Medicines for COPD.

Pulmonary rehabilitation is an exercise and education program for people with chronic lung diseases such as COPD. It is one of the key approaches to treatment for COPD.

Pulmonary rehabilitation can help reduce shortness of breath and fatigue, improve exercise capacity, and have a positive effect on your mood and quality of life.

Most pulmonary rehabilitation programs include a gradual program of low- to moderate-intensity exercise to help with lung function, and breathing exercises to help strengthen chest muscles. They also include education on medicines and nutrition and help with quitting smoking.

Talk to your doctor, physiotherapist or accredited exercise physiologist or to Lung Foundation Australia about local pulmonary rehabilitation programs available to you.

There are lots of ways you can help keep yourself as well as possible. Looking after yourself can help prevent exacerbations of your condition and keep you out of hospital.

What you can do

• Try to stop smoking and avoid second-hand smoke.
  
• Avoid contact with anyone who has a cold or a lung infection – either of these will make your COPD worse. Preventing infection is essential.
  
• Wash your hands carefully with soap and water – this will help you avoid catching a virus or other infection.
  
• Get vaccinated regularly against influenza (flu) and pneumococcal disease – this can lower your chances of having a flare-up and going to hospital.
  
• Avoid triggers that can make you worse, like breathing very cold or very humid air.
  
• If you don't already have one, ask your health professional for a COPD Action Plan.
  
• Know how and when to take your medicines
• If you have any questions on the use of or side effects of your medicines, talk to your doctor, nurse or pharmacist. 
  

There is strong evidence supporting the benefits of regular exercise and physical activity for people with COPD. Getting short of breath during exercise is not harmful if you have COPD. Breathing exercises can also help reduce shortness of breath in people who are unable to exercise.

Ask your health professional about taking part in a supervised exercised program. Your health professional can advise what type of program would be suitable, how long to exercise for and when to stop.

Call your doctor if:

• your breathing is getting more difficult, shallow or faster than before
  
• you have been needing your reliever medicine more often than you usually do
  
• you develop a fever
  
• your mucus becomes thicker, discoloured and increases in amount.
  

You may need to go to hospital if your breathing is getting more difficult, you have more mucus and you have at least one of the following symptoms.

• You find it hard to talk.
  
• You find it hard to walk.
  
• You can’t sleep because of shortness of breath.
  
• You feel drowsy or confused.
  
• Your lips or fingernails have turned grey or blue.
  
• Your heartbeat or pulse is very fast or irregular.

For more information, see the Consumer Medicine Information for your brand of medicine, available on our Medicine Finder page or from your pharmacist or prescribing clinician.

The MedicineWise app can be downloaded from NPS. Keep an up-to-date list of all the medicines you take and get reminders on how and when to take your medicines.

Complete a COPD Action Plan together with your doctor. It will guide you in recognising when your symptoms change and what action you should take.

Lung Foundation Australia has a range of resources on COPD, including:

• COPD fact sheets to download
  
• Better Living with COPD: A Patient Guide
  
• Living with a lung condition for information on self-management, education and exercise, pulmonary rehabilitation and other issues
  
• Information about the location of pulmonary rehabilitation programs in your area
  
• Patient support groups in your area
  
• Information and Patient Support available on toll free number 1800 654 301

Information on COPD, with ideas about things you can do around the home can be found in GOLD Patient Guide: What You Can Do About a Lung Disease Called COPD.

• de Marco R, Accordini S, Marcon A, et al. Risk factors for chronic obstructive pulmonary disease in a European cohort of young adults. Am J Respir Crit Care Med 2011;183:891–7 [PubMed]
• Dransfield MT, Kunisaki KM, Strand MJ, et al. Acute exacerbations and lung function loss in smokers with and without COPD. Am J Respir Crit Care Med 2017;195:324-330 [PubMed]
• Fletcher C, Peto R. The natural history of chronic airflow obstruction. Br Med J 1977;1:1645–8 [PubMed]
• Global Initiative for Asthma, Global Initiative for Chronic Obstructive Lung Disease. Diagnosis of diseases of chronic airflow limitation: asthma, COPD and asthma-COPD overlap syndrome (ACOS). GINA, 2015. [Online])
• Global Initiative for Chronic Obstructive Lung Disease. Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease (2020 Report).
• Hayen A, Herigstad M, Pattinson KTS. Understanding dyspnea as a complex individual experience. Maturitas;76:45–50 [PubMed]
• Howcroft M, Walters EH, Wood-Baker R, et al. Action plans with brief patient education for exacerbations in chronic obstructive pulmonary disease. Cochrane Database Syst Rev 2016;12:CD005074 [PubMed]
• Lamprecht B, McBurnie MA, Vollmer WM, et al. COPD in never smokers: results from the Population-Based Burden of Obstructive Lung Disease Study. Chest 2011;139:752–63 [PubMed]
  
• Lung Foundation Australia. COPD fact sheet. Lung Foundation Australia. [Online]
• Lung Foundation Australia. COPD-X concise guide for primary care, 2016. [Online]
• McCarthy B, Casey D, Devane D, et al. Pulmonary rehabilitation for chronic obstructive pulmonary disease. Issue 2. Art. No.: CD003793. Cochrane Database of Systematic Reviews 2015 [PubMed]
• O'Donnell DE, Revill SM, Webb KA. Dynamic hyperinflation and exercise intolerance in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2001;164:770–7 [PubMed]
• Paulin LM, Diette GB, Blanc PD, et al. Occupational exposures are associated with worse morbidity in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2015;191:557–65 [PubMed]
• Perera WR, Hurst JR, Wilkinson TMA, et al. Inflammatory changes, recovery and recurrence at COPD exacerbation. European Respiratory Journal 2007;29:527–34 [PubMed]
• Repine JE, Bast A, Lankhorst I. Oxidative stress in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 1997;156:341–57 [PubMed].
• Stoller JK. Alpha-1 antitrypsin deficiency: an underrecognized, treatable cause of COPD. Cleve Clin J Med 2016;83:507–14 [PubMed]
• Wedzicha JA, Donaldson GC. Exacerbations of chronic obstructive pulmonary disease. Respir Care 2003;48:1204–13; discussion 13–15 [PubMed]
• Yang I, Dabscheck E, George J, et al. The COPD-X plan: Australian and New Zealand guidelines for the management of chronic obstructive pulmonary disease v2.47. Milton, QLD: Lung Foundation Australia, 2016. [Online] (accessed October 2016)
• Yin P, Jiang CQ, Cheng KK, et al. Passive smoking exposure and risk of COPD among adults in China: the Guangzhou Biobank Cohort Study. Lancet 2007;370:751–7 [PubMed]