Ask Dr Trisha: Chronic Obstructive Pulmonary Disease

Ask Dr Trisha: Chronic Obstructive Pulmonary Disease

COPD, or Chronic Obstructive Pulmonary Disease, is one of the most common chronic diseases in the UK, thought to affect nearly four million people, although only 900,000 people have actually been diagnosed with it.

COPD is a group of several different, largely preventable, lung diseases caused mainly by smoking. Just 15 per cent of COPD is work-related due to exposure to fumes, dust (such as coal, cotton or silica) and certain chemicals, including welding fumes and isocyanates. Most people are diagnosed in the later stages of the disease, when symptoms are severe and damage to the lungs is extensive and generally not reversible. Early diagnosis would allow people to take action to protect their lungs and stop the disease in its tracks so being aware of symptoms is really important.

The most common forms of COPD are chronic bronchitis and emphysema. In bronchitis the breathing tubes become narrowed as the thin lining becomes inflamed and swollen and thick secretions fill the spaces. In emphysema, the delicate airsacs, or alveoli, break down, destroying the membranes where oxygen and carbon dioxide are exchanged.

In COPD the inflamed lining of the airways and the damaged lung tissue gradually restrict the flow of air into the lungs, making it harder to breathe and get enough oxygen into your body. This leads to symptoms such as wheezing and a tight chest – especially when trying to breathe out – breathlessness, which stops you doing everyday activities, and a persistent mucus cough. Risk of chest infections increases and each one could damage lungs further. As the disease progresses you get weaker, lose your appetite and lose weight.

Doctors can recognise most cases of COPD simply by asking about your background, smoking habits and symptoms. They may recommend tests to measure the flow of air in and out of your lungs, as well as a chest x-ray or even a CT scan. Treatments start with help and advice to stop smoking because it’s never too late to give up and limit further damage.

The aim then is to keep as healthy as possible, with a good diet and regular exercise, improve your symptoms and prevent them getting worse. There are a variety of drug treatments to help open up your airways and reduce inflammation, as well as low-dose antibiotics to keep infection at bay.

COPD doesn’t have to be a life sentence. If you look after yourself, get help to give up smoking and follow advice about medication, it’s possible to live long and well after diagnosis.

Q. My husband has really bad breath – what could be the cause?

Dr Trisha says: Most halitosis (bad breath) cases are straightforward, so stay positive that he can improve it. The number one cause is tooth decay and gum disease, so a trip to the dentist and hygienist is vital. He should be brushing his teeth at least twice a day and flossing to clear the gaps between his teeth. A mouthwash could help control the bacteria that causes bad breath.

Dry mouth is another common cause, affecting about one in three over-65s. Keep well-hydrated and increase saliva flow by chewing gum. Think about food, too; garlic is the best-known culprit, but strong spices and herbs can also cause problems.

  • Dr Trisha writes a column every fortnight in Yours magazine. Ask Dr Trisha about your health problems by emailing