COPD

Chronic Obstructive Pulmonary Disease (COPD) is a long-term lung disease where the airways become narrow and inflamed, and the air sacs are damaged. Breathing becomes progressively harder. It includes chronic bronchitis and emphysema.

Main causes in India

• Tobacco smoke — cigarettes, bidis, hookah. The single biggest cause.
• Indoor biomass smoke — cooking with wood, crop residue or dung in poorly ventilated kitchens. COPD in Indian women is often caused by this, even without smoking.
• Outdoor air pollution — major driver in Delhi-NCR and other cities with high PM2.5.
• Occupational dust and chemicals — stone quarries, cement, coal, bakeries, textile industry.
• Repeated childhood chest infections.

Symptoms

• Long-standing cough, often with phlegm ("smoker's cough").
• Progressively worsening breathlessness — first with exertion, later at rest.
• Wheeze and chest tightness.
• Frequent chest infections, especially in winter.
• Weight loss and fatigue in advanced disease.

Red flags — dial 112 or go to hospital

• Severe breathlessness at rest; unable to complete a sentence.
• Bluish lips or fingertips.
• Confusion, drowsiness.
• Chest pain with breathlessness.
• Rising fever with increasing phlegm.

Diagnosis

Spirometry (a simple breathing test) is the key test — it measures how fast and how much air you can blow out. A chest X-ray and sometimes CT may be done. COPD is often missed in India and diagnosed late; if you have a long-standing cough or breathlessness, ask specifically for spirometry.

Treatment — the goal is to slow the disease and live well

• Stop smoking. The single most important step — lung decline slows within weeks of quitting.
• Reduce indoor smoke exposure — use LPG or clean fuel where possible; improve kitchen ventilation.
• Wear an N95 mask on high-pollution days.
• Inhalers (bronchodilators, inhaled steroids) — the mainstay; used correctly they relieve symptoms and reduce flare-ups.
• Vaccines — annual flu vaccine, and pneumococcal vaccine, reduce infections.
• Pulmonary rehabilitation — breathing exercises, supervised exercise, education — improves quality of life markedly.
• Long-term oxygen for severe disease.
• Lung-volume reduction surgery or transplant — select cases.

Myth-correction

COPD is not only a smoker's disease, and not "just old age." Millions of Indian women who never smoked develop COPD from cooking smoke. And breathlessness in a 50-year-old is not normal — it deserves a proper diagnosis.