COAD - Chronic Obstructive Airways Disease
EDP column by Dr Ketan Dhatariya

“My doctor tells me I have something called COAD. What is this?"

Chronic Obstructive Airways Disease is a long term lung disease that has in the past also been known as ‘chronic bronchitis’, or ‘emphysema’. 90% of all cases are usually in people who are (or have been) smokers. Up to 15% of smokers will go on to develop this progressive disease. Other causes include second hand smoke and exposure to environmental pollutants, and certain enzyme deficiencies. There are about 600,000 known cases in the UK, with many more undiagnosed.

COAD is associated with chronic obstruction of the flow of air out of the lungs. This obstruction is generally permanent and progressive over time. This is because cigarette smoke causes an inflammation of the lining of the lungs. Over time, this chronic inflammation destroys the normal elastic tissue that keeps the airways open. Normally when we breathe out, the airways are prevented from collapsing under pressure by this elastic tissue. Without this tissue being present, the airways collapse, leading to trapping of air and mucus, which can get infected and cause more damage.

People with this condition often cough up large amounts of sputum for several months of the year because the inflammation stimulates the production of mucus. This mucus further narrows the already inflamed airways. Unlike asthma, where the inflammation and airway narrowing is reversible, in COAD, the degree of reversibility is substantially less, and so treatments for this condition are less successful, although new treatments are being developed to minimise the inflammation. 

The main symptoms of this condition are being short of breath on exertion, coughing up sputum (usually in the mornings) for more than three months of the year for two or more years in a row. In the long term up to half of all the people who suffer from this condition say that it limits what they can do.

Exercising is important because it helps to keep the airways open and helps to clear away the mucus. Other treatments include the use of airway opening drugs (‘bronchodilators’), and short courses of antibiotics and anti-inflammatory drugs such as steroids, when infection occurs. In severe cases, the damage may require the use of home oxygen. In addition, it is important that you keep up to date with yearly flu vaccinations.

If you already smoke then your doctor can help you decide which method to help you stop. There are nicotine patches, gum, spray and so forth. Many people find that hypnosis helps. There are also some drugs that can help when taken for a short time.

However, as always the ideal way to prevent this condition from happening and to stop it getting worse is to not smoke.

For more information about COAD/ Chronic Obstructive Airways Disease click this link: