Chronic obstructive pulmonary disease (COPD) makes breathing increasingly more difficult. But it develops slowly over many years and you may not be aware you have it at first.

Most people with COPD do not have any noticeable symptoms until they reach their late 40s or 50s.

Common symptoms of COPD include:

• shortness of breath – this may only happen when exercising at first, and you may sometimes wake up at night feeling breathless
• a persistent chesty cough with phlegm that does not go away
• frequent chest infections
• persistent wheezing

The symptoms will usually get gradually worse over time and make daily activities increasingly difficult, although treatment can help slow the progression.

Sometimes there may be periods when your symptoms get suddenly worse – known as a flare-up or exacerbation. It's common to have a few flare-ups a year, particularly during the winter.

Less common symptoms of COPD include:

• weight loss
• tiredness
• swollen ankles from a build-up of fluid (oedema)
• chest pain and coughing up blood – although these are usually signs of another condition, such as a chest infection or possibly lung cancer

These additional symptoms only tend to happen when COPD reaches an advanced stage.

See a GP if you have persistent symptoms of COPD, particularly if you're over 35 and smoke or used to smoke.

There are several conditions that cause similar symptoms, such as asthma, bronchiectasis, anaemia and heart failure. A simple breathing test can help determine if you have COPD.

Find out more about tests for COPD.

While there's currently no cure for COPD, the sooner treatment begins, the less chance there is of severe lung damage.

Find out more about how COPD is treated.