Chronic Obstructive Pulmonary Disease (COPD): Symptoms, Stages, Causes, Diagnosis & Management

Chronic Obstructive Pulmonary Disease, better known as COPD, is a long-term respiratory condition that makes it hard for the patient to breathe. There’s still no cure for COPD, but you can take steps to slow down its progression and manage the symptoms. Here’s everything you know about COPD. 

What Is COPD?

In some references, chronic obstructive pulmonary disease is a collective term used to describe two specific illnesses: emphysema and chronic bronchitis. However, other reports identify COPD as an illness in itself, and emphysema and chronic bronchitis are the main contributing conditions. 

Throughout this article, we’ll refer to chronic obstructive disease as a health condition in itself. 

Now, the COPD meaning can we described by breaking down its name:

• Chronic pertains to long-term, which means the disease doesn’t get better the way other diseases, like common cold and flu, do. 
• Obstructive means the condition involves some blockage. 
• Pulmonary indicates the lungs are affected; and 
• Disease means COPD is a recognized sickness that produces various signs and symptoms. 

In other words, chronic obstructive pulmonary disease is a long-term sickness that involves blockages in the lungs, particularly in the air passages. Due to these obstructions, the patient eventually finds it hard to breathe. 

COPD is also a progressive condition, meaning it will get worse over time, especially if you don’t follow through with your treatment plan. 

COPD Causes and Risk Factors

The leading cause of chronic obstructive pulmonary disease is long-term exposure to lung irritants primarily cigarette smoke. Cigar, pipe, tobacco, and secondhand smoke also count. 

You see, consistent and prolonged exposure to lung irritants increases the risk for emphysema and chronic bronchitis – the two main contributing factors to COPD. 

Emphysema

This lung disease occurs when there is destruction in the alveoli, the air-filled sacs in the lungs where gas exchange happens. Due to the damage, the airflow in the lungs is impaired, causing breathing difficulties. 

Chronic Bronchitis

In chronic bronchitis, the bronchial tubes where air passes through become inflamed and narrowed. This triggers excessive production of mucus, which further narrows the tubes. As a result, there is productive cough and breathing difficulties. 

There are also times when an underlying health condition causes COPD. Case in point, people with alpha-1 antitrypsin deficiency may develop COPD because low levels of the protein lead to lung damage, especially when there is exposure to lung irritants. 

COPD vs Asthma

Asthma and COPD are both long-term respiratory conditions, but they are not the same diseases. 

Like chronic bronchitis, asthma involves narrowing of the airways. However, instead of consistently having asthma, a patient experiences asthma attacks. This is because avoiding the triggers and following through the treatment plan “reverse” the narrowing and inflammation in asthma. 

Keep in mind, though, that people with asthma may develop COPD, especially if they have exposure to lung irritants. 

The Signs and Symptoms of COPD

Initially, COPD may not present with symptoms until the lungs have sustained notable damages. When the signs and symptoms start to appear, they usually include the following:

• Smoker’s cough or a cough that produces a lot of phlegm. In some cases, the cough is ongoing. Mucus color varies; it can be greenish, yellowish, white, or clear. 
• Shortness of breath, especially when performing a physical activity. 
• Chest tightness. 
• Wheezing or high-pitched sound when breathing. 
• Frequent respiratory infections, like the common cold and influenza.
• Dizziness. 
• Cyanosis or bluish discoloration of the skin, particularly in the lips and fingernails. This indicates lack of oxygen. 
• Swelling in ankles and feet. 
• Unexpected weight loss (typical in the late stages)
• Fatigue or lack of energy. 

Exacerbation is also common among COPD patients. It refers to periods of worse COPD symptoms compared to what the patients usually experience on a day-to-day basis. In most cases, a COPD exacerbation lasts for days. 

Please note that COPD signs and symptoms vary, meaning not everyone who has chronic obstructive pulmonary disease experiences the symptoms enumerated above. Similarly, experiencing the mentioned symptoms doesn’t automatically mean that you have COPD. After all, many respiratory conditions present with the same signs. 

When to Seek Medical Help

Since COPD usually does not cause signs and symptoms until there is notable lung damage, many people only attribute mild concerns into “getting older” or “not being the way they were before.” 

However, there are some symptoms you must never ignore. 

For example, if the previously mild symptoms become worse, you should strongly consider setting an appointment with the doctor as it’s indicative of progressing lung damage. 

Likewise, seek emergency treatment for the following concerns:

• Trouble in catching breath during simple physical activity and talking. 
• Cyanosis 
• Fast heartbeat or pulse rate. Normal range is 60 to 100 per minute, but this range may increase with physical activity, injury, illness, or strong emotions. 
• Problems in focusing, or hearing comments from loved ones that you’re not mentally alert. 
• The symptoms don’t get better despite home remedies or doctor-approved treatment. 

COPD Diagnosis

Experts say it’s quite common for chronic obstructive pulmonary disease to be misdiagnosed. For this reason, expect a lengthy COPD assessment test with your doctor. This includes laboratory exams and an interview about the following:

• Your family and medical history. 
• The signs and symptoms you observed. 
• Your exposure to respiratory irritants, especially cigarette smoke. 

To help you through the interview assessment, it’s helpful to note the details of your signs and symptoms. Jot down all your concerns, including the first time you experienced them and how severe they are now compared to when they first surfaced. Pay particular attention to the changes in your cough and phlegm as well as the quality of your breathing. 

After the interview assessment, the doctor may order the following tests to check if you really have COPD: 

Spirometry or Lung Function Testing

In this test, you are asked to blow air to a tube connected to a machine. The device then measures how much air your lungs can take and release, and whether or not they can still effectively deliver oxygen to the blood. Reports say it’s the most important tool in confirming COPD and its progression. 

Imaging Tests

The doctors may also suggest chest x-ray and CT scan to detect emphysema, one of the leading causes of COPD. 

Arterial Blood Gas or ABG

This tests how well your lungs deliver oxygen and remove carbon dioxide in the blood. 

Other Laboratory Tests

Depending on your signs and symptoms, the physician may order other lab tests to rule out COPD. 

Stages of COPD

Because COPD is a long-term, progressive illness, experts use a system to classify its severity. This system, called GOLD (Global Initiative for Chronic Obstructive Lung Disease) classification, uses four stages: 

Stage 1 

Under stage 1, COPD usually doesn’t present with any signs and symptoms. 

If symptoms appear, they are most likely mild, like persistent coughing or shortness of breath upon strenuous physical activities. In other words, it’s easy to mistake COPD with other fleeting conditions like respiratory infections and allergies. 

Stage 2 

A patient with stage 2 COPD under the GOLD guidelines begins observing more symptoms. These symptoms tend to be more persistent that they already affect the activities of daily living. 

It is typically during this stage that patients visit a doctor because they suspect it’s not just the fleeting cold, flu, or allergy. 

Stage 3

With progressing lung damage, someone with stage 2 COPD develops worse symptoms. Their respiratory symptoms are more severe and they might have cyanosis (bluish discoloration), swollen legs, feet, and ankles, and reduced mental alertness. 

Stage 4

According to the GOLD COPD Guidelines, stage 4 chronic obstructive pulmonary disease negatively impacts even the slightest of activities. Normal breathing needs conscious effort and low oxygen level may present even when the patient is just resting. Stage 4 is the final stage of COPD. 

COPD Complications

The complications of COPD are not just encompassing, but they are also potentially debilitating. According to the US Center for Disease Control, COPD complications include:

• Limitations in physical activities; patients with COPD often develop difficulty in climbing stairs and even walking. 
• Needing tools to help ease their symptoms, like a portable oxygen tank. 
• Reduced cognitive function, such as inability to focus, confusion, and memory loss. 
• Increased risk in developing other long-term conditions like arthritis, cardiovascular diseases, and diabetes. 
• Anxiety and depression, mainly due to their reduced capacity to do the things they enjoy doing, like social gatherings, working, worships, etc. 

COPD Treatment 

As of now, there’s still no cure for chronic obstructive pulmonary disease. The goals of treatment revolve around:

• Slowing down the disease progression. 
• Managing the COPD signs and symptoms. 
• Improving the patient’s tolerance to physical activities to retain their ability to stay active. 
• Improving the patient’s overall health
• Preventing complications from setting in. 

COPD treatment generally consists of two things: management through lifestyle modifications and medications. Of course, the management strategies and medications depend on factors like COPD stage and the patient’s overall health status. 

COPD Management 

If you have chronic obstructive pulmonary disease, the following practices will be helpful:

Quit Smoking and Avoid Exposure to Other Lung Irritants

The first, and perhaps most crucial thing to do, is to quit smoking. Smoking not only increases lung damage and triggers COPD exacerbation, but it might also lead to other health conditions, like cancer. 

Likewise, avoid other lung irritants. If the nature of your work exposes you to chemicals that may damage your lungs, talk to your doctor about how you can protect yourself.  

Have a Food Plan

COPD often makes it hard for the patient to eat, meaning there’s a possibility that the desired caloric requirement will not be met.

Nutritional deficiencies can further complicate things as it reduces energy reserve and triggers other conditions, like decreased immunity due to lack of vitamins. 

For this reason, it’s crucial to have a doctor-approved food plan. 

Protect Yourself From Respiratory Infections

Developing another respiratory illness while you have COPD can cause serious problems.

This is why doctors advise COPD patients to take the initiative in preventing other respiratory issues like pneumonia and influenza. Besides following safety measures such as frequent handwashing and boosting the immune system, you can also consider getting the flu and pneumonia vaccines. 

Ask About Oxygen Therapy for COPD

If you already experience low oxygen levels, discuss the possibility of using oxygen therapy with your doctor. Do not use oxygen on your own. There are things to consider, and only your physician can tell you how much oxygen to use, how frequent, and for how long. 

Consider Pulmonary Rehabilitation

Last on our list of COPD management is pulmonary rehabilitation. This is an individualized care that teaches the patient strategies to improve their quality of life by teaching them how to breathe more effectively and use their energy efficiently.

A pulmonary rehabilitation program may also include exercises and meal plans to achieve optimum health. 

COPD Medications

Below are some of the COPD medications that the doctor might prescribe:

Bronchodilators

These medications ease symptoms by dilating the narrowed air passages. There are three primary bronchodilators: anticholinergics, beta-agonists, and theophylline. The doctor will decide what type or combination suits your condition. 

Corticosteroids

Corticosteroids improve breathing by easing airway inflammation and reducing mucus production. For acute COPD exacerbations, the doctor may prescribe oral corticosteroids. On the other hand, patients with late-stage COPD may benefit more with inhaled corticosteroids. 

Antibiotics

Should there be infection, the doctor will likely order short-course antibiotics. 

Prevention of COPD

COPD may not be curable, but is highly preventable. 

The first step is to avoid smoking. If you’re smoking cigarettes, it’s best to stop now. It may not be easy for people who’ve been smoking for a long time now, especially if they tried to quit several times before. However, quitting smoking is your best shot in reducing lung damage and preventing COPD. Consider joining a smoking cessation program if you have difficulties quitting the habit. 

Next is to protect yourself against respiratory illnesses. Like mentioned earlier, get the annual flu vaccine. Pneumonia vaccination may not be for everyone, but if you are aged 65 and older or have other underlying conditions, like asthma, getting the pneumonia jab is recommended. 

Are You Worried About COPD?

If you’re worried about COPD, the best thing to do is to consult the doctor right away, especially if you have the symptoms we explained earlier. Reversing COPD may not be possible, but detecting it as early as possible increases the chance of better managing its symptoms, slowing down its progression, and preventing complications.

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