COPD – Causes, Stage, Treatment and More

What is COPD?

Chronic obstructive pulmonary disease or COPD is a chronic and progressive lung diseases that leads to obstructed airflow from lungs.(1)

COPD includes two most common diseases which are  emphysema and chronic bronchitis. Many people with COPD have both of these conditions.(2)

Emphysema gradually destroys air sacs in your lungs, which impades with outward air flow. Bronchitis leads to inflammation and narrowing of the bronchial tubes, which causes build up of mucus.

It’s estimated that about 30 million people in the United States have COPD. As many as half are unknowing that they have this disease.

COPD can lead to a faster development of diseases such as heart problems, and worsening respiratory infections ,if left untreated.

What are the symptoms of COPD?

COPD makes breathing difficult. Symptoms may be mild at first, starting with intermittent coughing and shortness of breath. As it progresses, symptoms can become more severe and constant to where it can become increasingly hard to breathe.(3)

You may experience wheezing and chest tightedness or have excessive production of sputum. Some people with COPD have acute aggravations , which are outbursts of severe symptoms.

Early symptoms

At first, symptoms of COPD can be quite mild. You might confused them for a cold.

Early symptoms include:

  • infrequent shortness of breath, particularly after exercise
  • mild but frequent cough
  • required to clear your throat often, particularly first thing in the morning

You might begin making precise changes, such as avoiding stairs and skipping physical activities.

Worsening symptoms

Symptoms can get continuously worse and harder to ignore. As the lungs become more damaged, you may feel:

  • shortness of breath(dyspnea), after even mild forms of exercise like walking up a flight of stairs
  • wheezing, which is a type of higher-pitched noisy breathing, mainly during exhalations
  • chest tightness
  • chronic cough, with or without mucus
  • required to clear mucus from your lungs every day
  • reccuring colds, flu, or other respiratory infections
  • lack of energy or tiredness

In advanced stages of COPD, symptoms may also include:

  • fatigue or exhaustion
  • swelling of the feet, ankles, or legs
  • weight loss

Symptoms are probably to be much worse if you currently smoke or are continuously exposed to secondhand smoke.

What causes COPD?

Most people with COPD are minimum 40 years of age and have at least some history of smoking. The longer and more tobacco products you smoke, the larger your risk of COPD is.

Besides the cigarette smoke, cigar smoke, pipe smoke, and secondhand smoke can lead to COPD. Your risk of COPD is even larger if you have asthma and smoke.

Other causes

You can also develop COPD if you’re frequently exposed to chemicals and fumes in the workplace. Prolonged exposure to air pollution and inhaling dust can also lead to COPD.

In developing countries, along with tobacco smoke, homes are usually not ventilated properly, forcing families to breathe fumes or smokes from burning fuel used for cooking and heating.

There may be a genetic predisposition to developing COPD. Up to an estimated 5 percent of people having COPD have a deficiency of a protein called alpha-1-antitrypsin.

This deficiency causes the lungs to deteriorate and also can affect the liver. There may be other associated genetic factors at play as well.

Diagnosing COPD

There’s no single test for COPD. Diagnosis is based on symptoms, a physical exam, and diagnostic test results.

When you visit the doctor, be sure to mention all of your symptoms. Tell your doctor if:

  • you’re a smoker or have smoked in the past
  • you’re exposed to lung irritants on the job
  • you’re exposed to a large amount of secondhand smoke
  • you have a family history of COPD
  • you have asthma or other respiratory conditions
  • you take over-the-counter or prescription medications

Exam and tests

During the physical exam, your doctor will listen to your lungs as you breathe with the help of a sthethoscope. Based on all this information, your doctor may perform some of these tests to get a more complete analysis:

  • Spirometry is a noninvasive test to evaluate lung function. During the test, you’ll take a deep breath and then blow into a tube attached to the spirometer.
  • Imaging tests, such as a chest X-ray or CT scan. These images can give a complete look at your lungs, blood vessels, and heart.
  • An arterial blood gas test. This involves taking a blood sample from an artery to measure oxygen, carbon dioxide, and other important levels in your blood.

These tests can help find out if you have COPD or other condition, such as asthma, a restrictive lung disease, or heart failure.

Treatment for COPD

Treatment can alliavate symptoms, prevent complications, and usually slow down the progression of the disease.Your healthcare team may include a lung specialist (pulmonologist) and physical and respiratory therapists.

Oxygen therapy

If your blood oxygen level is extremely low, you can receive supplemental oxygen through a mask or nasal cannula which can make your breathing easier. A portable unit can make it easier to get around.


Surgery is performed in severe COPD or when other treatments have failed, which is more probably when you have a form of severe emphysema.

One type of surgery is known as bullectomy. During this procedure, surgeons remove large and abnormal air spaces (bullae) from the lungs.

Another procedure is lung volume reduction surgery, which removes damaged upper lung tissue. Lung volume reduction surgery can be successful at improving breathing, but few patients undergo this major, somewhat risky procedure.

Lung transplantation is an option in some cases. Lung transplantation can successfully cure COPD, but has its several risks.

There is a less invasive method of improving the ability of airflow in people have severe emphysema known as endobronchial valves (EBV), which are one-way valves that redirect inspired air to healthy lungs and away from non-functioning, damaged lungs.

In 2018, an EBV device called the Zephyr Endobronchial Valve was accepted by the FDA and has been shown to improve lung function, exercise capability and quality of life for patients having emphysema.

Lifestyle changes

Certain lifestyle changes may also help relieve your symptoms or give relief.

  • If you are asmoker, quit smoking. Your doctor can suggest right products or support services.
  • Whenever possible, avoid secondhand smoke and chemical fumes.
  • Get the appropriate nutrition your body needs. Work with your doctor or dietician to make a healthy eating plan.
  • Take help of yiur doctor about how much exercise is safe for you.

Medications for COPD

Medications can lower symptoms and cut down on outbursts. It may take some trial and error to determine the medication and dosage that is appropriate for you, but these are some of your options:

Inhaled bronchodilators

Medicines called bronchodilators help loosen tight or hard muscles in your airways. They’re generally taken through an inhaler or nebulizer.

Short-acting bronchodilators last from 4 to 6 hours. You only use them when you needed. For progressive symptoms, there are long-acting forms you can use daily. They last about 12 hours.

For people with COPD who experience dyspnea or breathlessness or difficulty breathing while exercising, the American Thoracic Society strongly suggests a long-acting-beta-agonist (LABA) combined with a long-acting muscarinic antagonist (LAMA).

These bronchodilators work by relaxing or loosening tightened muscles in the airways, which widens your airways for better air flow. They also help your body clear mucus from the lungs. These two types of bronchodilators can be taken in combination by inhaler or with a nebulizer.

Here’s a list of suggested LABA/LAMA bronchodilator therapies:

  • aclidinium/formoterol
  • glycopyrrolate/formoterol
  • tiotropium/olodaterol
  • umeclidinium/vilanterol


Long-acting bronchodilators are generally combined with inhaled glucocorticosteroids. A glucocorticosteroid can lower inflammation in the airways and reduce the production of mucus.

The long-acting bronchodilator can relax the airway muscle to help the airways stay wider. Corticosteroids are also accessable in the form of a pill.

Phosphodiesterase-4 inhibitors

This type of medication can be taken in pill form to help reduce inflammation and relax the airways. It’s normally recommended for severe COPD with chronic bronchitis.


This medication relieves chest tightness and dyspnea. It may also help prevent. It’s available in the form of pill.

Theophylline is an older medication which helps in the relaxation of the muscle of the airways, and it may lead to side effects. It’s usually not a first-line treatment for COPD therapy.

Antibiotics and antivirals

Antibiotics or antivirals may be recommended when you get certain respiratory infections.


To reduce the risk of other respiratory infections, talk to your doctor if you should get a yearly flu shot, pneumococcal vaccine, and a tetanus booster that includes prevention from pertussis (whooping cough).

Diet recommendations for people with COPD

There’s no certain diet for COPD, but a healthy diet is necessary for retaining overall health. The stronger you are, the more capable you’ll be to prevent complications and other health issues.

Choose various types of nutritious foods from these groups:

  • vegetables
  • fruits
  • grains
  • nuts
  • protein
  • dairy products

Also, remember to take limited amount of salt. It causes the body to retain water, which can trouble breathing.


Drink enough fluids. Drinking at least six to eight 8-ounce glasses of non-caffeinated drinks per day can help keep mucus thinner. This may make the mucus easier to cough out.

Control caffeinated drinks because they can interfere with medications. If you have heart issues, you may need to drink in small quantity, so take help of your doctor.

Weight management

Maintaining a healthy weight is necessary. More energy is needed to breathe when you have COPD, so you might require to take in more calories. But if you’re overweight, your lungs and heart may have to work harder.

If you’re underweight or weak, even primary body maintenance can become hard. Overall, having COPD weakens your immune system and reduces your ability to fight off infection.

Eating habits

A full stomach creates difficulty for your lungs expansion and causes shortness of breath or dyspnea. If you find that this happens to you, follow these remedies:

  • Clear your airways about an hour before having a meal.
  • Take little bites of food that you chew slowly before swallowing.
  • Replace three meals a day to five or six smaller meals.
  • Save liquids until the end so you feel less full during the meal.

Living with COPD

COPD needs lifelong disease management. That means taking and following the advice of your healthcare team and maintaining healthy lifestyle

Since your lungs are weakened, you’ll want to avoid anything that might harmful for them or cause a outburst. Here’s a list of advices to follow as you adjust your lifestyle.

  • Avoid smoking. If you’re having difficulty quitting, take help of your doctor about smoking cessation programs. Try to avoid secondhand smoke, chemical fumes, air pollution, and dust.
  • Work out. A small exercise per day can help you stay strong. Talk to your doctor about how much exercise is appropriate for you.
  • Eat a diet of nutritious foods. Avoid highly processed foods that are full of calories and salt, but lack nutrients.
  • Treating other conditions. If you have other chronic diseases along with COPD, it’s necessary to manage those as well, mainly diabetes mellitus and heart disease.
  • Clean house. Clear the mess up and streamline your home so that it takes little energy to clean and do other household tasks. If you have advanced COPD, get help with daily tasks.
  • Be prepared for flare-ups. Carry your emergency contact information with you and post it on your refrigerator. Include information about what medications you take, including the doses. Program emergency numbers into your phone.
  • Find support. It can be a relaxation to talk to others who understand. Consider joining a support group. The COPD Foundation provides a comprehensive list of organizations and resources for people living with COPD.

What are the stages of COPD?

One measure of COPD is attained by spirometry grading.

There are various grading systems, and one grading system is part of the GOLD classification. The GOLD classification is used for finding the severity of COPD and helping to form a prognosis and treatment plan.

There are four GOLD grades on the basis of spirometry testing:

  • grade 1: mild
  • grade 2: moderate
  • grade 3: severe
  • grade 4: very severe

This is based on the spirometry test result of your FEV1. This is the amount of air you can exhale from the lungs in the first second of a forced expiration. The severity increases as your FEV1 reduces.

The GOLD classification also takes into account your specific symptoms and history of acute aggravation. Based on this information, your doctor can designate a letter group to you to help specify your COPD grade.

As the disease progresses, you are at larger risk to develop complications, such as:

  • respiratory infections,such as common colds, flu, and pneumonia
  • heart complications
  • high blood pressure in lung arteries (pulmonary hypertension)
  • lungs cancer
  • anxiety and depression

Is there a connection between COPD and lung cancer?

COPD and lung cancer are major health problems all over the world. These two diseases are related in several ways.

COPD and lung cancer have several common risk factors. Smoking is the primary risk factor for both diseases. Both are more likely if you breathe secondhand smoke, or are in contact of chemicals or other fumes in the workplace.

There may be a genetic predisposition to developing both diseases. Also, the risk of developing either COPD or lung cancer increases with age.

It was approximated in 2009 that around 40 to 70 percent of people with lung cancer also have COPD. This same 2009 study concluded that COPD is a risk factor for lung cancer.

2015 study indicates they may really be different outlooks of the same disease, and that COPD could be a reason of lung cancer.

In few cases, people don’t know they have COPD until they’re diagnosed with lung cancer.

Although, having COPD doesn’t essentially mean you’ll get lung cancer. It does mean that you are at a larger risk. That’s another reason why, if you smoke, stopping is useful.

COPD statistics

It is estimated that about 65 million people have moderate to severe COPD all over the world. Around 16 million adults in the United States have a diagnosis of COPD.

Most people with COPD are 40 years of age or more.

The majority of people with COPD are smokers or former smokers. Smoking is the most essential risk factor that can be modified.

In around 5 percent of people with COPD, the reason is a genetic disorder including a deficiency of a protein called alpha-1-antitrypsin.

COPD is a leading cause of hospitalizations in industrialized countries. In the United States, COPD is accountable for a abundant number of emergency department visits and hospital admissions.

In the year 2000, it was noticed that there were over 700,000 hospital admissions and about 1.5 million emergency department visits.

COPD is the third leading cause of death in the United States. More women than men die from COPD every year.

It’s estimated that the number of patients diagnosed with COPD will increase by more than 150 percent from 2010 to 2030. Much of that can be assigned to an aging population.

What’s the outlook for people with COPD?

COPD usually lowers life expectancy, however the viewpoint varies considerably from person to person.

People with COPD who never smoked may have a modest reduction in life expectancy, while former and current smokers are likely to have a more depletion in life expectancy.

COPD tends to develop gradually. You may not even know you have it during the initial stages.

Once you have a diagnosis, you’ll need to start seeing your doctor on a daily basis. You’ll also have to follow steps to control your condition and make the proper changes to your daily life.

Early symptoms can generally be controlled and certain lifestyle improvements can help you maintain a good quality of life for some time.

As the disease continues, symptoms can become increasingly restricting.

People with advanced stages of COPD may not be able to take care for themselves without assistance. They’re at increased risk of getting respiratory infections, heart complications, and lung cancer. They may also have a risk of depression and anxiety.

Besides smoking, your interpretation depends on how well you respond to treatment and whether you can avoid severe problems. Your doctor is in the best position to assess your overall health and give you an idea about what to expect.

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