Chronic Obstructive Pulmonary Disease – Symptoms & Treatment

Chronic obstructive pulmonary disease (COPD) is a progressive condition in which damage to the lungs and airways causes thickening and inflammation of tissue. Because less air can reach the lungs and the body can’t easily eliminate carbon dioxide, sufferers often have difficulty breathing. ⁽¹⁾
Individuals diagnosed with COPD in the United States typically have one of two conditions:

• Emphysema. Emphysema occurs when damage to the walls between air sacs in the lungs causes them to lose elasticity, making it harder to inhale and exhale.
• Chronic bronchitis. Repeated irritation or inflammation of the bronchial linings can cause chronic bronchitis. The resulting mucus can make breathing difficult. ⁽¹⁾

Although COPD has no cure, those diagnosed can manage it through medication and lifestyle changes. However, as the disease progresses, it may result in a chronic disability and, ultimately, death. In 2020, the Centers for Disease Control and Prevention (CDC) listed COPD and other chronic lower respiratory diseases as the sixth leading cause of death in the United States. ⁽²⁾

What Causes COPD?

COPD typically results from damage to the lungs and airways due to long-term exposure to irritants. Although the American Lung Association cites smoking as the main cause of COPD, the disease may also result from environmental contaminants, such as:

• Dust
• Air pollution
• Chemical fumes
• Secondhand smoke ⁽³⁾

Individuals with a history of respiratory infections during childhood may be more prone to developing COPD. Workers in certain industries, such as mining and food preparation, may also be at higher risk. ⁽²⁾
More rarely, COPD results from an inherited condition known as alpha-1 deficiency-related emphysema. The condition inhibits the body’s production of alpha-1, a protein that helps safeguard the lungs from damage. ⁽³⁾

What Are Symptoms of COPD?

During COPD’s early stages, individuals may experience few or no symptoms. As the disease progresses, COPD symptoms may include:

• Frequent respiratory infections
• Shortness of breath or gasping for air, particularly during or after physical activity
• Chronic coughing, often with excessive mucus
• Tightness or heaviness in the chest
• Whistling, wheezing, or squeaking when breathing
• Lower-extremity swelling
• Fatigue ⁽⁴⁾

Symptoms typically get worse over time. Some individuals may also experience a sudden worsening of symptoms due to infection or environmental triggers. These are referred to as flare-ups or exacerbations. ⁽⁵⁾

Do I Have COPD? How Is COPD Diagnosed?

Individuals who exhibit symptoms, such as chronic coughing, wheezing, or shortness of breath should speak with a doctor about testing for COPD. However, the disease often has no symptoms during its initial stages, and diagnosis typically requires a doctor to assess the person’s lung function. To diagnose COPD, a lung specialist, known as a pulmonologist, may perform a spirometry. This painless, noninvasive test determines if there’s a blockage or narrowing of the airway and how an individual’s lung function compares to others of the same gender, age, and height. ⁽⁶⁾

During testing, the patient blows into a mouthpiece connected to the spirometer. The device measures how much air is exhaled both in the first second of exhalation and the entire breath. These test results can help a physician diagnose COPD and determine the disease’s severity, so they can formulate a treatment plan. To help with diagnosis, the doctor may order additional tests, such as a chest X-ray, CAT scan, or diffusing capacity study, which measures how well the lungs exchange oxygen and carbon dioxide. ⁽⁶⁾

Individuals who are asymptomatic but have a high risk for developing COPD due to smoking, chronic exposure to lung irritants, or a family history of the disease may also want to ask their doctor about testing. ⁽⁶⁾

What Is the Best Treatment for COPD?

The four COPD stages range from mild to very severe, and treatment varies depending on how advanced the disease is. ⁽⁷⁾ Individuals in early stages may simply require lifestyle changes, such as quitting smoking or avoiding secondhand smoke. Patients in more advanced stages often need more aggressive COPD treatment, which may include:

• Oral medications. Oral corticosteroids can treat COPD flare-ups. However, if taken long term, these medications can increase an individual’s risk of infection or cause serious side effects, such as cataracts or diabetes. Other oral COPD treatments include phosphodiesterase-4 inhibitors, which decrease inflammation and relax the airways to facilitate breathing.
• Inhalers. Short- or long-acting inhalers are sometimes prescribed for use daily or prior to physical activities. They may contain inhaled corticosteroids, which help reduce inflammation, or bronchodilators, which relax the muscles around the bronchial tubes to make breathing easier. Some inhalers contain a combination of medications.
• Oxygen therapy. Individuals with advanced COPD may benefit from supplemental oxygen, which they can administer at home. Treatment may extend the life of some individuals.
• Surgery. In some cases, a pulmonologist may recommend a lung transplant or surgery to remove damaged tissue. However, individuals typically must meet stringent criteria, and surgery may have significant risks. ⁽⁸⁾

How to Cope With a COPD Diagnosis

When diagnosed with chronic obstructive pulmonary disease, it’s helpful to remember that those diagnosed can often manage the condition effectively with lifestyle changes and simple medical treatments. Diagnosed individuals may be able to improve their quality of life by:

• Reducing exposure to cigarette smoke and other lung irritants that can cause flare-ups ⁽⁹⁾
• Maintaining a vitamin-rich diet that includes complex carbohydrates, fiber, and plenty of fluids ⁽¹⁰⁾
• Following a physician-approved exercise regimen to help improve cardiovascular fitness, increase energy levels, and minimize anxiety. ⁽¹¹⁾
• Finding support and encouragement by connecting with family members, friends, or a dedicated COPD support group

Individuals experiencing severe anxiety and depression after a COPD diagnosis should speak with their doctor or a trained mental health counselor.

How to Help Someone With COPD

To help a friend or family member who’s been diagnosed with COPD, it’s important to be well-informed. Learning about the disease, potential treatments, and early signs of a flare-up can help someone become a knowledgeable advocate. To create a safe environment for a loved one with COPD, it’s important not to smoke near them. Family members may also want to accompany loved ones on medical visits to ask relevant questions and make note of important information so the patient doesn’t have to. ⁽¹²⁾