What Is COPD? Symptoms, Causes, Diagnosis, Treatment, and Prevention

• Persistent cough that may contain mucus, referred to as “smoker’s cough.”
• Chest tightness
• Wheezing
• Dyspnea, or shortness of breath that worsens with activity
• Fatigue

• Weight loss
• Swelling of the feet and ankles, called edema
• Blueness of the skin, lips, and fingernails, called cyanosis
• Mental confusion or disorientation

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People with COPD often experience flare-ups, or periods of time when symptoms worsen. These usually result from a respiratory infection or an increase in air pollutants.

A COPD diagnosis usually requires an assessment of the patient’s health history, along with certain tests.

• Spirometry This involves blowing into a tube connected to a spirometer, a machine that measures the airflow into and out of the lungs. This is the main test used to diagnose COPD.
• Bronchial Provocation Test The patient undergoes spirometry after inhaling a certain drug (methacholine or histamine) to evaluate the sensitivity of their lungs. Pulmonologists rarely order this test.
• Exercise Tolerance Test This can identify dyspnea (difficulty breathing) and evaluate how exercise affects the ability of the heart and lungs to provide oxygen to, and remove carbon dioxide from, the bloodstream. This test is rarely done to diagnose COPD but rather to explore alternative diagnoses.
• Exercise for Desaturation Test: Also known as the six-minute walk test, this assessment measures your oxygen needs while at rest and during exercise.

• Arterial Blood Gas Test This evaluates your lungs’ gas exchange capabilities by measuring the amount of oxygen and carbon dioxide in your blood.
• A1AT Deficiency Blood Test This tests for a deficiency in A1AT, a protein made in the liver, which can lead to lung damage.
• Chest X-Rays X-rays are performed to look for lung enlargement, bronchial scarring, and the formation of air-filled cavities in the lungs called bullae.
• Computerized Tomography (CT) Scans CT scans provide more information than typical X-rays, such as whether there is airway inflammation.

Stage 1: Mild COPD

Stage 2: Moderate COPD

• Chronic coughing
• Increased sputum production
• Difficulty breathing

Stage 3: Severe COPD

• Weight loss
• Tiredness and difficulty exercising
• Respiratory infections

Stage 4: Very Severe COPD

• Blueness of the lips or fingernail beds (cyanosis)
• Chronic respiratory failure

All forms of COPD, including emphysema and chronic bronchitis, stem from airborne irritants that are inhaled.

• Indoor air pollution
• Exposure to dust and chemical fumes in the workplace
• Asthma
• Frequent childhood respiratory infections

Treatment focuses on relieving symptoms, reducing flare-ups of the disease, improving quality of life, and correcting lifestyle habits that may worsen the condition.

To slow the progression of the disease, it’s not only important to stop smoking and avoid exposure to lung irritants, but also to take medications and vaccinations, and to follow a healthy lifestyle.

Pulmonary Rehabilitation

• An exercise or activity plan to strengthen the muscles used for breathing
• Psychological counseling
• Dietary changes to maintain a healthy weight

Medications and Therapies

While not comprehensive, the list below notes some of the main types of COPD treatment.

Bronchodilators

Examples include:

• albuterol
• levalbuterol
• terbutaline

Examples include:

• formoterol fumarate (Perforomist)
• salmeterol xinafoate (Serevent)

Steroids

Combination Inhalers

Additional Medications

Other medicines may be prescribed to treat COPD, including:

• roflumilast (Daliresp), to relax airways and decrease inflammation

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• ensifentrine (Ohtuvayre), an inhaled medication that works as a bronchodilator and an anti-inflammatory while also helping to clear mucus from the lungs

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• dupilumab (Dupixent), an injectable biologic therapy for certain adults with poorly controlled COPD who have high levels of eosinophils, white blood cells that can cause inflammation in the lungs and trigger breathing problems

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• theophylline (Uniphyl, Theo-24), an older and less-expensive oral bronchodilator

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• Antibiotics, which are sometimes prescribed to treat acute exacerbations or pneumonia
• Vaccinations: Patients with COPD should be fully vaccinated to decrease the risk of Influenza, Pneumonia, Covid, Pertussis, shingles, etc.

COPD Medication Prices

Here are some price ranges for COPD medications without insurance, but with pharmacy coupons for both generic and brand-name versions.

COPD is a chronic, lifelong condition, but treatment can help you manage symptoms and slow the progression of the disease, delaying the onset of later-stage COPD.

Talk to your doctor if you have questions about your life expectancy with COPD, but keep in mind that tools like the BODE index are generalized measurements, and life span varies tremendously from person to person.

One of the best ways to prevent COPD is to never start smoking or to stop smoking if you already do.

• Make sure any wood-burning stove or fireplace is well ventilated.
• Stay indoors if there’s noticeable air pollution outside.
• Make your home an environment free from secondhand smoke.
• If you work in an environment where you are exposed to chemical fumes and dust, speak with your supervisor about respiratory protective equipment and other ways to protect yourself.

• Heart disease
• Lung cancer
• Pulmonary hypertension
• Repeat infections
• Gastroesophageal reflux disease (GERD)
• Osteoporosis
• Depression

COPD shares signs and symptoms with several other conditions, including:

• Asthma Overlapping symptoms include shortness of breath, cough, wheezing, and chest tightness.

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• Rheumatoid Arthritis (RA) This autoimmune disease affects the joints, and it's been linked to a higher risk of COPD. The reason for this is unknown, but inflammation may play a role.

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• Eosinophilic Esophagitis (EoE) This chronic disease of the esophagus may look like COPD or occur along with it. EoE causes white blood cells to fill and inflame the lining of the esophagus, leading to breathing and swallowing problems.

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• COPD is a common yet serious lung condition that makes breathing difficult by blocking airflow, often through emphysema or chronic bronchitis.
• Symptoms like wheezing, shortness of breath, and fatigue can develop slowly, sometimes leading to severe health issues. Smoking is the primary cause, but other factors like genetic predispositions and environmental irritants also contribute.
• Proper diagnosis and treatment, which include medications, lifestyle changes, and sometimes advanced therapies, can help manage the disease and improve quality of life.
• Understanding COPD's causes, symptoms, and treatment options is crucial for managing this lifelong condition effectively.