What Is COPD and What Are Its Symptoms?

COPD is one of the most common chronic diseases in the world and often progresses insidiously over years. The name may sound frightening, but its basis is simple: your airways become permanently narrowed and your lungs struggle to take air in and push it out. This guide brings together in one place what COPD is, the symptoms it shows, its causes, how it is diagnosed and treatment options. For each heading you want to explore in depth, we'll also point you to our related guide articles.

What is COPD?

COPD is the abbreviation of "Chronic Obstructive Pulmonary Disease." "Chronic" means long-term, "obstructive" means obstructing (narrowing). The disease covers two main conditions: chronic bronchitis, with long-term airway inflammation and excess mucus, and emphysema, in which the air sacs (alveoli) are damaged. In many patients these two coexist. The common result is air trapping in the lungs and shortness of breath.

COPD symptoms

COPD symptoms usually begin slowly and increase over time. Because they are mild in the early period, they are often overlooked. The main symptoms are:

• Persistent cough (often mistaken for a "smoker's cough")
• Phlegm production — especially in the mornings
• Shortness of breath that increases with exertion (first on stairs/hills, then on level walking)
• Wheezing and a feeling of tightness in the chest
• Frequently recurring respiratory infections
• Fatigue and weight loss in the later period

Causes of COPD

By far the most common cause of COPD is cigarette and tobacco exposure. But it is not the only cause. Other risk factors are: long-term air pollution and workplace dust/chemical exposure, biomass fuel (wood, dung) smoke, past serious respiratory infections and the rare genetic alpha-1 antitrypsin deficiency. COPD can also develop in non-smokers due to these causes.

How is COPD diagnosed?

The basis of a COPD diagnosis is a simple, painless breathing test called spirometry. The test measures how much air you can blow out and how fast you can do it. The physician also evaluates your symptoms, smoking history and, if needed, lung imaging. Early diagnosis is very valuable: the earlier the disease is caught, the higher the chance of slowing its progression.

COPD stages

COPD is classified into four GOLD stages according to the airflow limitation in spirometry: mild (1), moderate (2), severe (3) and very severe (4). As the stage rises, symptoms and flare-ups increase and treatment intensifies accordingly. For the details of the stages and what to expect at each, see our separate guide.

COPD treatment

COPD cannot be fully cured today, but it can be controlled. The foundation of treatment is quitting smoking; to this are added long-acting inhalers, pulmonary rehabilitation, vaccines and flare-up management. In selected advanced patients who do not respond adequately to medication and rehabilitation, surgical or bronchoscopic interventions (endobronchial valves, volume reduction, balloon methods in chronic bronchitis) may be evaluated. These interventions do not cure the disease; the aim is to relieve symptoms and improve quality of life, and eligibility depends on specialist assessment.