Chronic obstructive pulmonary disease, or COPD, is the third leading cause of death worldwide – in 2019 alone it caused 3.23 million deaths, according to the World Health Organization. It is primarily caused by smoking or exposure to tobacco smoke, although it can also result from other environmental causes, such as fumes, dust and chemicals.

Read on to find out more about COPD, or connect to other people who are living with the condition by joining Carecircle.

What is COPD?

COPD is an umbrella term for progressive lung conditions that make it harder to breathe. Emphysema and chronic bronchitis are the two most common conditions, and people with COPD may have one or both of them. Both cause damage to the lungs, which makes it harder to breathe. As the name implies, COPD is chronic and cannot be cured, but its progression can be slowed with treatment.

What is the difference between emphysema and COPD?

Emphysema and COPD are terms that are often used interchangeably, but they’re not quite the same. Emphysema comes under the umbrella term of COPD, so someone with emphysema might be said to have COPD. However a person with COPD might not necessarily have emphysema: they might just be affected by chronic bronchitis, another disease under the COPD umbrella term.

Types of COPD

Two common lung diseases come under the umbrella term of COPD, and often they occur together:

• Emphysema – The airways in the lung split into smaller and smaller passageways, which eventually end in tiny air sacs called alveoli. In emphysema, these alveoli are damaged and split into larger air spaces, consequently reducing the surface area of the lung and making it less efficient at extracting oxygen from the air. This results in shortness of breath and potentially other complications.
• Chronic bronchitis – This is where the airways of the lung (bronchi) become inflamed and narrowed, making it harder to breathe. People with chronic bronchitis often cough up phlegm.

Asthma is sometimes also listed as a COPD condition, although it’s not universally recognised as one.

COPD symptoms

The main symptoms of COPD are:

• Breathlessness that steadily gets worse over time. At first, this might only happen during exercise.
• A chesty cough that is persistent and produces phlegm.
• Chest infections that keep recurring
• Wheezing

Occasionally these symptoms may suddenly get worse: what’s known as a flare-up or exacerbation.

Other, less common symptoms include tiredness, chest pain, swollen ankles and weight loss.

Signs of COPD getting worse

The above symptoms – breathlessness, a chesty cough, chest infections and wheezing – will gradually worsen over time. In addition to these, signs of an exacerbation or worsening COPD include fatigue, difficulty in sleeping, headaches, confusion and a drop in oxygen levels in the blood.

The four stages of COPD

COPD is a progressive disease, and its progression is measured according to the guidelines of the Global Initiative for Chronic Obstructive Lung Disease (GOLD). The four stages of COPD are designated according to the patient’s lung function, measured as the forced expiratory volume in 1 second (FEV1) – in other words, how much air the patient can breathe out in 1 second. The four stages are:

• Mild (Stage 1) – FEV1 of 80% or more
• Moderate (Stage 2) – FEV1 of 50–79%
• Severe (Stage 3) – FEV1 of 30–49%
• Very severe (Stage 4) – FEV1 of less than 30%

In addition, patients are assigned to a group on the basis of their symptoms:

• Group A – 0–1 flare-ups each year that do not require hospitalisation, and fewer symptoms
• Group B – 0–1 flare-ups each year that do not require hospitalisation, and more symptoms
• Group C – 2 or more flare-ups each year, or 1 or more that require hospitalisation, and fewer symptoms
• Group D – 2 or more flare-ups each year, or 1 or more that require hospitalisation, and more symptoms

Join Carecircle for free and find help, hope and control with your COPD diagnosis. Our global network for health makes you part of a worldwide community where your voice matters. Together, we can work towards a better future.

What causes COPD?

The main cause of COPD is smoking, which is thought to be responsible for around 90% of cases. The chemicals in tobacco smoke cause irreversible damage to the lungs.

The inhalation of dust and fumes over a long period has also been linked to COPD. These could be things like flour dust, welding fumes or coal dust. Air pollution has also been suggested to be a risk factor for COPD, but research into this is ongoing.

In roughly 1% of COPD cases, there is a genetic factor, where people are more susceptible to COPD because they are deficient in a chemical called alpha-1-antitrypsin, which normally acts to protect your lungs.

COPD diagnosis

If you’re worried about COPD, you should schedule a visit with your doctor. They will ask you some questions about your symptoms, as well as listen to your breathing with a stethoscope. In addition, they will usually arrange for a spirometry test – a test designed to measure the capacity of your lungs. The test involves breathing into a spirometer after inhaling a drug called a bronchodilator, which widens the passageways in your lungs. In addition to measuring the total amount of air you can breathe out, the machine will measure the volume of air you can breathe out in 1 second (FEV1). These results will then be compared with the typical results for someone the same age as you.

You’re also likely to be scheduled for a chest X-ray to look for other potential problems such as lung cancer, and be given a blood test to rule out any other conditions that could be producing similar symptoms. The blood test can also be used to check for alpha-1-antitrypsin deficiency, a rare risk factor for COPD.

Further tests might be required to assess the severity of the disease or confirm the diagnosis, such as an electrocardiogram (ECG), a CT scan or a blood oxygen test.

What to do if you have COPD?

If you’re a smoker, the first thing to do if you have been diagnosed with COPD is to stop smoking. This is by far the most effective way of slowing the progression of the disease.

Beyond this, it’s important to maintain a healthy lifestyle by eating healthily and exercising regularly. Your doctor can advise you on how much and what type of exercise you should be doing given your symptoms. Losing weight can also help to ease breathlessness.

It’s important to seek support wherever you can, whether it’s from doctors, friends, family, counsellors or charities such as Asthma + Lung UK. By joining Carecircle, you can connect with others who are experiencing similar problems with COPD.

COPD life expectancy

The impact that COPD has on life expectancy can vary dramatically on the basis of things like age, overall health and the severity of symptoms. But making positive changes such as stopping smoking, controlling your weight and exercising regularly can have a big impact on the condition.

Join Carecircle for free and find help, hope and control with your COPD diagnosis. Our global network for health makes you part of a worldwide community where your voice matters. Together, we can work towards a better future.

COPD treatment

There is no cure for COPD, but there are a range of treatments that can slow the progression of the disease or ease the symptoms:

• Smoking cessation – Stopping smoking has a dramatic effect on COPD.
• Pulmonary rehabilitation – This is an exercise and education programme that helps patients to manage their symptoms.
• Inhalers – These usually deliver bronchodilators directly into your lungs to widen the air passageways and make breathing easier. Steroid inhalers can also be prescribed to reduce inflammation in the lungs.
• Tablets – These can include theophylline, a type of bronchodilator; mucolytics, for clearing mucus in the lungs; steroids, for calming inflammation; antibiotics, for dealing with chest infections; and roflumilast, for treating flare-ups.
• Oxygen therapy – This is where oxygen is delivered through a nasal tube or mask.
• Surgery – In extreme cases, surgery might be needed to remove a damaged section of lung or to remove a pocket of air. In a few cases, a lung transplant might be needed.

Breathing exercises for COPD

There are several breathing techniques that can help to control breathlessness. Importantly, worrying thoughts can lead to breathlessness, which in turn can cause sensations of panic, leading to more problems with breathlessness. Techniques like paced breathing and pursed-lips breathing can help you to control your breathing: see the Asthma + Lung UK website for more information on how to manage breathlessness.

Chronic Obstructive Pulmonary Disease (COPD) FAQs

Below are a few answers to some of the most commonly asked questions about COPD.

Is COPD hereditary?

In the vast majority of COPD cases, there is no genetic factor involved. However, a small number of people are deficient in a chemical called alpha-1-antitrypsin, which may make them more vulnerable to developing COPD.

How fast does COPD progress?

The rate of progression of COPD varies hugely from person to person. Stopping smoking has the biggest effect on slowing the progression of COPD, and diagnosing the disease early and making appropriate lifestyle changes can also have a big impact.

How to test yourself for COPD?

There is no at-home test for COPD. But if you have a cough that does not seem to go away, or you frequently experience shortness of breath, you should consult your doctor, who may perform a spirometry test.

When to go to the hospital with COPD?

If you are suddenly struggling to breathe, and your chest feels tight, you have a spreading pain in your chest, or you feel sick, then you should call for help straight away.

Join Carecircle for free and find help, hope and control with your COPD diagnosis. Our global network for health makes you part of a worldwide community where your voice matters. Together, we can work towards a better future.

COPD resources

Below are a few links to websites that can provide information about COPD:

• Asthma + Lung UK
• COPD Foundation
• American Lung Association
• NHS COPD Overview

We hope that this guide has been useful if you or someone close to you has been recently diagnosed with COPD, or if you suspect you or someone close to you shows symptoms. If you’re concerned about any of the symptoms mentioned in this article, speak with your doctor. And remember that there’s a whole community out there on Carecircle who can provide support.

Guide sources

• NHS COPD Overview
• World Health Organization: COPD
• Asthma + Lung UK: COPD
• Centers for Disease Control and Prevention: COPD
• Devine, J. F. Chronic Obstructive Pulmonary Disease: An Overview. Am. Health Drug Benefits 1(7), 34–42 (2008);
• American Lung Association: Chronic Obstructive Pulmonary Disease (COPD)
• Mayo Clinic: Emphysema
• Stanford Health Care: Types of Chronic Obstructive Pulmonary Disease
• Medical News Today: What are the signs of worsening COPD?
• Global Allergy & Airways Patient Platform: Four Stages of COPD
• NICE: Chronic Obstructive Pulmonary Disease: What is the prognosis?