What you should know about the stages of COPD

Chronic obstructive pulmonary disease (COPD) is a group of lung diseases that affects more than 15 million American adults, with many more going undiagnosed, according to the U.S. Centers for Disease Control and Prevention.

COPD is a lung condition that comes on gradually, and people often don't realize they have it until symptoms become severe.

With COPD, less air flows in and out of the airways, making it hard to breathe. This can result in less physical activity and diminished quality of life. This lung condition is often accompanied by other health problems, known as comorbidities. These conditions include high blood pressure, diabetes, and heart disease.

What causes COPD?

Smoking is the No. 1 cause of COPD, so if you smoke or used to smoke, you are at a higher risk of developing the disease. Quitting smoking helps not only with reducing COPD risk, but it can also decrease your risk of developing other smoking-related illnesses such as cancer and heart disease.

Stopping smoking can slow down the progression of COPD and make your treatments more effective. Within just a few weeks of quitting, you can notice improvements in your breathing, coughing, and clogged sinuses. If you smoke and are having trouble stopping, you don't have to do it alone. There are various resources that can help you successfully quit for good.

Smoking is not the only factor that contributes to COPD. Environmental toxins found in the workplace and even at home, such as ammonia, asbestos, fumes, cleaning chemicals, and dust, can cause COPD. Genetics play a part as well. If your family has a predisposition to or a history of COPD, you may be more susceptible.

Emphysema and bronchitis

Lung diseases emphysema and chronic bronchitis are the most common types of COPD.

Emphysema is a condition that causes shortness of breath. In people who have it, the alveoli, which are the tiny air sacs at the end of the smallest air passages in the lungs, have been damaged. Over time, the inner walls of the air sacs weaken and rupture, creating larger air spaces instead of many small ones. This reduces the surface area of the lungs and, in turn, the amount of oxygen that reaches your bloodstream.

Most people with emphysema have chronic bronchitis, in which the bronchial tubes, which carry air to and from the alveoli, become inflamed, causing a persistent cough and mucus development, making it difficult to breath.

Symptoms of COPD

COPD symptoms often don't appear until significant lung damage has occurred. These symptoms include:

• Being short of breath
• Chest tightness
• Chronic cough that might produce clear, white, yellow, or green mucus
• Excess phlegm or sputum
• Recurring respiratory infections
• Frequent wheezing
• Lack of energy
• Trouble taking a deep breath
• Swelling in ankles, feet, or legs

People with COPD also experience episodes called exacerbations, or flare-ups. During this time, their symptoms worsen and can last for several days or more.

The four stages of COPD

The severity of COPD is diagnosed using a simple breathing test called spirometry that measures lung function. A patient blows into a mouthpiece that is connected to a machine called a spirometer. This testing captures two measurements:

• Forced vital capacity (FVC): The amount of air you can completely exhale in one breath
• Forced expiratory volume (FEV1): The amount of air you can exhale from your lungs in one second

Those two numbers are then compared to the values of a healthy person your age, height, and race. These figures are also used to measure your COPD status through a process known as the GOLD staging system. Developed by the Global Initiative for Chronic Obstructive Lung Disease (GOLD), this testing method helps determine the stages and severity of your condition to guide your treatment options.

The GOLD stages are:

• Stage 1: FEV1 80% volume or more of normal (mild)
• Stage 2: FEV1 between 50% and 80% volume of normal (moderate)
• Stage 3: FEV1 between 30% and 50% volume (severe)
• Stage 4: FEV1 lower than 30% volume (final stage)

Treating COPD

Though COPD is a progressive disease, it is treatable. With proper treatment and life care from a pulmonologist, many people with COPD can effectively manage their symptoms, improve their quality of life, and reduce the risk of associated conditions.

If you have COPD, the most important thing you can do is follow your provider's instructions. When you follow your treatment plan as prescribed, you can expect to:

• Breath better
• Cough less
• Increase strength and mobility
• Improve your mood

In addition to taking medication, your provider will suggest some specific steps you should take to improve your condition or slow its progression. Some of those steps may include:

• Avoiding smoky areas and places with fumes
• Being physically active
• Breathing exercises to strengthen the muscles needed to breathe
• Cooking meals near open doors or windows
• Eating a nutritious diet
• Keeping the air at home clean
• Maintaining a healthy weight

According to the COPD Foundation, there is no set life expectancy for people with the disease. In fact, even those with severe COPD can live a long life when they follow their treatment plan.

Long-term oxygen therapy may be used for COPD if you have hypoxia or Stage 3 or 4 COPD. Use of oxygen can slow or prevent heart failure and can increase your life expectancy.

COPD is not curable, but proper treatment can help manage symptoms and prolong quality of life. Request an appointment with one of the board-certified pulmonologists at Reid Health and start getting relief.