Says it all in a nutshell


How Does COPD Progress?

By Kristen Stewart | Medically reviewed by Lindsey Marcellin, MD, MPH

There's no cure for COPD, but you can work with your doctor to slow its progression. First, learn about how the chronic lung condition develops.

Few things are as scary as the inability to breathe, one of the most serious symptoms of COPD progression.

“Initially, the patient will develop a cough and possibly sputum production,” says Brian W. Carlin, MD, an assistant professor of medicine at Drexel University School of Medicine in Philadelphia and the immediate past chairman of the COPD Alliance. COPD, or chronic obstructive pulmonary disease, affects your lungs and generally gets worse over time. As the elasticity in the airways and air sacs decreases, less air is able to go in and out as you breathe. Other complications of COPD — such as thickening or inflammation of the airways and more mucus accumulation — can further restrict airflow.

The progression of COPD can vary greatly. “COPD is an exaggeration of the natural aging process of the lung,” says Richard S. Novitch, MD, director of cardiopulmonary rehabilitation at Burke Rehabilitation Hospital in White Plains, N.Y. “Each individual is different, and the illness presents differently in them.”

How COPD Progresses

Think of COPD progression in stages. Stage I, or mild COPD, appears subtly — you might notice you feel short of breath when you exercise or do strenuous tasks around the house like yard work or carrying heavy objects. Sometimes an unexplained cough is the flashing red light. Many people at this stage don’t even realize they have a medical problem and fail to mention it to their doctors, instead chalking off the symptoms to age, weight gain, or smoking.

“While many smokers think that they have a ‘normal’ smoker’s cough, there is really no such thing as a ‘normal cough,’” says Dr. Carlin. “The cough often occurs years before the development of other symptoms, such as shortness of breath.”

Exacerbations are another warning sign of COPD, according to Carlin. Many people mistakenly believe these periods of increasing shortness of breath, cough, or sputum production are bronchitis, but in reality they are likely warning signs that the condition is progressing.

Moderate or stage II COPD is where most diagnoses are made. The symptoms at this stage of COPD will start to interfere with daily activities, making them harder to ignore.

Stage III or severe COPD is impossible to dismiss. “This is when patients are usually no longer able to work and have significant quality-of-life issues,” says Meg Schneider, co-author with Kevin Felner, MD, of COPD for Dummies. At stage III, you often feel short of breath even when sitting or lying down, Dr. Schneider explains. You cough frequently and often cough up a lot of mucus. Your immune system is weak, making you more susceptible to colds and other respiratory infections, and it takes much longer to recover. Fatigue, muscle weakness, and lack of appetite are also common.

Slowing the Progression of COPD

Smoking is the No. 1 risk factor for developing COPD and worsening of symptoms, so quitting is key in trying to slow the condition’s progression. “The sooner you quit, the sooner you stop the damage to your lungs,” says Schneider.

Lighting up is not the only cause, however. Exposure over a long period of time to dust, certain chemicals or fumes, secondhand smoke, and other air pollution can also contribute to COPD, so avoiding these situations is critical.

Getting the right treatment is important, too. With mild COPD, a fast-acting inhaler can help constricted airways on an as-needed basis. Longer-acting bronchodilators (which can keep airways open) or inhaled steroids may be prescribed for stage II COPD. Stage III requires intensive treatment usually including steroids, oxygen, bronchodilators, and sometimes even surgery. Pulmonary lung rehabilitation is another option to help you stay active. Your doctor is the starting point for any of these approaches.

Finally, positive lifestyle habits can help slow COPD progression and boost your overall health. These include regular exercise, a healthy diet in order to maintain an ideal weight, and getting enough rest.

I make no apologies for posting this in full as it says all we copders need to know.

Coughalot x

35 Replies

  • Good post coughalot, no point in burying your head in the sand is there. It pays to face up to the problem and set about doing what you can to help yourself.

    Tony x

  • Very interesting post cough and will relay the info to Pete. He does need to work on the healthier diet I feel. Take care, xxxx

  • I think this is brilliant. It says it in words we can all understand doesn't it? Straightforward and to the point. x

  • excellent post cough, thank you xxx

  • Has there been a re-think on stages? I was told I was Stage 4, but it's not listed above in the post.

  • Its an American report so not the same as our stages.

    But basically saying everything thats on our NHS site about COPD.

  • Hi Riverbank nice to see you. I thought the stages were the same - mild, moderate, severe, very severe and end stage. It says it all succintly so think it is better than the NHS site. x

  • At last I will know what the 3 stages are. Thank you

  • I think stage 4 is very severe and stage 5 is end stage. But you can live a long time in both stages x

  • Stage 4 is AKA 'End stage':

  • Fair enough thank you. I think the USA version is more generally descriptive though. x

  • Great clarification, stilltruckin, thank you. I intend to be around for a long time x

  • Coughalot very interesting post I am stage 11 I have had COPD for over 35 years now :( so to still be at that stage is a bonus :) 70 in April :( lol x

  • That's great Victoria, you must be doing something right! After hearing of some copders fast progression you give us all hope. x

  • Glad if it helps. It's such a blow to find out you have this awful disease wish there had been something like this when I was diagnosed.

    Take care Rose

  • I understand there are 4 stages - stage 4 being very severe. I think the information you posted, with respect is out of date and misleading. :)

  • Well apart from the stages which parts are out of date and misleading?

  • Hi coughalot, I thought the part about stage 3 was misleading but I realise it was written with no reference to Stage 4 -very severe and is also called end stage. I presume the information is from an American site where there is no stage 4? The Nice guidelines here refer to 4 stages. :)x

    I think 'end stage' is a horrible term that can frighten people. It's not a terminal prognosis at all.

  • Well end stage isn't mentioned in the article is it? So apart from the stages the rest of it isn't misleading or out of date as far as I can see. Because the stages are slighly different it doesn't invalidate the whole article.

  • Apologies, I didn't mean the whole article only the bit about stages and I should have made it clear. In fact I think it's quite an informative article. :)

  • Fair enough thank you sirjames. x

  • Stilltruckin did post a link from a UK site that does give the 4 stages of the condition, but the origional post did have me confused x

  • good post cough, and good thread, as tony says, no point in burying our heads in the sand,

    lots of love jimmy xxx :)

    p.s stage 1, stage 2 stage 3 i'm on stagecoach!!!, :D i just hope them horse are very slow at pulling it :D [big slow easy going clydesdales :D , def not race horses ] jimy xx :)

  • You will live forever Jimmy :d x

  • no doubt about that cough :D

    just think of it :D youll just have to put up with me at your new years part,,, next year :D,,,again lol x

    many thanks cough,, love jimmy xxx :)

  • You will be the guest of honour every year Jimmy - next year will be fancy dress and I expect you to come as a squirrel... :d :) xx

  • or a nut!! :D jimmy xx

  • How about a squirrel holding his nuts? :d x

  • you said that not me:D i was only thinking that :D

    or i could go in my kilt,,,,,,,,,,,,,,,,,

    holding my,,,,,,,,,,,,,

    sporran!! :D love jimmy xxx :)

  • Is that where you would store your nuts? :d x

  • Good bit of info there.

  • Interesting read. Always pays to be informed. Cheers for that coughalot xx

  • Thanks Cough,I,ve decided I,m stopping at very severe and won,t be entertaining " end stage". I,m far to young and beautiful( lol ) to be ending anything.I intend to still be very severe until at least I,m 80.That gives me 21 years to get up to all sorts of mischief ! :D

  • Good on you FarmerD - go for it :d xx

  • Thank you :)

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