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COPD: Stages, Causes, Symptoms And Treatment



COPD, which stands for Chronic Obstructive Pulmonary Disease, refers to a group of lung diseases that are lifelong, excruciatingly painful and irreversible. These illnesses are chronic because they are incurable. Smoking, air pollution due to industrialization and long-term exposure to irritants are just some of the causes. The patient faces difficulty breathing, and coughs or wheezes, as his lungs struggle to exchange the two primary gases of respiration, COand H2O. In this article, we will do a quick overview of the causes, effects and preventive measures of this malady.

Stages Of COPD

Although its name makes it seem like a single disease, it really isn’t. In fact, it is a group of related diseases all of which are pulmonary and can make you feel out of breath. Depending on the intensity of the disease, the affected patients are placed in one of four categories i.e. stages.

  • Early Stage COPD (I)
  • Moderate Stage COPD (II)
  • Severe COPD (III)
  • Very severe COPD (IV)

Early Stage COPD

In its early stage, the patient manifests symptoms in a very mild and discreet manner. The symptoms are unnoticeable so much so that it is very rare for somebody to visit a doctor at this point. Most people are alerted that there may be something seriously wrong with their breathing apparatus at a later stage. However, if you are very observant and are experiencing a persistent cough or are spitting phlegm on a regular basis, then you must see a doctor at the earliest.

Moderate Stage COPD

This is the stage where symptoms actually aggravate to a degree where the patient is wondering, “Something is wrong with me.”  This is the most common stage at which most patients visit a doctor for the first time. The symptoms that are observed at this stage are trouble breathing especially in extreme weathers (such as a snowstorm), trouble sleeping, wheezing during a flare-up, coughing all the time and spitting out a white, yellow or green mucus. Likewise, some mental indications include forgetfulness, tiredness, and confusion.
To diagnose stage II, medical specialists conduct a breathing test. One of the results for this test is FEV1. A stage II patient would have an FEV1 from 50-80%.


Stage III is the point where things get so worse that your condition starts to take a toll on your daily life. You begin to experience more frequent flare-ups. You may start having chest tightness and a faster heartbeat than normal. Your lips and nails may be tinted blue. Some patients also have swollen feet, hands, and legs.

Very Severe COPD

The fourth stage is the end stage of this disease. It is characterized by irreparable damage to the airways and alveoli with the breathing mechanism disturbed and almost out of order. When a patient of Stage IV struggles to catch a breath, it is an unfortunate spectacle. It seems as if he is dying and breathing his last. Some other signs and symptoms that act as markers for this stage are:

  • Crackling sound while breathing
  • Expirations that last for a longer duration than normal
  • Constant coughing and wheezing
  • Barrel-shaped chest
  • Acute exacerbations
  • Low blood oxygen levels

Causes Of COPD

Extensive research done into the causes of COPD reveals that the most common everyday activity that leads up to the disease is smoking.

Smoking and COPD

Smoking And COPD
Smoking And COPD

COPD has become a global public health crisis over the decades. According to estimates, nearly a billion people would die of tobacco use in the 21st century. According to studies, about 15-20% of long-term smokers develop COPD with heavy smokers(over three packs a day) showing a greater incidence of the illness.
Actually when a person smokes and the tobacco burns, a large number of chemicals enter his airstream. These chemicals include tars, nicotine and carbon monoxide. As these chemicals reach the lungs, they cause inflammation of airways and air sacs. Also, they change normal cells into malignant cells. In addition to causing cancer, these cells are fully capable of increasing the production of mucus in the lungs.

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When large amounts of mucus are being secreted in the lungs, it clogs and obstructs the respiratory channels. The passage of respiratory gases is hindered. As a result, the affected person feels out of breath for long periods of time and coughs out mucus regularly. The long and short of it is that smoking prevents the lungs from performing their main role i.e. gaseous exchange. Consequently, smokers are at a higher risk of suffering from COPD, lung cancer, Tuberculosis, pneumonia, chest infection, and emphysema.

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Alpha-1 Antitrypsin Deficiency

It is a genetic anomaly that is caused by a mutation in the SERPINA1 gene. This gene encodes information for the synthesis of a protein called Alpha-1 Antitrypsin. Further, this protein regulates the activity of a powerful enzyme, neutrophil elastase.
If there occurs a mutation of the SERPINA1 gene, the synthesis of Alpha-1 Antitrypsin is defective. The protein is not formed normally and hence the Neutrophil Elastase, that generally attacks foreign invaders, now begins to attack healthy tissues especially those of the Lungs. It destroys air sacs and causes inflammation of lung tissue. This is how a deficiency of functional Alpha-1 Antitrypsin is responsible for causing Chronic Obstructive Pulmonary Disease.
The diagnosis of Alpha-1 Antitrypsin deficiency is rare. Often times, it is misdiagnosed as asthma. The deficiency affects 1 out of every 3500 individuals of European descent.

Exposure To Industrial Agents

There is sufficient research that links exposure to industrial chemicals and toxins with the development of COPD. For instance, coal miners, hard-rock miners, tunnel workers, concrete-manufacturing workers, brick-making, stonemasonry, non-mining industrial workers are at the highest risk for the disease. According to studies conducted on animals, occupational agents can induce the condition.

Many large population-based studies suggest that the exposure to work-related dusts, noxious gases, vapors and fumes (DGVF) contributes to a sizeable amount of COPD cases. To sum up, this exposure may be inhalation of mineral and biological dusts or breathing in chemicals such as hydrofluoric acid. Listed below are some of the agents that induce emphysema or COPD:

  • Cadmium dust and fumes
  • Oven cleaners
  • Grain and flour dust
  • Spray polish
  • Silica dust
  • Household cleaners that contain bleach or ammonia
  • Welding fumes
  • Isocyanates
  • Coal dust

“There’s very strong evidence that if you’re exposed to vapors, dust, gas, and fumes at the workplace, then you have increased risk of COPD – independent of smoking.”

Dr. John Balmes, a professor at the University of California–San Francisco medical school and at the UC–Berkeley School of Public Health.

Symptoms Of COPD

Chronic Obstructive Pulmonary Disease develops over many years as the symptoms worsen over time. As a result, the patient may be unaware he has COPD at first. The general symptoms include:

  • Breathlessness(dyspnea)
  • Having trouble breathing at night
  • Having trouble breathing in extreme weather
  • Cough that never seems to go away
  • Spitting phlegm
  • A general feeling of tightness in your chest
  • Wheezing and coughing
  • Fatigue

The symptoms aggravate over time making regular breathing difficult and daily activities uncomfortable. However, treatment can help a person get better and slow down the progression of the disease.

Treatment Of COPD

Although COPD is incurable, the patient can feel better with therapeutic options like pulmonary rehabilitation and anti-inflammatory drugs. Elaborated below are some of the treatment options available to a patient of COPD:

  • Anti-inflammatory drugs to help reduce inflammation
  • Quick-relief drugs that have an immediate effect on the lungs
  • Long-term antibiotics
  • Steroids
  • Bronchodilators
  • Oxygen therapy
  • Pulmonary rehabilitation
  • Use of an endotracheal tube


Tobbaco Smoking
Tobbaco Smoking

In short, Chronic Obstructive Pulmonary Disease is a deadly lung disease and living with it can be very challenging. But treatment programs like pulmonary rehabilitation appear very promising for patients. The Pulmonary Rehab program actually contains a tailored scheme of exercises, breathing techniques and lifestyle choices that can help patients cope better with challenges of everyday life. Therefore, patients must not lose hope and stay optimistic and goal-oriented toward bettering their condition.

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