COPD Symptoms, Diagnosis, and Treatment

Chronic obstructive pulmonary disease (COPD) affects more than 15 million adults in the United States. COPD makes it hard for patients to breathe. It also can increase patients’ risk of getting severely ill from other infections like COVID-19.

James Mojica, MD, a Mass General Brigham pulmonologist and critical care doctor, answers common questions about COPD symptoms, causes, risk factors, and treatment options. Dr. Mojica is the vice chief and clinical director of pulmonary and critical care at Massachusetts General Hospital, and the director of the Sleep Center at Spaulding Rehabilitation. 

What is COPD?

"We use the initials COPD to describe the disease,” says Dr. Mojica. “I think it's helpful to think of it backward.”

• D is a disease or a condition that causes symptoms
• P is pulmonary meaning that it affects the lungs
• O is obstructive because mucus and swelling can affect airflow and obstruct the lungs
• C is a chronic condition that does not go away but can be managed

COPD Symptoms

Symptoms of COPD can include:

• Shortness of breath
• Frequent wheezing or coughing
• Excess phlegm or mucus
• Trouble taking deep breaths

What are the types of COPD?

There are two general types of COPD:

1. Emphysema. This condition makes it hard for your body to transfer oxygen from the air into your blood. It also causes shortness of breath. This is because the lungs lose elasticity and cannot expand as they should.
2. Chronic bronchitis. This condition causes irritation of the airways or the bronchial tubes. Chronic bronchitis causes an increase in mucus, coughing, and shortness of breath.

COPD risk factors

COPD risk factors can include:

• Air pollutants
• Tobacco smoke
• Fumes
• Chemicals
• Mold
• Dust
• Genetic history

Treatment for COPD

While we can't cure COPD, there are three types of treatment that help manage it:

1. Medications
2. Pulmonary rehabilitation
3. Smoking cessation (quitting smoking)

COPD medications

COPD medications sometimes come in tablet form. Other times, patients inhale medications using a nebulizer. This is a small device that turns liquid medication into a mist. In both cases, these medications relax the lungs, improve airflow, and reduce inflammation caused by COPD.

Pulmonary rehabilitation

Pulmonary rehabilitation is another essential COPD management tool. Typically, this is a two-part program of supervised exercise and classroom work. The structured exercises help patients improve their endurance, well-being, and breathing ability. And the coordinating classes can teach patients how their lungs work and how COPD affects them.

"One of the things that I see is people with COPD restricting their activities," says Dr. Mojica. “The benefit of pulmonary rehabilitation is that you’re able to resume activities such as walking your dog.” 

Smoking cessation

Smoking is one of the leading causes of COPD in the U.S. For some patients, quitting smoking is an important, and challenging, part of COPD treatment. Luckily, there is more support than ever before for people who want to quit. 

“People come to me all the time stating that they’ve tried everything to stop smoking and nothing works,” says Dr. Mojica. “But actually, smoking cessation therapies continue to evolve and can be personalized to help you stop smoking.”