COPD GUIDE
What Is COPD? Symptoms, Causes, Stages and Treatment
Prof. Dr. Yalçın Karakoca · Last updated: 25 September 2026
SHORT ANSWER
COPD (chronic obstructive pulmonary disease) is a long-term lung disease. The airways narrow and the air sacs are damaged. This makes breathing out harder. The most common symptoms are shortness of breath that gets worse with exertion, a cough that does not go away, and phlegm. The most important cause is smoking. The diagnosis is made with a breathing test (spirometry). COPD does not go away completely. But with treatment, symptoms may decrease and the progression of the disease can be slowed.
What happens in the lungs in COPD?
In COPD, two problems are present together in different proportions:
- Chronic bronchitis: The inner lining of the airways becomes inflamed and thickened. A lot of phlegm is produced and the airways narrow. → Chronic bronchitis
- Emphysema: The air sacs are damaged and the lung loses its elasticity. Air stays inside when you breathe out. → Emphysema
Which of the two predominates determines both the symptoms and the treatment options.
Symptoms
The most common symptoms are:
- Shortness of breath on exertion (stairs, hills, walking fast)
- A long-lasting cough
- Phlegm, especially in the morning
- Wheezing and chest tightness
- Tiring easily
- Frequent chest infections
As the disease progresses, shortness of breath may also occur during light activities such as getting dressed. Shortness of breath may occur even at rest, and the oxygen in the blood may fall. Details: COPD symptoms.
Causes and risk factors
| Factor | Explanation |
|---|---|
| Smoking and tobacco | The most important cause; this includes exposure to cigarette smoke (passive smoking). Not everyone who smokes develops COPD; it can also occur in people who do not smoke |
| Air pollution | Long-term exposure to polluted air |
| Dust and chemicals at work | Mining, construction, metalwork, textile and agricultural work |
| Smoke from wood, coal or dung | Heating and cooking with these fuels (especially in women) |
| Heredity | Deficiency of alpha-1 antitrypsin (a protein that protects the lungs); may lead to emphysema at a young age |
| Early life | Premature birth, severe lung infections in childhood, incomplete development of the lungs |
| Asthma | Long-term inflammation of the airways |
How is the diagnosis made?
- Breathing test (spirometry): You take a deep breath and blow into a device as fast as you can. The test is repeated after you have been given a bronchodilator medicine. If there is a persistent narrowing of the airflow, COPD is diagnosed. The test also shows how severe the disease is.
- Imaging: A chest X-ray and, if needed, a chest CT scan. The CT scan shows where the emphysema is and how widespread it is. It also shows the airway walls and any accompanying diseases.
- Other tests: Fingertip oxygen measurement or a blood gas test is carried out. A blood count and a walk test may also be done. If COPD occurs at a young age or runs in the family, the alpha-1 antitrypsin level is checked. If a treatment such as a lung valve is being planned, other tests are also done. These are lung volume measurements and an oxygen transfer test (DLCO).
A normal chest X-ray does not rule out COPD. A breathing test is needed for the diagnosis.
Stages
Based on the breathing test values, COPD is divided into four stages, from mild to very severe. In reports, these stages are written as “GOLD 1–4”. GOLD is the name of the international COPD guideline. Your doctor also looks at how severe your symptoms are and at the flare-ups you have had in the past year. The stage alone does not show how you feel. Details: Stages of COPD · End-stage COPD.
Treatment
- Stopping smoking: This is the most effective step for slowing the progression of the disease. (Smoking and COPD)
- Inhaler medicines: Long-acting bronchodilator medicines are used. Some patients also need a steroid inhaler. Using the medicine with the correct technique is very important.
- Vaccines: Flu, pneumococcal (pneumonia), whooping cough and COVID-19 vaccines. At the appropriate age, RSV (a respiratory virus) and shingles vaccines are also given.
- Breathing exercises and an exercise programme: These reduce shortness of breath and make daily life easier. (Breathing exercises)
- Oxygen therapy: If the oxygen in the blood is below a certain level. (Oxygen therapy)
- Preventing flare-ups and treating them early. (Exacerbations)
- New medicines: Biologic medicines given by injection, and ensifentrine, for certain groups of patients. (New treatments)
- Treatments using a bronchoscope: A bronchoscope is a tube with a camera at its tip. It is passed through the mouth into the airways. These treatments are considered in selected patients whose symptoms continue despite medicines. In COPD in which cough and phlegm predominate, balloon treatment is used. In emphysema, lung valves are used. There are also surgical options. (Comparison)
Details: COPD treatment.
When should you see a pulmonologist?
See a pulmonologist if you have any of the following:
- A cough or phlegm that has not gone away for weeks
- Shortness of breath on exertion
- A drop in your fitness, if you smoke or have smoked in the past
Call 112 immediately in these situations:
- Sudden or severe shortness of breath
- Breathing difficulty that makes it hard to speak
- Lips turning blue
- Confusion
PRELIMINARY ASSESSMENT
Is it suitable for you?
Book an appointment and bring your breathing test and chest CT scan reports. We decide together at the consultation. If you are coming from outside Istanbul, an online preliminary consultation can be held first.
Please bring: your breathing test, your chest CT scan report and images (CD/USB), your list of medicines and, if you have one, your blood gas test result.
RELATED PAGES
COPD GUIDE
Most searched COPD topics
Breathing exercises, physical activity and nutrition.
HAVE A QUESTION?
Frequently asked questions
The questions our patients and their relatives ask most often, with answers. We discuss questions about your own situation together at the consultation.
APPOINTMENT
Book an appointment for a preliminary assessment
To find out whether you are suitable, book a preliminary assessment appointment. Bring your breathing test, chest CT scan report and list of medicines with you.
info@yalcinkarakoca.com · Rüzgarlıbahçe Mah. Cumhuriyet Cad. Hasoğlu Plaza Kat:3, Kavacık / Beykoz, İstanbul
REFERENCES
- International COPD guideline (GOLD 2026 report); Turkish Thoracic Society COPD Diagnosis and Treatment Consensus Report.
This page is for general information purposes. It does not replace a medical examination or diagnosis. Treatment decisions are made during an examination, on an individual basis. In an emergency, call 112.
Medical content review: Prof. Dr. Yalçın Karakoca, Pulmonologist · Last updated: 25 September 2026