COPD Symptoms: From Early Signs to the Advanced Stage

COPD symptoms differ from one stage to the next. At the beginning, shortness of breath is usually noticed when climbing stairs or walking fast. As the disease progresses, everyday tasks also become harder. In the advanced stages there may be breathlessness even at rest, and the cough and phlegm become more marked.

The stages are assessed according to the GOLD classification, and symptoms do not follow the same course in every patient. Which stage your complaints correspond to, and how your treatment will be arranged, depends on your doctor’s assessment. You can read more on the COPD stages page.

The assessment usually looks at:

• How much shortness of breath affects daily life
• How the cough and phlegm are changing
• Frequent chest infections
• Tiredness and weight changes

Diagnosis begins with an assessment of your complaints and risk factors. Your doctor first asks about shortness of breath, cough and phlegm, and about your smoking history. A breathing test (spirometry) is then done; this is the basic test that shows narrowing of the airways.

• Chest X-ray: requested to assess the general appearance of the lungs and to rule out other conditions.
• CT scan: used when needed to see structural changes such as emphysema in more detail.
• Blood gas test: taken to assess your oxygen level and how well you are breathing.

Your doctor decides which tests are needed and interprets the results. For the options once a diagnosis is made, see the COPD treatment page.

COPD is a chronic disease that develops when the lungs are exposed to harmful substances for a long time. The most common cause is cigarette smoke and other products of combustion; see smoking and COPD for details. Dust, chemical fumes and particles in the workplace also raise the risk. Air pollution in cities, especially fine particles, can contribute to the disease. In rare cases, a family predisposition also plays a part.

If you have one or more of the following, it is worth talking to your doctor about assessing your lung function:

• Smoking, or exposure to cigarette smoke
• Dust and chemicals in the workplace
• Living in an area with heavy air pollution
• A family history of COPD

When symptoms last a long time, the cause should always be investigated. A cough that does not go away for weeks, phlegm that comes up especially in the mornings, and shortness of breath that increases with effort are among these symptoms. In people who have smoked, these complaints should not be put down to a cold or to ageing.

It is appropriate to see a chest diseases specialist if:

• The cough and phlegm do not ease for weeks
• Shortness of breath has started to make daily tasks harder
• Wheezing, tiring quickly or chest tightness come with it
• These complaints keep coming back in a person with a smoking history

Talk to your doctor about having a breathing test and starting treatment. You may also find our pages on shortness of breath, advanced-stage COPD and chronic bronchitis helpful.