Stages of COPD

Updated Oct. 19, 2020

Chronic obstructive pulmonary disease (COPD) refers to a group of lung diseases that includes emphysema and chronic bronchitis. It’s most commonly caused by smoking, but not always.

“When we talk about COPD, we’re talking about small airways narrowing as a result of smoking-related lung injury,” says Constance Jennings, MD, pulmonologist, UPMC.

COPD is a progressive disease, meaning it gets worse and there is no cure. Symptoms can include shortness of breath, coughing, and poor lung function. Early detection is critical to getting the appropriate treatment and managing the disease.

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COPD Stages

The four stages doctors use to diagnose and treat COPD are:

Stage 1: Mild

At this stage, you may not know you have COPD. You may experience more coughing or increased mucus production. If you’re concerned that you may be developing COPD, your doctor may order a spirometry test to measure your lung function.

If you’re a smoker, quit immediately to slow the decline of lung function. Your doctor may also recommend breathing exercises or lifestyle changes to help manage symptoms.

Stage 2: Moderate

At this stage, people have a cough, mucus, and shortness of breath. Some people pass these symptoms off as signs of aging or a cold. If you haven’t had a spirometry test, your doctor is likely to order one to determine if you need treatment.

Your doctor may recommend breathing exercises to help control your breathing and give you advice on how to avoid triggers that cause symptoms to worsen. You also may need to begin using a bronchodilator, a type of medication that opens the airways to help get more oxygen into your lungs.

Stage 3: Severe

Your lung function has seriously declined at this stage. Symptoms are more pronounced, and you may have flare-ups when symptoms get worse. Your doctor will likely prescribe a long-acting bronchodilator and possibly steroids, expectorants, or oxygen therapy.

Stage 4: Very Severe

At this stage, you have very low lung function. You get winded with small amounts of activity, and when symptoms flare up, they can be life threatening. At this stage, treatment would build on your current therapies. Surgery may be needed to remove damaged areas of the lungs. In severe cases where all other treatment options have failed, a lung transplant may be necessary.

If you have an increase in coughing or mucus, make an appointment with your doctor. The earlier you find out what’s causing your symptoms, the better your chances of starting treatment or making lifestyle changes that can slow the progression of COPD.

“The UPMC Center for COPD and Emphysema offers a broader array of therapies than available at most centers,” Dr. Jennings says. “We really emphasize an expanded array of therapies that go beyond the traditional therapies, focused at treating the patient as a whole person and addressing all the aspects of their health that may be impacting on their illness. Beyond that, we have advanced therapies for people with very severe disease.”

For more information on the UPMC Center for COPD and Emphysema, call 412-648-6161.

About UPMC

Headquartered in Pittsburgh, UPMC is a world-renowned health care provider and insurer. We operate 40 hospitals and 700 doctors’ offices and outpatient centers, with locations throughout Pennsylvania, Maryland, New York, West Virginia, and internationally. We employ 4,900 physicians, and we are leaders in clinical care, groundbreaking research, and treatment breakthroughs. U.S. News & World Report consistently ranks UPMC Presbyterian Shadyside as one of the nation’s best hospitals in many specialties and ranks UPMC Children’s Hospital of Pittsburgh on its Honor Roll of America’s Best Children’s Hospitals. We are dedicated to providing Life Changing Medicine to our communities.