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Lung Disease & Respiratory Health Center

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Understanding and Treating COPD

The more you know, the easier it is to control COPD.

Chronic Coughs and COPD

In the beginning, a chronic dry cough may be the only symptom of COPD, and people often don’t even notice it. Or they may ignore a symptom such as feeling breathless or mistakenly attribute it to aging or being out of shape. It’s important to remember that difficulty breathing is not a normal sign of aging. Any unusual shortness of breath should be checked by a doctor.

“Patients will tell me they’re coughing all the time,” says Schachter. “Or they complain that they can’t keep up with their friends or climb stairs.”

As a result of ignoring symptoms, many people with COPD aren’t diagnosed until the disease is advanced. At that point, it’s harder to control the symptoms. But the disease can still be managed, and following an effective treatment plan can help keep the symptoms under control.

Stages of COPD and Lung Function

The stages of COPD are based on the severity of lung function, measured as airway obstruction.

To determine the severity of lung function, doctors use a test called spirometry. You blow into a mouthpiece and tubing that’s attached to a recording device. The test measures your ability to move air in and out of the lungs quickly.

One specific measurement, FEV1, or forced expiratory volume, shows how much air a person can blow out in one second. FEV1 is used to determine how far COPD has progressed. There are four stages of COPD:

Stage 1: Mild. FEV1 is greater than 80%. At this stage, the person with COPD may not even be aware that there is any abnormal lung function.

Stage 2: Moderate. FEV1 is between 79% and 50%. At this stage, the person may have shortness of breath and other respiratory symptoms.

Stage 3: Severe. FEV1 is between 49% and 30%. At this stage, the person may have a reduced ability to exercise. The person may also have more shortness of breath and frequent exacerbations.

Stage 4: Very Severe. FEV1 is below 30%. At this stage, the person may have life-threatening exacerbations. Some patients have chronic respiratory failure.

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