What Happens When You Have COPD?

Chronic obstructive pulmonary disease (COPD) is a lung disease mainly caused by smoking. You can also get it from long-term exposure to air pollution, dust, and chemical fumes. It causes the airways in your lungs to inflame and thicken.

You’ll have trouble breathing and cough often, or you’ll cough up mucus. You’ll probably wheeze a lot, and you could feel tired all the time. Your lips or fingernails might turn blue because of a lack of oxygen.

But your doctor has ways to manage your disease and its symptoms at each of these four stages:

  • Mild: Your airflow is somewhat limited, but you don’t notice it much. You cough and have mucus every once in a while.
  • Moderate: Your airflow is worse. You’re often short of breath after doing something active. This is the point where most people notice symptoms and get help.
  • Severe: Your airflow and shortness of breath are worse. You can't do normal exercise anymore. And your symptoms flare up frequently, also called an "exacerbation."
  • Very severe: Your airflow is limited, your flares are more regular and intense, and your quality of life is poor.

Your doctor has a few ways to decide which stage your disease is in. She'll use a test called spirometry to measure how much air your lungs can take in, or your lung capacity. She may also take X-rays of your chest or do a blood test to measure how much oxygen is getting into your lungs.

Your doctor also looks at other symptoms (like shortness of breath), how strong your lungs are, and your overall quality of life to find out the stage. Most people have about half of their normal lung capacity by the time they get diagnosed.

How Is COPD Treated?

You’ll try different ways to manage your disease and its symptoms at each stage. Your doctor will try to:

  • Ease your symptoms, such as improving breathing.
  • Keep your disease from getting worse, or slow its move to the next stage.
  • Improve your quality of life and energy level.


Treatments include many different drugs, special exercises, oxygen therapy, surgery, and complementary therapies.

If you smoke, the most important thing you can do is quit. It’s the best way to improve your COPD symptoms or keep your disease from getting worse. If you live with a smoker, it will help you if they quit. If you work in a place where people smoke or the air is polluted, you may have to consider changing jobs.

Medication can help improve your lung capacity, ease inflammation, relax muscles in your airways, and improve your breathing. They include:

  • Bronchodilators that you breathe in through an inhaler. These come in short- and long-acting forms. Some stop the muscles in your airways from tightening up (anticholinergics). Others relax muscles that are already tight (beta agonists).
  • Anti-inflammatory meds or corticosteroids (or steroids) are often inhaled COPD drugs. But if your symptoms are getting worse, you may get pills that you take for a short time.
  • Antibiotics to fight infections that cause symptom flare-ups
  • Vaccinations against the flu or pneumonia
  • Roflumilast (Daliresp), the first of a new class of COPD drugs called phosphodiesterase-4 inhibitors, designed to ease flares for people at the severe stage

Other treatments can also make breathing easier:

  • Oxygen therapy gives you more energy for your daily tasks and helps you sleep.
  • Surgery can remove diseased lung tissue, make your lungs smaller so you can breathe better, or give you a new transplanted lung.
  • Pulmonary rehabilitation includes exercises and better nutrition to help improve your breathing and overall health.

How Do Treatments Change With Stages?

Your doctor will prescribe different treatments at each stage of your disease. If your COPD gets worse, you may need to add treatments to help you breathe, feel better, or lower your chance of having flares.

Mild: You’ll take a short-acting bronchodilator and a flu vaccine.

Moderate: You may add a long-acting bronchodilator if needed, and try pulmonary rehabilitation.

Severe: You might add inhaled corticosteroids if you have flares that get worse or more frequent.

Very severe: You may add long-term oxygen therapy if you have chronic respiratory failure, as well as consider lung surgery.


You can try treatments to improve your quality of life at any stage. This is called palliative care. There are medicines that may help ease your anxiety. Counseling or education can help you manage your symptoms, improve your mood, or just relax. And support groups are a great way to connect with other people who have COPD, so you don’t feel alone.

Complementary treatments like acupuncture, massage, or yoga might help you feel a bit better, too.

WebMD Medical Reference Reviewed by Neha Pathak, MD on June 16, 2017



Albert Rizzo, MD, chief of pulmonary and critical care medicine, Christiana Care Health System, Wilmington, DE.                                                                   

American Lung Association: “COPD: Symptoms, Diagnosis and Treatment,” “COPD Treatment Options,” “Managing Your COPD Medications,” “Palliative Care and COPD.”

Global Initiative for Chronic Obstructive Lung Disease: “Pocket Guide to COPD Diagnosis, Management, and Prevention.”

National Heart, Lung, and Blood Institute: “What Is COPD?” “How Is COPD Treated?”

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