COPD - Chronic Obstructive Pulmonary Disease: Recognizing Symptoms and Understanding Treatment for People with Chronic Obstructive Pulmonary Disease

Chronic obstructive pulmonary diseases include, in particular,

• chronic obstructive bronchitis (COB) and
• pulmonary emphysema.

If either of these two lung diseases is present—either alone or in combination—doctors refer to the condition as COPD.

According to estimates, between 8% and 12% of adults in Europe and North America suffer from COPD. The disease is thus a truly widespread condition.

Older adults are particularly affected. Men are about two to three times more likely to develop the disease than women.

COPD is also one of the leading causes of death. Globally, it ranks as the fourth leading cause of death—and the trend continues to rise.

Typical symptoms of COPD include

• Shortness of breath: Initially only during physical exertion, but in advanced stages also at rest,
• Chronic cough: It gets worse and more persistent over time. It is particularly distressing in the morning after waking up.
• Increased phlegm: Over time, it becomes increasingly thick and difficult to cough up.

Doctors also refer to these symptoms as the “AHA” symptoms (shortness of breath, cough, phlegm). In addition to these AHA symptoms, other symptoms develop as the disease progresses, such as

• weight loss and
• reduced exercise tolerance.

Depending on the severity of the symptoms, doctors classify COPD into the following stages. These are primarily based on the level of lung function:

• Stage 0: High-risk group with simple chronic bronchitis.
• Stage 1: Mild chronic obstructive pulmonary disease, possibly with cough, sputum, and shortness of breath during strenuous physical activity.
• Stage 2: Moderate chronic obstructive pulmonary disease, possibly with cough, sputum, and shortness of breath.
• Stage 3: Severe chronic obstructive pulmonary disease, possibly with cough, sputum, and shortness of breath.
• Stage 4: Very severe chronic obstructive pulmonary disease with chronic insufficient oxygen supply.

The main cause of chronic obstructive pulmonary disease is smoking. Approximately 80% to 90% of COPD patients are smokers or former smokers. Overall, about 15% to 20% of long-term smokers develop COPD at some point in their lives.

In addition to smoking, however, there are other risk factors for COPD. These include, for example,

• frequent respiratory infections during childhood,
• living on busy streets with high levels of particulate matter, or
• air pollution in the workplace.

In rare cases, COPD can also be caused by congenital genetic disorders. These include, for example, a lack of antibodies (antibody deficiency syndrome) or alpha-1 antitrypsin deficiency.

To make a diagnosis, the doctor first conducts a patient interview (medical history). During this, the doctor asks about the patient’s medical history and the exact nature and duration of their symptoms.

This is followed by various tests, including

• a physical examination,
• lung function testing using spirometry, and
• allergy testing to rule out bronchial asthma.

Under certain circumstances, the doctor may order additional tests, such as

• a blood test, 
• chest X-rays, and
• a bronchoscopy.

The goal of COPD treatment is to alleviate the symptoms caused by the disease and to maintain or improve the patient’s quality of life.

Various treatment options are available for this purpose, including

• medication with specific inhaled bronchodilators, as well as
• various non-pharmacological treatment approaches, such as exercise and physical therapy.

COPD is treated by pulmonologists specializing in the medical fields of pneumology and bronchology.

COPD is a progressive lung disease in which early diagnosis is crucial to positively influencing its course. The development of COPD is closely linked to risk factors for the disease, with smoking being the primary cause. Many patients with COPD often do not notice symptoms such as a cough until the disease is already well advanced. A chronic cough, in particular, should be taken seriously, as COPD can develop without being immediately recognized.

Diagnosis and treatment are guided by clear guidelines, such as the national COPD care guidelines, which provide a structured framework for the diagnosis and treatment of patients. The goal of COPD treatment is to alleviate symptoms and improve quality of life. COPD treatment includes both medication and measures to stabilize lung function. People with chronic obstructive pulmonary disease benefit particularly from consistent treatment of COPD.

In advanced COPD, the airways become increasingly narrowed, which severely restricts breathing. The disease often occurs alongside chronic obstructive bronchitis and pulmonary emphysema, which exacerbate the symptoms. A comparison between asthma and COPD also shows that different mechanisms are at play, even though the symptoms may be similar. Patients with chronic obstructive bronchitis often experience a severe course of the disease, especially if it remains untreated.

The stages of COPD help assess the severity of the disease and select the appropriate treatment. COPD develops gradually and can affect life expectancy if not treated properly. Nevertheless, targeted measures can slow its progression and alleviate symptoms. Living with COPD means actively managing the disease and attending regular checkups.

Overall, it is clear that COPD is a complex disease that requires individualized treatment for patients with chronic obstructive pulmonary disease. The onset of chronic obstructive pulmonary disease can be reduced through prevention and smoking cessation. Internationally as well—for example, through initiatives such as the Global Initiative for Chronic Obstructive Pulmonary Disease—the importance of structured care is emphasized. COPD is one of the most common lung diseases in Germany, which is why education and early treatment are particularly important.