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What Are The Early Signs Of COPD?

Early signs of chronic obstructive pulmonary disease (COPD) include a chronic cough, increased mucus, and tiredness. Knowing which symptoms to look out for at home can help a person know when to visit a doctor for tests.

COPD is the term for a group of lung diseases that tend to worsen over time. Examples of these conditions include emphysema and chronic bronchitis.

COPD obstructs a person's airways, making it difficult to breathe. It is a progressive condition, meaning it tends to worsen over time. Without treatment, COPD can be life threatening.

According to the World Health Organization (WHO), the Global Burden of Disease Study estimated that COPD caused 3.23 million deaths worldwide in 2019. Additionally, health experts estimate around 16 million people in the United States have the disease.

This article describes the early signs and symptoms of COPD and how it gets worse. It also covers when to speak with a doctor.

The Global Initiative for Chronic Obstructive Lung Disease's COPD Gold Guidelines can help doctors assess whether a person has COPD according to the nature and degree of their symptoms, their history of symptom progression, and the presence of additional medical diagnoses that might cause or worsen their symptoms.

Additionally, the guidelines classify the severity of airflow limitation in COPD according to forced expiratory volume (FEV). FEV is how much air a person can push out of their lungs in 1 second during a spirometry test. The lower the value, the more breathing difficulties an individual has. Health experts grade the severity of airflow limitation using four categories:

However, the organization also recognizes that assessment of airflow limitation alone is not sufficient, as health experts now know COPD affects more than a person's ability to breathe. With this in mind, a full medical examination by a doctor can best determine whether an individual has COPD and the degree of the disease's severity.

In its early stages, COPD symptoms may be so mild that the individual does not notice them. The symptoms and severity of COPD can also vary from person to person.

However, because the disease is progressive, symptoms often worsen over time. The early signs and symptoms of COPD can include the below.

Chronic cough

A persistent or chronic cough is often one of the first symptoms of COPD. A person may experience a chesty cough that does not go away on its own.

Doctors generally consider a cough that lasts for longer than 8 weeks to be chronic.

Coughing is a protective mechanism that typically occurs in response to irritants, such as inhaled cigarette or tobacco smoke, getting into the lungs. Coughing also helps remove phlegm, or mucus, from the lungs.

However, if a person has an ongoing cough, this may signify a problem with their lungs.

Excess mucus production

Producing too much mucus can also be an early symptom of COPD. Mucus is essential for keeping the airways moist, and it also captures germs and irritants that get into the lungs.

When a person inhales an irritant, their body produces more mucus, which can lead to coughing. Smoking is a very common cause of excess mucus production and coughing.

Long-term exposure to irritants can damage the lungs and lead to COPD. Other lung irritants can include:

chemical fumes, such as those from paints and strong cleaning products

dust

pollution, including car exhaust fumes

perfumes, hairsprays, and other spray cosmetics

Shortness of breath and tiredness

The obstruction of the air passages can make it more difficult for a person to breathe, which can lead to shortness of breath, another common symptom of COPD.

At first, shortness of breath may only occur after exercise, but it can worsen over time. Some people cope with their breathing difficulties by becoming less active, which can lead to them becoming less physically fit.

A person with COPD needs to exert extra effort to breathe. This exertion can result in lower energy levels and feeling tired all the time.

Because their lungs are not functioning as well as they should, people with COPD are more likely to experience chest infections, including the common cold, flu, and pneumonia.

Other symptoms of COPD include:

unintentional weight loss, according to an older 2013 study

swelling in the lower legs

itching

dry mouth

sexual problems

dizziness

bladder problems

bloating

drowsiness

fatigue

A person with a COPD diagnosis may experience flare-ups, which are also known as COPD exacerbations, when symptoms suddenly worsen. Triggers of COPD flare-ups can include chest infections and exposure to cigarette smoke and other lung irritants.

Exacerbations may begin as mild, but they can become very serious quickly without prompt medical care. Early warning signs of a COPD flare-up may include:

symptoms suddenly becoming more severe within days or even hours

coughing becoming stronger, more frequent, or different than usual

suddenly becoming out of breath and struggling to do things a person can normally do, such as walking or taking a shower

the color of the person's sputum — the thick mucus that comes from the lungs — changing from clear to a darker color

producing more sputum than usual

being more tired than usual

unusual insomnia, feeling or appearing confused to those around them, or having difficulty waking up, which can indicate high carbon dioxide levels — seek immediate medical attention

lower than usual oxygen levels according to pulse oximeter measurements

A person who experiences any of the above symptoms regularly should speak with a doctor. Anyone who experiences signs of COPD exacerbation should also consult their doctor as soon as possible.

Even if people are not sure they have COPD, a healthcare professional can usually distinguish between COPD and other diseases. Early diagnosis of COPD can allow individuals to receive treatment sooner, which can help slow the progression of the disease before it becomes severe or life threatening.

The most common cause of COPD is smoking cigarettes or other tobacco products. According to the National Heart, Lung, and Blood Institute, up to 75% of people with COPD either smoke or have smoked. However, long term exposure to other irritants or harmful fumes may also cause or contribute to the condition.

Genetics may also increase the risk of developing COPD. For example, people with a deficiency in a protein called alpha-1 antitrypsin may be more likely to develop the condition, especially if they smoke or have regular exposure to other lung irritants.

The signs and symptoms of COPD most often start in people aged 40 years or older.

Getting a COPD diagnosis begins with a medical exam. Doctors usually start by asking the individual about their symptoms and medical history, including whether or not they smoke and if they have had exposure to any lung irritants.

They may also perform a physical examination and check for wheezing or other signs of lung problems.

To confirm their diagnosis, a healthcare professional may order some tests, such as:

Spirometry: A person breathes into a tube that connects to a machine called a spirometer, which measures how well their lungs are working. To begin the test, the doctor may ask the individual to inhale into a bronchodilator, a type of medication that opens up the airways.

Chest X-ray or CT scan: These imaging tests allow a doctor to see inside a person's chest to check for signs of COPD or other medical conditions.

Blood tests: The doctor may order blood tests to check a person's oxygen levels or rule out other conditions that cause similar signs and symptoms to COPD.

COPD is a common condition. However, some people mistake its symptoms for the normal signs of aging, which can mean they do not get a diagnosis. Without treatment, COPD can become progressively worse over time.

COPD can be a significant cause of disability. An individual with severe COPD may struggle with day-to-day tasks, such as climbing a flight of stairs or standing for prolonged periods to cook a meal. Flare-ups and complications can also severely impact a person's health and quality of life.

There is no cure for COPD, but early diagnosis and treatment can greatly improve a person's outlook. Appropriate treatment and lifestyle changes can relieve symptoms and slow or halt the progression of the condition.

Treatment options include medications, oxygen therapy, and pulmonary rehabilitation. Lifestyle changes involve engaging in regular exercise, eating a nutritious diet, and stopping smoking.

When Lung Disease Interrupts Your Exercise Routine

Exercise is great for your health, strength, and quality of life. But if you have chronic lung disease, symptoms like shortness of breath may make you afraid to work out.

Lung disease can interrupt your exercise routine, making it harder to be as active or independent as you once were, says Pat Owens, 76, who lives alone in Tucson, AZ. She uses supplemental oxygen to support her breathing during exercises like squats, leg lifts, and balancing on one leg while she holds onto the kitchen sink.

"I also have some exercise and stretching tapes. I walk inside and when I can, I walk outside too. I do all my own housework, shopping, and laundry," says Owens, who has chronic obstructive pulmonary disease (COPD). "I try to stay as active as I can, so I can continue to care for myself. My only obstacle is that I can't move around as fast as I used to. It takes me longer to do things, but at least I get things done."

If you haven't exercised for a while due to lung disease, start again slowly, says pulmonologist Albert Rizzo, MD, chief medical officer of the American Lung Association.

"Just pace yourself. Listen to your body and slowly increase your activity," he says. "Exercise is so important for building your muscle strength and breathing, but also improves your mood. You can even do exercises while you're sitting in a chair. It can be something simple, like walking back and forth to your mailbox or around the block."

Somer Love, 41, was a high school swimmer, diver, and cheerleader, and enjoyed skiing and volleyball growing up in Utah. She has cystic fibrosis, a chronic lung disease with symptoms like shortness of breath, congestion, and frequent infections that can keep her from being active.

"Some days, just walking to the bathroom or kitchen can be exhausting. When I am able to, I go on walks outside. Maybe that's because we are living through a global pandemic, and it's my only way to be out in the world and not quarantined away," Love says. "I live for my walks and so does my dog, Tulip. I am grateful for those days that I'm able to get outside and make it happen."

Love tries to do resistance exercises for muscle tone and to help her clear and strengthen her lungs. If her chronic lung disease sidelines her at times, she may start up again with just 1 or 2 minutes of bouncing on a small rebounder trampoline. "Something else I'm really proud of is that this year, I found my inner yogi as well. I've really enjoyed experimenting with yoga and listening to my body."

Lung disease symptoms may make you afraid to exercise, but it's actually good for your lungs, says Frank C. Sciurba, MD, director of the Emphysema/COPD Research Center at the University of Pittsburgh Medical Center.

"Your reflex is to avoid any activity that may trigger your shortness of breath. You can become deconditioned and out of shape," Sciurba says. "If you get more exercise, you'll be able to do more and your conditioning will improve. You may be afraid to push yourself if you have shortness of breath."

Pulmonary rehab, where a respiratory therapist shows you how to safely exercise, build strength and stamina, and breathe more efficiently, may help you get active again.

"You may start out with strength exercises with resistance bands, light weights, or squats, then work up to walking on a treadmill," he says. Upper-body exercises help improve breathing too. "The muscles you use when you're short of breath are the same as the ones you use when you do arm work. Train your muscles to do those moves without shortness of breath."

Lung disease can make once-doable activities now seem very hard, and that's scary, says Trina Limberg, a respiratory therapist at Pulmonary Care Consulting and Training in San Diego, CA.

"If your muscles decondition, you may feel that your legs can't support your body weight or your arms can't handle carrying groceries," Limberg says. "You have more breathlessness during ordinary activities, and your world starts to shrink."

Lung disease often causes depression or anxiety too, she says. If symptoms interrupt activities you enjoy, like playing golf, your self-esteem can plummet. Rehab can help you exercise safely with less breathlessness.

"You can learn to use your lungs more efficiently and learn pacing and new breathing techniques. You can achieve high levels of fitness that can be surprising and very encouraging."

If you have supplemental oxygen, be sure to use it when you exercise. Your doctor can adjust your flow rate to support your breathing during workouts.

"If I'm going to exercise, I need oxygen," says Valerie Chang, who has COPD. She uses portable oxygen concentrators with extra batteries on walks or when she uses a rowing machine at her Honolulu home. "I listen to podcasts while I row. One of the advantages of rowing is that you can stay stationary. I can plug in my oxygen and row, and just think or meditate while I exercise."

You can also use a pulse oximeter, a small device clipped to your finger that tests oxygen levels in your blood, when you work out, Rizzo says. Don't be alarmed if the number drops during a strenuous activity. "Just slow down and let your number come back up."

Love knows she may need a lung transplant one day. She says that regular exercise could help her delay surgery, and it has also improved her sleep quality and energy levels.

"It's not always easy. I can't just walk out my front door and go on a walk. There's a lot that I have to factor in, such as air quality, the temperature, if I have a full oxygen tank. I have to have my pulse oximeter in my hand at all times," she says.

A year ago, an infection caused Love's lung function to plummet. She didn't know if she could rebound and exercise again, but she started slowly to build stamina and confidence.

"A cold or virus can be devastating for someone with chronic lung disease. So, I just started moving, taking baby steps, walking short distances, and experimenting with yoga," she says. She slowly extended her walks and held yoga poses longer each time. She takes online yoga classes designed for people with advanced lung disease on a platform called Beam. "Seeing my body begin to heal and feel stronger again was exciting and energizing. I was hooked, and dare I say, I started loving exercise again."

Lung Disease

Increasing level of pollution has made breathing in urban areas very difficult, raising the incidence of respiratory problems. Out of the world's top 20 cities with polluted air, 13 belong to India and according to the World health Organisation (WHO) report published in 2011, lung diseases rank 2ndin the list of top 20 causes of death. Naturally, lung disease is a big health issue that needs to be addressed. Here are some facts about lung disease you should know about.

To understand the condition of your lungs, you need to first understand how the lungs function. Lungs are soft organs present on both right and left side of the chest. They are protected by a had covering called the ribcage. Each lung is made of sections called lobes. The main function of the lungs is to make oxygen available for purifying blood and to and eliminate carbondioxide from impure blood or deoxygenated blood. So when you breathe, air travels down your windpipe (trachea). The windpipe bifurcates with each branch entering each of the lungs. Into the lungs, the windpipe is further branched to tubes called bronchioles that end in small sacs called alveoli, where the inhaled air reaches for delivering oxygen.

A lung disease or disorder occurs in the various structures of lungs and disrupts its functioning. It can vary from a mild common cold to life-threatening conditions like pneumonia and cancer. Lung disease can be caused by infections, inflammation, obstruction of airways, decreased lung function, problems related to pulmonary circulation, etc. Smoking, infections, air pollution, genetics, exposure to asbestos, etc. Can cause various lung diseases.

Types

The common as well as rare types of lung disease include -

Causes

'In any form of lung disease mainly the breathing gets affected,' says Dr Animesh Arya, Senior Consultant, Respiratory Medicine, Delhi based Sri Balaji Action Medical Institute. Here are some common forms of lung diseases he explains.

1. Asthma:It is the most common lung disease triggered by allergies, infections and pollutants that harm the airways and cause inflammation.

2. Acute bronchitis: Bronchitis is the inflammation of the air passage. Acute bronchitis is caused by viral or bacterial respiratory infections.

3. Chronic Obstructive Pulmonary Disease (COPD): It a group of diseases that causes breathing difficulties and interfere with the exhalation process of breathing.

4. Chronic bronchitis: It is a type of COPD caused mainly due to smoking.

5. Emphysema: It is a COPD caused by environmental factors and may also be triggered by allergens or organisms that cause diseases like pneumonia and tuberculosis.

Apart from these common forms of lung diseases, other rare lung diseases include:

6. Cystic fibrosis: It is rare lung disease caused by genetic mutation that results in excess mucus production causing blockage of airways.

7. Acute respiratory distress syndrome (ARDS): It is a medical emergency caused as a result of lung injury due to a severe illness.

8. Lung cancer: It can affect any part of the lung. It is mainly caused due to smoking. Here are 10 common symptoms of lung cancer you need to know.

9. Interstitial lung disease: This is a group of diseases affecting the interstitium, a thin lining separating the air sacs.

Symptoms

'Bronchitis, asthma, COPD, lung infections and pulmonary fibrosis have similar symptoms even though they are very different in nature,' says Dr Arya. He lists a few common symptoms of lung diseases:

Difficulty in breathing

Chronic cough

Being short of breath easily after any strenuous activity

Excess mucus production

Coughing up blood due to inflammation in the lining of the respiratory tract

Chest pain

Air hunger which indicates lack of oxygen and also can cause fatigue

Diagnosis

In most cases, chronic cough, chest pain and breathing difficulties necessitate a lung function test. But your doctor might first take a look at the results of your blood test that may indicate whether you have any kind of lung infection. Otherwise, based on your symptoms your doctor might recommend the following lung function tests for you, as explained by Dr Arya.

Imaging tests: A chest X ray, CT scan or nuclear lung scanning can be done to reveal any kind of structural abnormality of the lungs and the chest. With the help of an Xray, the doctor will be able to detect lung tumors, infections like pneumonia, emphysema, interstitial lung disease. It also helps identification of fluid accumulation around the lungs (pulmonary edema).

Lung Volume measurement or spirometry: This test will determine how much air your lungs can hold. A device called spirometer is used in the test to record and analyse the volume of air inhaled and exhaled. The test is repeated after administering a bronchodilator which opens up the airways.

Diffusing capacity measurement: This test determines how well oxygen is transferred from the air sacs (alveoli) to the bloodstream.

Maximal Voluntary Ventilation: The maximum capacity a person can breathe is checked in this test.

Lung biopsy: In case interstitial lung disease is suspected, the doctor may suggest a lung biopsy where a tissue from the lung is obtained using procedures like bronchoscopy for investigation.

Treatment

'If any of the above mentioned symptoms persist for a long time, it is better to consult a doctor immediately for diagnosis,' says Dr Arya. The management of lung disease depends on the type of lung disease you're diagnosed with but largely medication is the main treatment option for lung disease patients.

Asthma and COPD patients may require bronchodialtors and inhalers for relieving asthma symptoms and opening up the airways. Read more about medicines for asthma

Expectorants may be prescribed in case of chronic productive cough to loosen the mucus and facilitate easy expulsion

Corticosteroids are given for reducing inflammation and swelling of the lung tissue

Patients with extreme shortness of breath are managed with oxygen therapy, where the prescribed level of oxygen is delivered through a mask

Antibiotics like azithromycin may be prescribed for patients diagnosed with interstitial lung disease. Lung Infections are also treated with antibiotics

There are some thoracic surgical interventions in which the lung volume or contraction and expansion of the diaphragm can be improved for better lung function

Lung transplantation is the last option for patients with end stage lung disease

'However additional measures like lifestyle management are also needed,' says Dr Arya. These measures not only help you protect lung function but also prevent lung disease. Here are some tips he offers for better management and prevention of lung disease.

If you are a smoker, quit smoking and if not, avoid smokers as far as possible.

Identify things that you are allergic to and avoid them. Some common allergens include animal dander, dust, and aerosols.

Contrary to popular belief, exercise helps with lung diseases. Exercising for even half an hour daily can increase your lung capacity.

Manage your weight as being obese puts more stress on your heart and lungs.

It is important is to take your medication on time every day.

Lastly, get as much rest as possible.

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