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Chronic obstructive pulmonary disease (COPD) isn’t a single disease. Several types of lung conditions that cause airway and lung obstruction and make it hard to breathe fall under the umbrella of COPD. Most types of COPD share common symptoms, such as shortness of breath, persistent coughing, and fatigue, which can make it tricky to know which kind you have. Understanding the type of COPD you or a loved one has is essential for making informed decisions about treatment options and planning care.
In this article, we’ll walk you through the main types of chronic obstructive pulmonary disease, as well as their common causes and symptoms. Knowing these distinctions can help you work with your doctor to choose the best treatment plan and manage your symptoms.
Pulmonary emphysema is a lung disease that affects more than 3 million people in the U.S. It’s caused by damage to the alveoli (small air sacs in your lungs). Most people have about 300 million alveoli in their lungs.
These small sacs fill with air when you inhale and help you get rid of that air when you exhale. But if the alveoli are damaged, you may have trouble pushing air out of your lungs when you breathe out.
The most common cause of emphysema is smoking cigarettes. Cigarette smoke can damage your lung tissue and cause airway irritation. The inflammation and lung damage that smoking causes can make your airways swell up. It can also cause an increase in mucus production and make it more difficult to clear your airways. Together, these issues make it more difficult to breathe.
Other causes of emphysema besides tobacco smoke are less common. They include:
When the alveoli get damaged and break, large pockets of air can form in your lungs. This reduces your body’s ability to breathe fresh air in and out. This process may lead to several symptoms, including:
If you have these symptoms, your healthcare provider may evaluate you for emphysema.
To diagnose emphysema, a pulmonology expert or other healthcare professional will perform an exam. They’ll also ask about your background, such as whether other family members have breathing problems and whether you smoked.
They may order imaging tests, such as chest X-rays and computed tomography (CT) scans. Your doctor is likely to perform lung function tests as well. These tests measure how well your lungs are working.
The most common test is spirometry. During this test, you’ll blow into a large tube connected to a small device. The device evaluates how quickly you can exhale and how much air your lungs hold. This tells the doctor how reduced your air flow may be.
Chronic bronchitis is a type of COPD that occurs when your airways become inflamed. This can make it hard to breathe. Chronic bronchitis isn’t the same condition as acute bronchitis, which may occur if you get a cold or other virus. Instead, chronic bronchitis is diagnosed if you have a stubborn cough with phlegm for most days each month, at least three months each year, lasting for two years or longer.
Chronic bronchitis is relatively common, affecting about 10 million people in the U.S.
As with emphysema, most cases of chronic bronchitis are caused by cigarette smoking. It may also be caused by inhaling air pollution or other particles. Chronic bronchitis has been linked to certain jobs, such as working in tunnels, livestock farms, concrete manufacturing facilities, or hard rock mines.
When your bronchi (breathing tubes) are damaged, you may experience chronic bronchitis symptoms, such as:
If you experience any of these symptoms, talk to your doctor. They can perform testing to determine whether you have chronic bronchitis.
During the diagnosis process, your provider will perform an exam and listen to your breathing using a stethoscope. They’ll also ask you about your personal and family history of breathing problems. They may order imaging studies, such as a CT scan or X-ray, to get a visual of what’s happening in your chest.
A pulmonary specialist might perform pulmonary function tests to evaluate your breathing capabilities. For instance, they’re likely to perform spirometry and peak flow monitoring. During peak flow testing, you’ll breathe into a small device that will measure how quickly and strongly you can exhale.
Some people have a combination of COPD and asthma. This is called asthma-COPD overlap syndrome (ACOS). It’s not a specific type of COPD, but it can affect people with COPD symptoms who also have symptoms of asthma. You may be diagnosed with ACOS if you meet certain criteria, including:
Some pulmonology organizations don’t recognize ACOS, noting that it’s more accurate to diagnose people with either COPD or asthma. But many researchers and clinicians still find it important to classify certain people with ACOS.
One reason is because individuals with ACOS may have more symptoms than those with just asthma or COPD. Plus, they may have more serious attacks, which can lead to a higher hospitalization rate. For that reason, doctors may need to adjust the treatment plan for people with ACOS to account for these more serious outcomes.
You may have ACOS if you experience the following symptoms often:
If your pulmonology team thinks you may have ACOS, they’ll perform an exam and may order imaging tests. In addition, they may review several factors to determine whether you have asthma, COPD, or ACOS. These include:
After evaluating all of these factors, your doctor will make their diagnosis. If they determine you have ACOS, they’ll work with you on a management plan.
COPD may be stable for long periods of time, but then may suddenly flare up. This is known as an exacerbation and means your COPD symptoms get worse. During these periods, you may have more trouble breathing, a worse cough, or thicker phlegm. You may even need to be hospitalized.
While you can’t avoid all COPD exacerbations, you may be able to avoid certain factors that cause flares. These are called triggers. Some potential COPD triggers include:
Everyone’s triggers may be different. For that reason, it’s important to work with your pulmonologist to pinpoint yours. You can then work on avoiding triggers whenever possible.
After getting a diagnosis of COPD, your doctor will share the specific type you have. This is important because, though COPD has no cure, there are treatments available. Your care team will tailor your treatment plan to your specific stage, type, and symptoms of COPD, as well as your overall health and other factors.
For example, your provider may recommend that you use a particular inhaler if you have chronic bronchitis but a different inhaler if you have emphysema. Always speak with your care team to get a personalized COPD treatment plan that can help you best manage your symptoms.
On MyCOPDTeam, people share their experiences with COPD, get advice, and find support from others who understand.
Which type of COPD do you have? Let others know in the comments below.
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I Have Stage 3/4 Stage COPD But I Never Cough Is This Possible ?Does Anyone Else Have This ?
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I have lived with copd for so long I have the symptoms and different names memorized. I have obstructive and restrictive symptoms caused by asthma and copd. It is not fun but I have made it for over… read more
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