Chronic obstructive pulmonary disease (COPD) comprises one or more of three separate illnesses:
- Emphysema (damages air sacs in your lungs)
- Chronic bronchitis (ongoing inflammation of tubes that bring air to lungs)
- Chronic obstructive asthma (asthma that doesn’t go away)
They all make it harder to breathe and get worse over time.
You must go to a doctor to know for sure whether you have COPD. That’s because there are things to consider for a diagnosis, as COPD can mirror the symptoms of other illnesses.
Getting a Diagnosis
First, your doctor will want to know your medical history, any family history of COPD, as well as any symptoms you might have and how long you’ve had them.
The key symptoms of COPD are shortness of breath, a cough that doesn’t go away, and a thick, often colored mucus (phlegm) that you cough up.
Other symptoms, especially in later stages of the disease, may include:
- Tight feeling in chest
- Less ability to stay active
- Less sexual activity
- Weight gain (because you can’t be as active)
- Weight loss (because of breathing problems while eating)
- Symptoms that are worse in the morning (typical for COPD)
Your doctor will definitely want to know about any of those symptoms when they assess you. They’ll also want to know about any smoking by you or anyone in your home, as smoking is the biggest risk factor for COPD. Long-term exposure to fumes, pollution, or dust is also a risk factor for COPD.
But keep in mind that in the early stages, you may have no symptoms at all. Or the signs may be very subtle -- something like being a little more tired from basic tasks like walking up stairs or bringing in your groceries.
Symptoms like these may be of particular interest to your doctor if they worsen slowly over time, with no obvious cause. If your doctor suspects COPD, they will likely test your breathing with a special airflow device called a spirometer. A chest X-ray and other tests may also help zero in on a diagnosis (see below).
It’s important to diagnose your COPD as soon as you can because, though there’s currently no cure, early treatment can do much to slow the progress of the disease.
Tests for COPD
A number of tests can help zero in on a COPD diagnosis. They reveal signs of COPD and help rule out signs of other illnesses that might be mistaken for COPD. These tests include:
Chest exam. Your doctor will inspect your chest visually and listen to it with a stethoscope. They will place the stethoscope on your chest to listen for anything unusual, like wheezing. They might even tap on your chest to listen for certain sounds. Based on what they hear, they may recommend more tests.
Spirometry. This tests the amount of air you can breathe in and out. It’s the most common lung function test and considered the best way to diagnose COPD. It’s simple and painless. You will be asked to take a deep breath, and you’ll blow hard into a mouthpiece that’s connected to a small machine. That machine, called the spirometer, measures how fast you blow air out of your lungs.
Results can tell you whether you have COPD, even if you haven’t gotten symptoms yet. It can also indicate whether you have another health issue, such as asthma or heart failure.
Chest X-ray. This creates an image of your chest, including your heart, lungs, and blood vessels. This shows whether there are problems in the lungs, including other diseases such as pneumonia, cancer, and heart failure (when your heart can’t pump enough blood).
Chest CT scan. This also creates an image of your chest, although it has more details than a chest X-ray. This test is also painless, although a dye may be injected into a vein in your arm to get clearer images of your chest.
You will lie on a table that moves into a CT scanner, which is shaped like a tunnel. You’ll hear clicks and various sounds as the scanner moves around you to take pictures. The entire scan takes about 30 minutes.
Arterial blood gas test. This measures how much oxygen and carbon dioxide you have flowing in your blood. You will get blood drawn so a lab can analyze it.
If you’re not getting enough oxygen into your bloodstream, it could be a sign that you have COPD or other lung diseases.
Alpha-1 antitrypsin deficiency testing. This tests for a protein called AAT, which is found in your lungs and blood.
The protein helps protect your lungs from diseases such as COPD. But some people don’t make enough AAT because they inherited a genetic mutation. People who lack AAT are more likely to get lung diseases earlier than usual, at around 30 to 40 years old.
This genetic mutation is rare. Your doctor may suggest you get this test if your family has a history of AAT deficiency.
For the test, a small sample of blood is taken from one of your veins, and it is then checked for levels of AAT.
