Diagnosis and Treatment of COPD

If you have chronic shortness of breath, cough or excessive mucus production with the cough, then all that points towards COPD. Some patients, early on, will just present with fatigue and that also is one of the common presentation that we see, especially in the milder form of the disease. Once you have any of these symptoms, you talk to your doctor and your doctor will mostly likely recommend what we call PFT, or the pulmonary function test, where you will breath out and in into a box or into some machines, which will determine how your breathing pattern is and will be able to help your doctor determine if you have COPD or not.

Then most likely after that, your doctor will either order a chest x-ray or a CT scan of your chest to look at your lungs and determine if there are any imaging patterns that will suggest COPD or if the shortness of breath is from other causes not related to COPD. So, your CT scan will give your doctor a very high resolution image of your lungs at multiple levels and that will tell us how your lung parenchyma looks like, what does the tissue look like, if there are any swollen airways, increased blood vessel or fluid in the lungs or if there are any alveolar damage suggesting of emphysema.

COPD treatment involves understanding your disease and your medication and details. First of all, it starts with whatever factor you had that is contributing to COPD or worsening of your COPD. Most of the time it is smoking. So, smoking cessation is absolutely essential and as soon as possible after diagnosis of COPD. Once you have quit smoking, other forms of treatment would involve inhalers and medications which we call bronchodilators or inhaled steroids. That will improve the lung function and also prevent flare-ups of the COPD. Your doctor may have you on oral medications to prevent flare-ups, including steroids and some non-steroidal agents and then may put you on oxygen as well to maintain your oxygen level, which also has shown significant improvement in your shortness of breath and functional capacity.

One other major factor is pulmonary rehab, which allows the patient to regain their lung function, develop strength of the respiratory muscles and breath better and be able to do more activity and function during their daily living. One other major factor involved in treatment is managing other diseases that contribute to worsening of the COPD, including obesity, congestive heart failure, high blood pressure and sleep apnea, so it is very important to discuss management of those comorbidities with your provider and manage those diseases as well as closely as possible.