Stages of COPD

Understanding the four stages of chronic obstructive pulmonary disease (COPD) is one of the most important things you can do to better your health.  COPD includes many different kinds of lung diseases. Doctors use a classification system called the GOLD staging or grading system.

GOLD System

The GOLD (Global Initiative for Chronic Obstructive Lung Disease) system looks at many different aspects of your COPD and gives an understanding of how severe your COPD is.  Your current grade will determine what treatments you need to receive. It also looks at how many times your COPD has worsened, how many hospital stays you’ve had because of COPD, and how much air you can exhale and at what speed (spirometry).

Stage I - Early Stage

The first signs of COPD can be difficult to catch, as they can sneak up on you and can take years to show themselves.  Once obvious symptoms appear, lung damage is already likely. If you are a smoker, have smoked in the past, or are at a higher risk of developing COPD, you’ll want to keep your eyes peeled for any early signs.

Early symptoms may be a dry, nagging cough with mucus that can be clear, white, yellow or even green. You may notice you're feeling short of breath.  Often times this is dismissed as age or a sedentary lifestyle.

To test for COPD, a spirometry test will be conducted.  If it is determined you have COPD Stage 1, you may be treated with an inhaler (bronchodilator) that will relax the muscles in your airway to make breathing easier.  It is suggested that you keep up with flu and pneumonia shots, exercise frequently and stop smoking (if you smoke).

Stage II - Moderate Stage

Stage 2 symptoms also include chronic coughing with mucus, shortness of breath when doing simple tasks, tiredness, trouble sleeping, and wheezing.  Once determined you have COPD Stage 2, you’ll likely be prescribed a bronchodilator and pulmonary rehab.

Stage III - Severe Stage

If you have COPD and are in Stage 3, you’ll have more flare-ups, your cough will worsen, and will experience shortness of breath.  You may get colds more often, your feet, ankles, and legs can swell, a tight feeling in your chest, unable to take deep breathes and/or wheezing and other breathing problems when conducting simple tasks.  You’ll continue to use bronchodilators, use your pulmonary rehab plan, and steroids and antibiotics may be used to manage flare-ups.

Stage IV - Very Severe

In Stage 4, you’ll experience the same symptoms but on a very severe level and more often.  You may develop a condition called chronic respiratory failure. You may hear a crackling sound as you inhale, experience constant wheezing, and exhaling takes a long time.  Treatment for Stage 4 includes bronchodilators, a pulmonary rehab plan, steroids and antibiotics, and oxygen therapy. Surgery may be needed if drugs aren’t working.

A person living with COPD, no matter the stage, should work with their doctor as their COPD advances to make sure sufficient treatment is given.  It is important to take note of any symptom changes, symptom triggers, and daily life with COPD and communicate that with your doctor.