An Overview of the Types of COPD

Medically Reviewed By Adithya Cattamanchi, M.D.

Chronic obstructive pulmonary disease (COPD) refers to a group of conditions that cause airflow obstruction. Emphysema and chronic bronchitis are the main types. Asthma-COPD overlap syndrome (ACOS) is a related condition. It is possible to have more than one type of COPD at a time. Each person’s case is unique. Your doctor will tailor a treatment plan to your specific needs. Treatment may involve medications, pulmonary rehabilitation, or surgery.

Read on to learn more about the types of COPD, their symptoms, and treatment options.

Overview

An older man riding his bicycle
Rob and Julia Campbell/Stocksy United

COPD is a chronic, progressive respiratory condition involving some type of obstruction in the airways. The obstruction leads to breathing difficulties.

There are two main types Trusted Source Centers for Disease Control and Prevention (CDC) Governmental authority Go to source of COPD: emphysema and chronic bronchitis. A related condition, ACOS, combines features of asthma with features of COPD.

Emphysema

Emphysema involves a breakdown in the elasticity of the walls of the alveoli, small sacs in the air passages. This leads to alveoli that are no longer soft and stretchy, but instead are stiff and enlarged. Waste gases become trapped in the alveoli, causing lung enlargement and reduced oxygen absorption.

Increased mucus production also occurs. This further obstructs the alveoli and the small tubes leading to them.

Emphysema typically occurs Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source when someone is exposed to toxic gases for long periods of time. These gases include cigarette smoke or environmental pollutants. There is also a genetic cause of emphysema called alpha-1 antitrypsin deficiency (AATD). AATD is relatively rare and only accounts for 1–2% of COPD cases.

Learn more about the causes of COPD.

Symptoms

Early emphysema often presents with these symptoms:

  • chronic shortness of breath
  • cough that may or may not produce mucus
  • loss of physical endurance

As the condition progresses, people with emphysema may find themselves short of breath even at rest. They generally do not have blue lips or nails but may have increased mucus production and coughing.

People with emphysema may also experience weight loss without dieting or trying to lose weight. The effort required to maintain breathing can be exhausting.

Chronic bronchitis

Chronic bronchitis involves irritation and inflammation in the bronchi. This leads to increased mucus production that further obstructs the upper airway. Like emphysema, chronic bronchitis commonly develops Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source in people who have been exposed to toxic substances. These include cigarette smoke or pollution.

Doctors may confirm a diagnosis of chronic bronchitis when inflammation and cough have lasted at least 3 months and have occurred at least 2 years in a row.

Symptoms

One of the most common symptoms of chronic bronchitis is coughing with mucus production. The mucus may be clear, green, yellow, or reddish. Other symptoms may include:

  • fatigue
  • wheezing
  • chest or abdominal pain associated with excessive coughing

Asthma-COPD overlap syndrome

ACOS occurs when a person has both asthma and COPD. According to the American College of Allergy, Asthma, and Immunology (ACAAI), this type of asthma can be classified as refractory. This means severe and difficult to treat.

Symptoms

Symptoms of ACOS may include:

Treatments

Some treatments may be useful for all forms of COPD. These include medications, pulmonary rehabilitation, and lifestyle changes.

Medications

Medications that can help with COPD may include:

  • Bronchodilators, such as albuterol (Proair) or ipratropium (Atrovent), relax the airway muscles, allowing them to open.
  • Corticosteroids, such as fluticasone (Advair) or budesonide (Symbicort), can be inhaled for maintenance therapy or taken in pill form for flare-ups.
  • Antibiotics may treat or prevent bacterial infections, which can worsen COPD symptoms.

Your doctor may also recommend Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source supplemental oxygen therapy if your blood oxygen levels are low.

Learn more about 10 commonly prescribed COPD medications.

Pulmonary rehabilitation

This is a program that involves a team approach. Pulmonary rehabilitation helps you understand your condition, improve your tolerance for exercise, and improve your quality of life. The program’s physical and breathing exercises help to improve lung function and relieve symptoms.

Lifestyle modifications

If you smoke, quitting smoking is one of the most important steps you can take to slow COPD progression. You should also avoid secondhand smoke and open flames like campfires.

Learn more about the stages of COPD.

Careful exercise will help you maintain endurance, balance, and flexibility. You may need Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source nutritional support such as protein shakes and high calorie snacks to maintain a healthy weight.

Ask your doctor about flu, COVID-19, and pneumonia vaccines to protect yourself from infections.

Learn 8 ways to help someone with COPD.

Surgery

Some surgical procedures may be beneficial for people with severe COPD. These include:

  • bullectomy, removal of cavities in the lung caused by structural damage
  • lung transplantation
  • lung volume reduction surgery

Summary

The two main types of COPD are emphysema and chronic bronchitis. Some people may also have a related condition called ACOS. This presents with symptoms of both COPD and asthma.

COPD is a progressive and incurable condition. However, there are actions you can take to slow the progression, manage symptoms, and improve quality of life.

Communicate with your doctor about your smoking history. Keep all appointments for exams and testing. Get regular vaccinations as your doctor recommends.

Take all medications and supplemental oxygen as directed, and ensure that you know how to maintain oxygen equipment. Pulmonary rehabilitation may also be beneficial for some people.

Talk with your doctor about ways to manage COPD.

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Medical Reviewer: Adithya Cattamanchi, M.D.
Last Review Date: 2023 Jun 7
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.