Various medical tests can uncover chronic bronchitis and emphysema, the two aspects of chronic obstructive pulmonary disease (COPD), as well as the general stage of your illness, but this diagnosis won’t offer a complete picture.
A COPD prognosis is personalized — your clinical results will combine with your specific set of symptoms and lifestyle factors to determine the severity and impact of your condition.
Only then will you be able to find the most effective approach to management and treatment of COPD.
The GOLD Test for COPD
Unlike other chronic progressive diseases, COPD is not divided into clear, visible stages. Instead, professionals use what’s known as the GOLD criteria to track the disease.
The Global Initiative for Chronic Obstructive Lung Disease (GOLD) evaluates a patient’s airflow with a technique called spirometry. The more difficult it is for you to expel all the air from your lungs, the more advanced your COPD is.
There are a few specific pulmonary function tests (PFTs) your doctor can use to determine two important elements of lung function:
- Forced expiratory volume (FEV)
- Forced vital capacity (FVC)
Understanding the COPD Stages
The old system of staging COPD through spirometry has recently been updated so a more precise diagnosis of COPD and its effect on patients can be made.
Below are the guidelines with each stage determined by spirometry testing:
- GOLD 1: Mild FEV1 > 80 percent predicted
- GOLD 2: Moderate 50 percent < FEV1 < 80 percent predicted
- GOLD 3: Severe 30 percent < FEV1 < 50 percent predicted
- GOLD 4: Very Severe FEV1 < 30 percent predicted
Depending on your FEV and FVC results, your COPD will fall into one of four stages. Stage one is mild, with little noticeable decline in lung function, while stage four is severe and will likely require long-term oxygen therapy.
COPD can progress rapidly, but the symptoms often build gradually, and many patients don’t even realize they suffer from COPD until they have reached stage two.
Common Symptoms of the Stages of COPD
The GOLD stages of COPD criteria are certainly helpful, but they don’t explain the breadth of symptoms that various COPD patients will experience.
It’s impossible to pinpoint which symptoms every patient will experience at every stage, but the discomforts typically strike in the following order:
- More mucus and chronic cough (most often the first sign of COPD).
- Shortness of breath and fatigue with daily activities (usually indicates some loss of lung function).
- Respiratory infections (frequency may increase gradually every year).
- Increasing breathlessness (eventually, this begins to impact your quality of life).
- Weight loss (the body requires more energy to breathe, and eating may become strenuous or uncomfortable).
- Headaches in the morning (high levels of carbon dioxide in the blood can lead to a headache).
- Swollen feet and ankles (circulation suffers because of stress on the heart).
Other lifestyle factors may affect your symptoms, so even if you’re technically at stage one, you may show symptoms of more advanced COPD, or you could have relatively mild symptoms at later stages.