COPD: Causes, Symptoms, and Treatment

Medically reviewed by Achuta Uppu, MD, Internal Medicine. Last reviewed: October 23, 2026.

What kind of doctor treats COPD?

COPD is usually treated by a primary care doctor at first, and by a pulmonologist, a doctor who treats lung problems, when the disease is moderate or severe. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.

What is COPD?

COPD (chronic obstructive pulmonary disease) is a group of lung diseases that make it hard to breathe and get worse over time. It includes two main types. Emphysema damages the air sacs in the lungs and the walls between them, making them less stretchy. Chronic bronchitis means the airway lining is constantly irritated and inflamed, which causes swelling and mucus. Most people with COPD have both.

Symptoms

At first, you may have no symptoms or only mild symptoms. As the disease gets worse, they usually become more severe. They can include:

  • Frequent coughing or a cough that produces a lot of mucus.
  • Wheezing, a whistling sound when you breathe.
  • Shortness of breath, especially with physical activity.
  • Tightness in your chest.
  • Fatigue.

Some people with COPD get frequent respiratory infections such as colds and the flu. In severe cases, it can cause weight loss, weakness in the lower muscles, and swelling in the ankles, feet, and legs.

Causes and who gets it

COPD is usually caused by long-term exposure to irritants that damage the lungs. In the United States, cigarette smoke is the main cause. Pipe and cigar smoke can also cause it. Up to 75 percent of people with COPD smoke or used to smoke. Secondhand smoke, air pollution, and chemical fumes or dusts at work can also contribute. Worldwide, tobacco is related to just half of all COPD cases.

Rarely, a genetic condition called alpha-1 antitrypsin deficiency plays a role. Asthma also raises the risk, but most people with asthma will not get COPD. Most people with COPD are at least 40 years old when symptoms begin.

How doctors diagnose it

To find out if you have COPD, your doctor may ask about your medical history, your family history, and whether you have ever smoked or breathed in other lung irritants. Tests may include lung function tests, a chest X-ray or CT scan, and blood tests, which may include an arterial blood gas test or an alpha-1 antitrypsin test.

Treatment

There is no cure for COPD. But treatments can help with symptoms, slow the progress of the disease, and improve your ability to stay active. Quitting smoking is the most important step you can take. Your doctor will set your plan based on your symptoms and how severe your COPD is.

  • Bronchodilators relax the muscles around your airways, opening them to make breathing easier. Most are taken through an inhaler. Mild COPD may need a short-acting one, taken only when you have symptoms. Moderate or severe COPD may need long-acting ones, taken every day.
  • In severe COPD or frequent flare-ups, your doctor may prescribe bronchodilators together with an inhaled steroid to reduce airway inflammation.
  • A new add-on medicine approved in 2024 combines a bronchodilator with a nonsteroid anti-inflammatory that helps clear mucus.
  • If inhaled medicines do not help, an add-on biologic approved in 2024 for COPD may improve breathing. Biologics are made from living sources, such as cells and proteins.
  • Antibiotics may be used to treat flare-ups caused by an infection. Ask your provider for a flare-up plan.
  • Oxygen therapy, if you have severe COPD and low blood oxygen. Never smoke or use flammable materials when using oxygen, because oxygen poses a fire risk.
  • Pulmonary rehabilitation, a supervised program with exercise training, health education, and breathing techniques.
  • Vaccines for the flu and pneumococcal pneumonia, since people with COPD are at higher risk for serious problems from these diseases.

Surgery is an option only when serious symptoms have not improved with medicines. It can remove damaged lung tissue or large air spaces called bullae. Some people with severe COPD need a lung transplant.

When to see a doctor

Call 911 if you have severe symptoms, such as trouble catching your breath or trouble talking. Also call 911 for chest pain or discomfort lasting two minutes or more, confusion, or fainting. Call your provider if your symptoms are getting worse or you have signs of an infection, such as a fever.

How a direct primary care or concierge doctor fits in

A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Such a doctor can show you the correct way to use your inhaler. They can also order tests such as lung function tests.

Common questions

Can COPD be cured?

No, there is no cure. But treatments can help with symptoms, slow the disease, and help you stay active. Quitting smoking is the most important step.

What is the difference between emphysema and chronic bronchitis?

Emphysema damages the air sacs and the walls between them, so it is harder to move air out. Chronic bronchitis means the airway lining is constantly irritated and inflamed, causing swelling and mucus. Most people with COPD have both.

Who should be tested for the genetic form of COPD?

People being checked for COPD may have a blood test for alpha-1 antitrypsin deficiency, a genetic condition that can play a role in causing COPD.

Can COPD be prevented?

Often, yes. Since smoking causes most cases, the best way to prevent COPD is not to smoke. Also avoid lung irritants such as secondhand smoke, air pollution, chemical fumes, and dusts.

Sources

  1. MedlinePlus - COPD (Chronic Obstructive Pulmonary Disease)
  2. National Heart, Lung, and Blood Institute - What Is COPD?
  3. National Heart, Lung, and Blood Institute - COPD Treatment

Medical Disclaimer

This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.