What Type of COPD Do I Have and How is it Treated?

Posted January 06, 2025

If you have been recently diagnosed with Chronic obstructive pulmonary disease (COPD) its important to understand that COPD isn’t just one disease, it’s a spectrum of conditions that impacts the ability to get air out of the lungs. COPD is a common condition that can be treated more successfully when you know what type of COPD you have been diagnosed with and how to manage it. 

COPD claims nearly as many lives as some cancers and due to the various causes and subtypes of the disease, it requires a personalized diagnosis similar to a cancer diagnosis. A COPD diagnosis should include discussion around the type of COPD, the stage of the disease and the available treatments. Just as you would expect your doctor to treat the specific individual type of cancer, chronic obstructive pulmonary diseases require equal precision and attentiveness. The COPD team at Summa Health has the tools to give the precise, personalized diagnosis you should expect and will develop a treatment specific to you. 

By understanding the ten most common types of COPD and their unique treatments, you can better partner with your healthcare provider to determine the cause of your symptoms and develop a chronic disease management plan that aligns with your lifestyle and specific COPD needs.

1. The most common type of COPD involves emphysema. Emphysema is the destruction of the lung tissue. This is treated with inhalers, oxygen therapy and physical therapy to address lung elasticity. Healthy lungs act like stretchy balloons. They deflate, or get the air out, quickly. With emphysema the lungs become more like a plastic shopping bag, loose, fragile and not elastic, making it difficult to breathe. 

2. COPD with emphysema can involve hyperinflation with air trapping. Hyperinflation occurs when too much air gets trapped in the lungs during exhalation, making it difficult to breathe. It causes symptoms like difficulty inhaling and shortness of breath. Sometimes it can be treated with surgery or less invasive measures using a bronchoscopy to place lung valves which help deflate the sickest parts of the lung. 

3. Chronic bronchitis COPD causes significant mucus production and is characterized by a chronic cough producing phlegm. This specific condition is primarily caused by long-term exposure to irritants that damage the lungs and airways such as exposure to cigarette smoke, either from active smoking or passive inhalation. Air pollution and work environment may also play a role. The most effective treatment is standard therapy with additional medications such to decrease congestion. Chest physiotherapy and vibratory oscillatory therapy can help remove mucus. 

4. Combined pulmonary fibrosis and emphysema (CPFE) is a rare disease that combines emphysema in the upper lungs and fibrosis in the lower lungs. Fibrosis is a thickening or scarring of lung tissue, which makes it difficult to breathe. Scarring of lung tissue affects lung elasticity and function. Medications are available to decrease scarring and research on this condition is ongoing. Scarred tissue in the lungs makes it more difficult for the heart to pump blood to the lungs. This leads to high blood pressure in both the arteries and the heart. 

5. Bronchiectasis COPD occurs when there is destruction and widening of the small airways and they are no longer able to as effectively drain mucus and other secretions. When germs become trapped, this creates a cycle of inflammation and infection that eventually forms irregular airway pockets, leading to further loss of lung function over time and can causes coughing up blood. With this condition ruling out additional associated diseases is important. 

6. Some patients also develop COPD with asthmatic overlap (ACOS). Some patients exhibit features of both COPD and asthma, requiring a tailored approach to treatment. Your doctor will gather a detailed medical history, perform a physical exam and may order a chest X-ray or CT scan. Also, your doctor may use a form to ask a series of questions to help them determine if its asthma, COPD or ACOS. This COPD type can benefit from newer steroids or steroid-sparing medications such as new biologic injection medications. 

7. A genetic type of COPD can be associated with a deficiency of Alpha-1 antitrypsin. A deficiency of Alpha-1 antitrypsin (AAT) is a known genetic factor that can significantly increase the risk of developing COPD, particularly emphysema. A lack of this protein leaves the lungs more vulnerable to damage from environmental factors like smoke and pollution; therefore, COPD can be associated with an AAT deficiency. Patients can be at an increased risk of getting liver failure and supplementation of the AAT protein is needed. 

8. Mild-to-moderate pulmonary hypertension is a common complication of COPD. Pulmonary hypertension is a type of high blood pressure that affects the arteries in the lungs and the right side of the heart. There's no cure for pulmonary hypertension. But treatments are available to help you feel better, live longer and improve your quality of life.

9. Constrictive Bronchiolitis COPD is a newly recognized type of obstructive lung disease. It is also known as bronchiolitis obliterans or more commonly, popcorn lung. Certain people have a higher risk of developing bronchiolitis obliterans because they come in close contact with toxic substances in the air due to their occupation. This includes veterans and workers in some manufacturing facilities. Treatments for popcorn lung may include corticosteroids to fight inflammation, inhalers to help with breathing and oxygen therapy.

10. COPD with obesity hypoventilation syndrome, or Pickwickian syndrome, is a breathing disorder that affects some people who have obesity. The condition results in too much carbon dioxide in your blood and not enough oxygen. This occurs due to hypoventilation, which means breathing at an abnormally slow rate. Obesity hypoventilation syndrome COPD treatment includes weight loss and breathing assistance.

Research of chronic obstructive lung diseases is rapidly developing leading to better understanding and new treatments. Talk to your health care provider about how to create a personalized COPD treatment plan. Visit www.summahealth.org/medicalservices/pulmonary to learn more.