A patient’s guide to COPD diagnosis

If you suspect that you may have COPD, it’s essential to go to your doctor and get checked out to confirm whether you have the condition.

If COPD is suspected, further assessments and tests may be performed to determine an accurate diagnosis and what stage you fall under.

This information was sourced from leading COPD health and advocacy organisations. This is general information and should not be taken as medical advice. Please consult someone from your medical team if you have specific questions about your COPD or general health. 

Who should get tested for COPD?

If you have any of the following symptoms, you may have COPD.

If you experience these, you should seek further medical advice and be tested for COPD:

• Shortness of breath¹
• Persistent wheezing¹
• A persistent chesty cough with or without phlegm¹
• Frequent chest infections¹

Initial assessment

When visiting your GP or a medical professional you trust, they will go through some key steps to help diagnose what may be causing your symptoms.

First, they will ask you about what symptoms you may be experiencing and assess how severe they are.²  Some questions they might ask you include:

• How long have you been breathless?³
• Do you cough and/or wheeze?³
• Do you bring up sputum/phlegm?³
• Do you have frequent chest infections?³
• Did you have any lung problems in your childhood?³

They may also examine and listen to your chest using a stethoscope for any abnormal signs indicating COPD.² 

They will also ask if you currently smoke or have a history of smoking. According to the World Health Organisation (WHO), tobacco smoking and exposure is the leading cause of COPD. This is because tobacco smoke contains thousands of toxic chemicals that can damage the lungs over time. Knowing whether or not you smoke allows your practitioner to evaluate your risk of developing the disease.

Your doctor will also review your family and medical history to assess whether you are at higher risk of the condition.² After your initial assessment, if COPD is suspected, then you may be sent for further testing to confirm a diagnosis. Below are some of the most common tests performed to confirm COPD.

Spirometry 

A spirometry test is a non-invasive breathing/lung function test used to help diagnose COPD.⁶ It measures how much air you can breathe out in one breath to evaluate your lung capacity.⁷ Spirometry is the main tool medical professionals will use to diagnose COPD, and everyone who has a diagnosis should have had a spirometry test.

When you take the test, you will be asked to take a deep breath and blow out all the air in your lungs into a mouthpiece connected to a spirometer machine.⁸ You may need to blow a few times, but it is crucial you put as much effort into the test as you can to get an accurate result.⁶

After the test is completed and the results are sent through, this is an excellent opportunity to discuss your findings with your doctor and what this will mean going forward.

A spirometry test helps determine the severity of your condition as well. This test is an essential part of categorising the disease into one of the four stages of COPD.⁷ Separating COPD into stages allows practitioners to provide you with the right treatment plan according to your needs.

You can learn more about how the disease progresses and the symptoms of severe COPD/emphysema here.

Chest imaging

Further clarity about your lung’s health and COPD severity may be needed to help diagnose your condition. Imaging tests may also be needed to help determine whether your symptoms are a result of another lung condition other than COPD.⁹

A chest X-ray can show problems related to COPD that are not seen otherwise, such as hyperinflation (over filling of your lungs with air), a flattened diaphragm (which indicates hyperinflation), changes in your airways, bullae, or changes to the heart muscle. While an X-ray can’t give an insight into your lung capacity, it can provide doctors with a better understanding of your condition.

A chest CT may also be done to examine your lungs in much greater detail. This is so your doctor can see if your symptoms are brought on by lung problems such as a nodule (small growths on the lungs), a blood clot, emphysema, or an infection.⁹ 

However, typically chest CTs aren’t a regular part of investigations, and normally are requested by a respiratory consultant if they believe it is needed.

Further testing

Sometimes, further tests are required to help establish whether or not you have COPD and determine the severity of your condition.

These can include:

• A blood test – this can eliminate conditions that have similar symptoms to COPD, such as anaemia or erythrocytosis.²
• A peak flow test – this can help rule out asthma.²
• A phlegm sample – this can help check for signs of a chest infection.²
• A blood oxygen test.²
• An electrocardiogram (ECG).²
• An echocardiogram.²
• A FeNO test – this is used to diagnose asthma

Why is it important to get tested for COPD?

It is essential to go and get tested if you suspect you have COPD or are concerned about your symptoms. 

Delaying diagnosis can result in significant health risks and complications. Untreated COPD tends to worsen over time and increases the risk of life-threatening flare-ups or exacerbations, which may require hospitalisation.¹⁰

Getting an early diagnosis allows for interventions such as pulmonary rehabilitation, smoking cessation support, and proper use of inhalers - all of which can significantly improve symptoms and slow disease progression.¹¹  Those who fail to get tested may miss out on these treatments and preventive strategies, leaving you more vulnerable to severe complications.

Contact your doctor or a trusted medical professional to discuss further steps and details about COPD.

You can also take our self-test to get a better idea of whether you are at risk of severe COPD/emphysema.

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References:

1.  https://www.nhs.uk/conditions/chronic-obstructive-pulmonary-disease-copd/symptoms/ 
2.  https://www.nhs.uk/conditions/chronic-obstructive-pulmonary-disease-copd/diagnosis/ 
3.  https://www.asthmaandlung.org.uk/healthcare-professionals/adult-asthma/diagnosis-testing/diagnosing-asthma-adults 
4.  https://www.who.int/news-room/detail/29-05-2019-who-highlights-huge-scale-of-tobacco-related-lung-disease-deaths 
5.  https://www.medicalnewstoday.com/articles/smoking-and-copd 
6.  https://www.asthmaandlung.org.uk/symptoms-tests-treatments/tests/spirometry 
7.  https://www.asthmaandlung.org.uk/conditions/copd-chronic-obstructive-pulmonary-disease/how-copd-diagnosed 
8.  https://www.copdfoundation.org/What-is-COPD/Understanding-COPD/How-is-COPD-Diagnosed.aspx 
9.  https://www.medicalnewstoday.com/articles/323363 
10.  https://pubmed.ncbi.nlm.nih.gov/31190785/ 
11. https://pubmed.ncbi.nlm.nih.gov/25363328/