What You Need to Know About COPD Treatment

What You Need to Know About COPD Treatment

An overview of medications, lifestyle changes and pulmonary rehabilitation for chronic obstructive pulmonary disease.

According to the American Lung Institute, more than 16 million people in the United States are affected by chronic obstructive pulmonary disease (COPD), a chronic respiratory condition that makes it more difficult to breathe and makes it more difficult for the lungs to pass oxygen into the bloodstream. The most common symptoms of COPD are shortness of breath, a cough that produces sputum (phlegm), and wheezing and tightness in the chest.

COPD occurs in two main forms: emphysema and chronic bronchitis. With emphysema, the elastic tissue that aids exhaling air as well as the walls between the tiny air sacs in the lungs are destroyed. In chronic bronchitis, the walls of the bronchial tubes become inflamed and thickened and produce excess mucus. Most people with COPD have a combination of the two conditions.

Risk factors for COPD
Tobacco use (past and present) is the biggest risk factor for COPD, and the risk increases with longer use and greater number of cigarettes per day. Habitual smoking can inflame and damage the linings of the airways in the lungs.

However, around 20 percent of people with COPD never smoked. Other risk factors for the disease include:

  • Long-term exposure to fumes, chemicals, dust and pollutants in the air.
  • A childhood history of respiratory illness and infection.
  • Genetics—COPD runs in families, and a genetic disorder called Alpha-1 antitrypsin deficiency (A1AD) is responsible for 1 to 2 percent of cases.

While there is no cure for COPD, there are ways to treat and manage the disease, including medications, pulmonary rehabilitation and lifestyle changes.

Medications to treat COPD
Bronchodilators—inhaled medications that open the airways—are a mainstay of treatment. Patients with mild COPD can use these on an as-needed basis, while those with persistent symptoms may be instructed to use at least one type of inhaler on a daily basis. Glucocorticoids, a type of steroid, are another medication option. Glucocorticoids may be taken on a regular basis with an inhaler, or may be prescribed as pills or injection on a short-term basis when symptoms get bad. Many patients with COPD use a combination of medications. Since COPD can result in low levels of oxygen in the blood, some patients are prescribed oxygen therapy.

Strategic lifestyle changes
Quitting smoking, and eliminating or reducing exposure to chemicals in the workplace and indoor air pollution from burning biomass fuel (like wood chips, manure and certain types of waste residues), can help keep your COPD from worsening. Patients are encouraged to monitor weather air quality and, depending on the severity of their disease, avoid vigorous activity outdoors or stay indoors during episodes when air quality is suboptimal.

Pulmonary rehabilitation
COPD patients will benefit from regular physical activity and are encouraged to remain active. Pulmonary rehabilitation is a supervised program that incorporates fitness, breathing exercise, nutrition, patient education and smoking cessation. Social and psychological counseling and support are also an important focus—patients with COPD are at a higher risk for anxiety and depression.

Food is another focus of COPD treatment, and nutrition is often a focus of pulmonary rehabilitation programs. Because COPD can make it difficult for a person to eat, and impacts the way the body metabolizes food, many COPD patients end up underweight. Getting adequate amounts of calories and nutrients is important to maintaining energy levels, and is also important to immune function. People with COPD may work with a healthcare provider to follow a special eating plan and may need vitamins and nutritional supplements.

COPD patients should talk to their doctor about vaccines to prevent illnesses that can worsen COPD. The Centers for Disease Control and Prevention recommends that people with asthma or COPD get an annual influenza (flu) vaccine, and to get vaccinated against pneumonia, whooping cough and shingles.

Medically reviewed in August 2018.

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