Uncontrolled asthma can lead to emergency room visits, hospitalizations and even premature death, according to allergist Myron Zitt, MD, past president of the American College of Allergy, Asthma, and Immunology (ACAAI).

If you have <a href="https://www.sharecare.com/health/asthma-respiratory-problems/article/video-different-types-asthma">asthma</a>, it is critical that you take your medication as directed, see your pulmonologist regularly and avoid allergy triggers to ensure you don&#39;t struggle to breathe. Here are some common missteps to avoid:

Not taking your symptoms seriously 
If you have symptoms more than two days a week that cause you to reach for your fast-acting relief inhaler&mdash;or find yourself waking up at night wheezing&mdash;see your doctor to discuss other asthma control options, such as inhaled corticosteroids, which may help address the airway inflammation that occurs with asthma.

Ignoring allergies 
<a href="https://www.sharecare.com/health/asthma-respiratory-problems/article/video-how-common-allergic-asthma">Allergens</a> are an asthma trigger for many people, and Zitt recommends undergoing allergy testing to learn what sparks a reaction and gain guidance in avoiding these allergenic triggers.

Not using your medication preventatively 
Patients who are prescribed a daily medication for asthma must take their medication every day. Yet when symptoms appear to be under control, some patients may skip doses or forget doses. Unfortunately, non-adherence to a treatment plan can lead to poorly controlled symptoms. Zitt stresses that it&#39;s always best to take your medicine regularly to prevent attacks rather than waiting until your symptoms hit and then trying to deal with them.

Not using your inhaler properly 
Many asthma patients do not administer the medication from their inhalers properly, which means they aren&#39;t getting the full benefits of the medicine, Zitt admits. &quot;Using inhaled medication requires instruction and practice to learn how to get it into the lower airways,&quot; he explains. Your doctor or pharmacist can review the technique with you. If you can&#39;t get the timing right, inquire about using an inexpensive device called a spacer, which may make the process easier to coordinate.

Not having a current asthma action plan in place 
The National Heart, Lung, and Blood Institute guidelines indicate that doctors should give each patient with asthma an individualized written plan. The plan should spell out the patient&#39;s triggers, his or her control medications and dosage, the warning signs that an <a href="https://www.sharecare.com/health/asthma-respiratory-problems/article/video-what-is-asthma-attack">attack</a> is impending and detailed directions on how to respond, such as increasing inhaler frequency, using a nebulizer or taking an oral steroid.

Not taking care of your health 
Part of controlling asthma is staying healthy. Take precautions to avoid getting sick. Get your annual flu shot as well as a pneumococcal vaccine, wash your hands frequently and steer clear of germy places. If you do become ill, you&#39;ll need to be on the lookout for asthma symptoms and respond by increasing your asthma medicines according to your asthma action plan.

Not working with your healthcare provider 
Understanding asthma and working as a team with your healthcare providers is vital to managing asthma. The good news is that with proper planning and communication, asthma can be managed.

Medically reviewed in May 2018.

7 Mistakes That Sabotage Asthma Control

Allergic asthma is a type of asthma where symptoms are triggered by contact with allergens, and it is the most common type of asthma. Watch Chandler D. Patton, MD, discuss the symptoms and management of allergic asthma in this video.

Medically reviewed in May 2018.

What Is Allergic Asthma?

Asthma comes in a variety of different types. Watch pulmonologist Harish Murthy, MD, discuss how allergies, infections, cigarette smoking, exercise and acid reflux can all cause asthma.

Medically reviewed in December 2020.

What Are the Different Types of Asthma?

Genetics and the environment are two causes of asthma, says <a href="https://www.sharecare.com/doctor/dr-clifford-bassett">Clifford Bassett, MD</a>. In this WisePatient video, he discusses those and other culprits.

Medically reviewed in April 2018.

What Causes Asthma?

Allergic rhinitis and asthma are both common conditions. While exact numbers are hard to pin down, it is estimated that 25 million adults and children in the United States have allergic rhinitis and another 25 million have asthma.

While they are different conditions, there is overlap. Many people who are diagnosed with <a href="https://www.sharecare.com/health/asthma-respiratory-problems/article/what-you-need-to-know-about-asthma">asthma</a> also have allergic rhinitis, and the most common type of asthma is allergic asthma, where allergens act as triggers for asthma symptoms.

What are allergies? 
An allergy is an immune system reaction to a harmless substance. Normally, the immune system reacts to get rid of germs and heal injuries. You sneeze to rid your nasal passages of germs. Your eyes water to keep harmful particles out. A sprained ankle swells as the area is flooded with fluid and white blood cells. All of these things are appropriate immune responses.

With an allergy, your immune system reacts to things that normally do not trigger any kind of immune response. People are allergic to all sorts of things, including foods, bites and stings from insects, materials and medications. Anything that causes an allergic response is called an allergen.

Allergic rhinitis is inflammation of the nasal membranes that results from allergic reactions. Its symptoms are what we typically call &ldquo;allergies,&rdquo; and include nasal congestion, sneezing and irritated eyes, as well as a sore or scratchy throat, coughing, hives and headaches. Common allergens for allergic rhinitis include pollen, mold spores, pet dander and <a href="https://www.sharecare.com/health/allergy/article/eliminate-dust-mites-stop-sneezing">dust mites</a>. You may also hear allergic rhinitis referred to as seasonal allergies, hay fever or indoor and outdoor allergies.

What is asthma? 
Asthma is a chronic condition in which the lungs and the airways&mdash;the tubes that carry air to and from the lungs&mdash;become inflamed. This inflammation causes the airways to spasm, and also causes an excess amount of mucus that blocks the airways. This makes it difficult to breathe normally.

Wheezing, coughing, tightness in the chest and feeling out of breath or shortness of breath are all symptoms of asthma. These symptoms can range from mild to severe. An asthma attack (also called an exacerbation or a flare-up) occurs when asthma symptoms become severe.

Asthma can be triggered by a variety of things&mdash;physical exercise, cold air, tobacco smoke and stress can all trigger asthma symptoms. Many people have more than one asthma trigger.

How are asthma and allergies connected? 
The most common type of asthma is <a href="https://www.sharecare.com/health/asthma-respiratory-problems/article/how-manage-allergic-asthma">allergic asthma</a>; approximately 60 percent of people who are diagnosed with asthma have allergic asthma. With allergic asthma, allergens trigger asthma symptoms. This includes skin and food allergens as well as allergens like pollen, pet dander, mold and dust mites.

Though they are different conditions, both allergic rhinitis and asthma are inflammatory disorders, and both involve similar immune responses in the body. It is common for people diagnosed with asthma to also have allergic rhinitis, and allergic rhinitis is a risk factor for developing asthma.

If you have symptoms of allergies, asthma or allergic asthma, or have been diagnosed with any of these conditions, it&#39;s important to work with your healthcare provider to get an accurate diagnosis and come up with a treatment plan to address your symptoms.

It is also important to understand that conditions like these can change over time and increase your risk for things like sinus infections, bronchitis and pneumonia. See your healthcare provider anytime you start to experience new symptoms, your symptoms worsen or your symptoms are not responding to treatment.

Is It Asthma, Allergies or Both?

Did you know half of all asthma cases are related to allergies? Learn more from Robin Miller, MD, in this video.

Medically reviewed in May 2018.

The Link Between Allergies and Asthma

Chronic obstructive pulmonary disease (COPD) is a chronic respiratory condition where breathing becomes difficult due to a diminished function of the lungs and airways. It 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, become damaged and no longer function properly. With chronic bronchitis, the walls of the bronchial tubes become inflamed and thickened, and produce excess mucus. Most people with COPD have a combination of these two conditions.

Tobacco smoking is the leading risk factor for COPD, and the majority of COPD cases are attributable to cigarette smoking. However, there are other risk factors, including genetics and exposure to <a href="https://www.sharecare.com/health/health-society/article/pollution-kills-millions-each-year-finds-study">pollution</a>, fumes and chemicals, and there are people with COPD who have never smoked. Some research also suggests that excess bodyweight and a lack of physical activity are associated with COPD symptoms.

The research looked at self-reported data taken from more than 113,000 participants in the National Institutes of Health-AARP Diet and Health Study, which began in 1995. While none of the participants reported COPD-like symptoms at the start of the study, 3,648 participants reported having COPD symptoms in the follow-up years between 1996 and 2006. The researchers discovered that obese people&mdash;as measured by <a href="https://www.sharecare.com/health/wellness-healthy-living/article/can-you-be-overweight-and-healthy">body-mass index (BMI)</a>&mdash;accounted for a greater percentage of those who reported COPD symptoms than did slimmer people.

How could COPD, a disease of the lungs, be associated with being overweight or obese? Carrying excess weight can impact breathing and exacerbate the symptoms of respiratory conditions, including COPD. Obesity can also contribute to inflammation, according to Gundula Behrens, PhD, a researcher in the department of epidemiology and preventive medicine at the University of Regensburg in Germany and co-author of the study. Cells in the immune system secrete proteins called cytokines, and one type of cytokines, known as pro-inflammatory cytokines, cause an inflammatory response in the body.

&quot;The fat tissue that is most active in the production of pro-inflammatory cytokines is visceral fat, which is found in the <a href="https://www.sharecare.com/health/obesity-overweight-condition/article/bad-body-fat-omentum-definition-causes-prevention">abdomen</a>,&quot; Behrens says. &quot;Those pro-inflammatory cytokines circulate through the body, and increased levels of those cytokines may stimulate COPD-related processes in the lung.&quot;

If you have been diagnosed with COPD, there are a number of steps you can take to slow the progression of the disease. At the top of this list is to quit smoking (if you smoke, and you haven&rsquo;t already quit). Exercising and adopting a healthy diet can also help. Speak with your healthcare provider about pulmonary rehabilitation&mdash;a treatment program that utilizes exercise, counseling, nutrition and breathing techniques to help people with respiratory illnesses improve lung function, manage symptoms and improve quality of life.

How Being Overweight Affects COPD

If you feel short of breath while exercising, or you&rsquo;re prone to fits of coughing, you may be wondering if asthma or COPD could be to blame. Asthma and <a href="https://www.sharecare.com/health/copd/article/what-you-need-know-copd">chronic obstructive pulmonary disease (COPD)</a> are often confused or lumped together because they share some of the same symptoms.

&ldquo;Both conditions cause wheezing and shortness of breath,&rdquo; says <a href="https://www.sharecare.com/doctor/dr-nicholas-roy">Nicholas Roy, DO</a>, a pulmonary, internal medicine and critical care specialist from Lourdes Health System in Camden, New Jersey. &ldquo;But not everyone who wheezes has asthma, nor do they necessarily have COPD&mdash;it takes a little more investigating to figure out which condition it is.&rdquo;

Here are some key similarities between the two conditions and how to tell them apart.

What are asthma and COPD? 
Asthma is a chronic lung disease that often appears during childhood. It may be reversed over time, but many people have <a href="https://www.sharecare.com/health/asthma-respiratory-problems/article/what-you-need-to-know-about-asthma">asthma</a> for life. &ldquo;It causes airway tightening, inflammation and constriction in the lungs. The small airways actually narrow, leading to shortness of breath, coughing and wheezing,&rdquo; says Dr. Roy.

These symptoms become especially severe during asthma attacks. Asthma attacks may be brought on by a number of <a href="https://www.sharecare.com/health/asthma-causes/causes-of-asthma">triggers</a> such as allergies, exercise, irritating fragrances and lung infections. Attacks can be life threatening, but they&rsquo;re usually treatable at home with rescue inhalers like albuterol.

&ldquo;COPD is a group of chronic lung diseases, which are almost always caused by&nbsp;smoking and don&rsquo;t typically appear until after age 40. These diseases include chronic bronchitis and emphysema,&rdquo; says Roy.

<ul>
	<li>Chronic bronchitis is an ongoing cough, which produces large amounts of mucous.</li>
	<li>Emphysema involves the damage and scarring of tiny air sacs in your lungs, called alveoli. When alveoli are destroyed, it&rsquo;s harder for your lungs to take in oxygen and release carbon dioxide.</li>
</ul>

There are treatments for COPD, but there&rsquo;s no known cure. Many of the same triggers that cause asthma attacks could also lead to COPD exacerbations, or symptom flare-ups. Exacerbations can be serious and require a hospital stay; with each flare, COPD tends to become a little worse.

Are COPD and asthma diagnosed the same way? 
Some of the same tests are used to diagnose both asthma and COPD. For example, your lung specialist will ask about your symptoms, listen to your heart and lungs and have you to complete a pulmonary function test (PFT).

A PFT involves taking a deep breath, and then exhaling as long and hard as you can into a special tube. The tube is attached to a computer, which measures your lung strength and capacity, or the amount of air you&rsquo;re able to exhale. If you don&rsquo;t score well on your PFT, your doctor will give you an inhaled medication to help open up your airways, and then let you redo the test. People with asthma typically score better after taking the medication, while those with COPD show little or no improvement.

Your lung specialist may also order blood tests, as well as a chest X-ray to determine if another condition like pneumonia could be causing your symptoms.

Are both conditions preventable? 
COPD is largely preventable since smoking causes 80 percent of cases. You can&rsquo;t prevent asthma, but you can limit the number of attacks you experience by:

<ul>
	<li>Avoiding triggers</li>
	<li>Getting your annual flu shot</li>
	<li>Taking your daily, or maintenance inhalers</li>
</ul>

Smoking can&rsquo;t cause asthma, but it can trigger attacks, make it harder to fight lung infections and increase your risk of developing COPD. &ldquo;People with asthma are actually more likely to damage their lungs with cigarette smoke,&rdquo; says Roy. &ldquo;It puts them a slightly higher risk for COPD than the average person.&rdquo;

Can asthma cause COPD? 
Asthma doesn&rsquo;t cause COPD. However, people with severe asthma whose symptoms don&rsquo;t improve with treatment are considered to have a type of COPD. People with poorly controlled asthma as children are more prone to this condition as adults.

How asthma and COPD are treated 
Quitting smoking is the number one treatment for COPD and a key part of controlling asthma symptoms. For help quitting tobacco:

<ul>
	<li>Call the national Smokefree Hotline at 1-800-QUIT-NOW (1-800- 784-8669)</li>
	<li>Visit Sharecare&rsquo;s <a href="https://www.sharecare.com/health/quit-smoking">quit smoking page</a> for tips and support</li>
	<li>Reach out to an <a href="https://www.sharecare.com/find-a-doctor/specialty/addiction-medicine">addiction specialist</a> for personalized help</li>
</ul>

Asthma and COPD also share some&mdash;but not all&mdash;medications. &ldquo;There&#39;s often a crossover between inhaler therapies for both conditions,&rdquo; explains Roy. &ldquo;Inhalers include bronchodilators, or drugs that help open up the airways to allow better air flow in and out. Both conditions may also require steroid inhalers, although people with asthma tend to respond a little better to steroid treatments. This is a major reason why that there&#39;s often confusion between the two conditions.&rdquo;

Visit your lung specialist at least once a year to determine which medications are right for you and to update your med list as symptoms change. Individuals with both asthma and COPD often need a combination of inhalers, which may vary from season-to-season or depending on how advanced your condition is. Use Sharecare&rsquo;s <a href="https://www.sharecare.com/find-a-doctor/specialty/pulmonary-disease">find a doctor tool</a> to make an appointment with a lung doctor near you.

Medically reviewed in April 2018.

How to Tell if It's Asthma or COPD

Some of the clues are a little surprising, but if you&nbsp;know what to look for, you&#39;ll be better prepared for your next attack

5 Weird Warnings of an Asthma Attack

Watch Keren Bakal, MD, from Summit Medical Group discuss why having an asthma action plan is an essential part of asthma management, plus her recommendations for her patients.

Taking Control of Your Asthma

For anyone who has lived with asthma for a while, one of the top questions has got to be: &quot;Is this the best treatment out there?&quot; With scientists always on the hunt for better drug therapies with fewer side effects, it&#39;s possible that the drug you&#39;re on now isn&#39;t the best option for you.

To make a smart decision with your doctor, it helps to know about the latest stuff available. For that, we talked with <a href="https://www.sharecare.com/doctor/dr-stephen-wasserman">Stephen Wasserman, MD</a>, professor of medicine in the division of Rheumatology, Allergy &amp; Immunology at UCSD.

Are there new quick-relief medicines? 
Turns out, there are still two main options for when you need immediate help&mdash;beta-agonists and anticholinergics. These drugs temporarily relax the muscles around the airways to relieve asthma symptoms quickly. <a href="https://www.sharecare.com/health/gastrointestinal-drugs/what-are-anticholinergic-medicines">Anticholinergics</a> don&#39;t work as quickly as beta-agonists, so some doctors don&#39;t consider them true relief medications. Also, Dr. Wasserman says most people seem to find beta-agonists, such as albuterol, to work the best for them, but that studies show the two drugs to be about the same in terms of effectiveness.

Are there new controller medicines? 
First, some inhalers combine a long-acting beta agonist (LABA) with a steroid in a single device. LABAs help open up the small airways inside the lungs. If someone&#39;s asthma isn&#39;t well controlled on an inhaled steroid alone, they usually step up to this type of inhaler. Once controlled, you can try to step back down under your doctor&#39;s guidance.

Examples include Advair (salmeterol and fluticasone), Breo Ellipta (vilanterol and fluticasone), Dulera (formoterol and mometasone) and Symbicort (formoterol and budesonide).

Wasserman doesn&#39;t recommend one brand over another, but says some people like the convenience of the once-a-day options. He notes, though, that the FDA has put a &quot;black box&quot; warning on LABA drugs because of early studies that showed an increased risk of death in patients with asthma. That&#39;s why LABA drugs are recommended only as &quot;add-on therapy&quot; to be used with a steroid.

Second, several studies show that long-acting anticholinergics work for asthma, too. Originally developed for <a href="https://www.sharecare.com/health/copd/article/what-you-need-know-copd">chronic obstructive pulmonary disease (COPD)</a>, these drugs stop the muscles from tightening around the larger airways, which happens when the lungs are irritated.

There&#39;s only one long-acting anticholinergic drug approved for asthma, called Spiriva Respimat (tiotropium). There&#39;s no black box warning for anticholinergics, but it doesn&#39;t necessarily mean they&#39;re better or safer, says Wasserman. Some doctors prefer to start their patients on this type of combo inhaler.

And there are a few oldies but goodies worth noting. Singulair (montelukast) is a pill that works well for some people, but it&#39;s not as likely to help as other long-acting drugs. Theophylline is another &quot;old-fashioned&quot; asthma pill that&#39;s related to caffeine and may cause the same jitters, says Wasserman. It fell out of favor because it can be toxic at high doses, but he says it&#39;s still a reasonable drug to consider if you&#39;re having trouble controlling your asthma, especially if you&#39;re one of the 25-30% of severe asthmatics who smoke.

What are biologics for asthma? 
The above treatments usually work for people with mild to moderate asthma, but they may not be enough to fully control more severe asthma. This gap has led scientists to test a new type of drug, called biologics. These drugs act similar to natural antibodies in your body.

The first biologic approved for allergic asthma is Xolair (omalizumab). Wasserman says this drug is very effective for asthma, probably even in people who don&#39;t have allergic asthma. The success of this medicine for difficult-to-treat asthma has sparked a lot of interest. More biologics that work in different ways are being tested, but it&#39;s not clear yet which patients will benefit most from which therapy.

Wasserman warns that biologics should be considered the final drug someone would add to their regimen. &quot;Biologics are pricey, require injections and require monitoring,&quot; he adds.

How do I know I&#39;m on the right drug? 
If you&#39;re reading this, chances are you&#39;re not totally satisfied with your <a href="https://www.sharecare.com/health/asthma-medication/how-medications-help-control-asthma">asthma drugs</a>. If your doctor thinks you&#39;re already on the best medicine, they may increase the dose to see if that helps. They&#39;ll probably also ask you if you&#39;re truly taking it as prescribed, since 30-70% of people with asthma don&#39;t follow their doctor&#39;s orders exactly.

The real key is figuring out why you&#39;re not happy, Wasserman says. If you&#39;re not doing well, ask your doctor: What more could we do or what are we missing? If you don&#39;t like the drug delivery, try a dry powder inhaler, for example. If the drug tastes bad or makes you feel sick, tell your doctor. There&#39;s probably an alternative you can try. Talk over your concerns and goals with your doctor to come up with the right treatment plan for you.

Medically reviewed in April 2018.

The Latest Asthma Treatments

But were too grossed out to ask, such as what does green snot even mean?

Everything You've Always Wanted to Know About Mucus

Often referred to as COPD, chronic obstructive pulmonary disease is a chronic <a href="https://www.sharecare.com/health/copd/article/overview-chronic-obstructive-pulmonary-disease">respiratory illness</a> that makes it difficult for a person to breathe and makes it more difficult for the lungs to pass oxygen into the bloodstream.

There is no cure for COPD, but there are ways to treat the condition and lessen the impact that the condition has on a person&rsquo;s life. Smoking is the number one risk factor for COPD and <a href="https://www.sharecare.com/health/smoking-treatment/slideshow/guide-nicotine-replacement-therapy">quitting smoking</a> should be a top priority when treating COPD.

Treatment typically involves a multi-faceted approach that includes medications, making lifestyle changes and taking steps to keep symptoms under control, including avoiding things that can make symptoms worse.

Factors that worsen COPD symptoms are often called triggers. If you or a loved one has COPD, identifying triggers is important to effectively managing and treating the condition, and avoiding those triggers can help to reduce the impact that COPD has on a person&rsquo;s life.

Avoid infections 
The majority of COPD exacerbations are caused by bacterial or viral infections&mdash;such as strep throat, the common cold or the flu. Patients should do what they can to avoid coming into contact with infectious agents, including getting an annual flu shot, washing hands and avoiding people who are sick. Since nutrition and sleep are both important to immune function, it is important to follow an eating plan that gives your body adequate amounts of fluids, fiber and nutrients, and to get adequate amounts of sleep. Nutrition and sleep are both things that you can discuss with your healthcare provider, and should be a focus of your COPD treatment plan.

Avoid outdoor triggers 
Irritants in the air can exacerbate COPD symptoms. People with COPD should avoid environments where they are exposed to pollution, smog, exhaust from vehicles, secondhand smoke, smoke from campfires and chemical fumes. They should also pay attention to the weather&mdash;sudden changes in weather can exacerbate symptoms, as can air that is cold and dry, and air that is hot and humid. Strong winds and high altitudes can also cause COPD exacerbations. For some people, COPD is triggered by allergies, and they should avoid pollen, mold and other allergens.

Avoid indoor triggers 
COPD triggers can also be found indoors. As mentioned above, secondhand smoke needs to be avoided. Other culprits include smoke from fireplaces and wood stoves, fumes from household products, and certain beauty products (especially perfumes or anything that contains fragrances). Indoor allergens, such as pet dander, dust mites and mildew, can also exacerbate symptoms.

Monitor symptoms 
One of the best ways to identify what exacerbates your or your loved one&rsquo;s COPD is to monitor your symptoms closely, and keep notes about how symptoms vary from day to day. This can also provide useful information to your healthcare provider.

Recognize the symptoms of a COPD exacerbation 
Closely monitoring symptoms is also important to recognizing a COPD exacerbation. Also called a flare-up, a COPD exacerbation is a worsening of a person&rsquo;s usual COPD symptoms. Signs of an exacerbation can include:

<ul>
	<li>Becoming more short of breath</li>
	<li>Wheezing more severely than normal</li>
	<li>Producing more mucus</li>
	<li>Mucus that changes in color (clear to yellow, green, brown or red)</li>
	<li>Feeling fatigued</li>
	<li>Having trouble sleeping</li>
	<li>Having a fever</li>
	<li>Swelling of the feet and/or ankles</li>
	<li>Lower oxygen levels (for patients who check their oxygen levels)</li>
</ul>

Having a headache in the morning, having difficulty waking up from sleep, difficulty sleeping and <a href="https://www.sharecare.com/health/copd/article/video-are-other-diseases-associated-copd">confusion</a> can be signs of high carbon dioxide levels in the body, which is a potential complication of COPD and requires immediate medical attention.

How to Avoid Common COPD Triggers

Walking, climbing stairs or just going out with friends may seem difficult or impossible if you have a chronic lung condition that blocks airflow or makes it hard for you to breathe. If you&rsquo;re wondering if there are ways to boost your energy level and become more active or self-sufficient, it&rsquo;s important to talk to your doctor about pulmonary rehabilitation.

These programs are designed to help some people with chronic lung conditions such as chronic obstructive pulmonary disease (COPD) breathe easier and improve their overall quality of life. While increasing one&rsquo;s physical activity is an important component of pulmonary rehab, it&rsquo;s important to understand that it&rsquo;s not only about exercise, advises <a href="https://www.sharecare.com/doctor/dr-sarahellen-e-stephens">Sarah Ellen Stephens, MD</a>, a pulmonary disease specialist affiliated with <a href="https://www.sharecare.com/group/memorial-health">Memorial Health University Medical Center</a> in Savannah, Georgia.

&ldquo;Essentially, these programs allow us to help patients be more functional and more independent,&rdquo; Dr. Stephens says. &ldquo;I think most people hear &lsquo;rehab&rsquo; and think that it&rsquo;s just physical exercises, like walking and strength training. But really, pulmonary rehab takes a more holistic approach. It includes coaching for healthy nutrition, understanding when, how and why to use prescribed medications and therapies, and provides an opportunity to share with and learn from other individuals with chronic lung diseases.&rdquo;

What is pulmonary rehab? 
Pulmonary rehab&mdash;essentially, rehab for the lungs&mdash;is a comprehensive program for people with chronic lung disease who may be on medications but still have trouble breathing and get winded easily during routine tasks. The program is often associated with <a href="https://www.sharecare.com/health/copd-treatment/article/understanding-copd-treatment-plan">treatment for COPD</a>, but it could also help people who&rsquo;ve had a lung transplant and those with other respiratory conditions, such as cystic fibrosis, <a href="https://www.sharecare.com/health/asthma-treatment/article/treat-asthma-breathe-easier">asthma</a>, pulmonary hypertension (a type of high blood pressure that affects blood vessels in the lungs) and lung cancer.

Rehab can supplement treatment for chronic lung disease, but it isn&rsquo;t a replacement for medication or other therapies. People who participate work with a team of specialists that typically includes doctors, nurses, physical and occupational therapists, respiratory therapists, exercise specialists, dietitians, psychologists and social workers.

What&rsquo;s involved? 
People with COPD and other chronic lung diseases tend to lower their activity levels because exercise can make it harder to breathe. But being inactive reduces fitness levels, causing people to tire more quickly or with even less physical acitivity. Pulmonary rehab can help break this cycle by helping patients build muscle and endurance.

If you participate in pulmonary rehab, you might learn how to perform leg and arm exercises that are suited to your abilities. You may use a treadmill, stationary bike or weights while your blood oxygen levels are monitored. Your exercise regimen may also be adjusted over time as your fitness level changes.

In addition to exercise, you can also expect your pulmonary rehab program to include the following:

<ul>
	<li>Nutritional counseling: Excess weight around the belly can put pressure on your diaphragm, a muscle that plays an important role in breathing. On the other hand, chronic lung disease can cause you to lose weight and muscle, which can make you weak and also make breathing more difficult. Your doctor and a nutritionist may recommend that you follow a certain eating plan or take protein supplements to help mitigate these effects, depending on whether you need to lose or gain weight.</li>
	<li>Education: During pulmonary rehab, you&rsquo;ll learn more about your condition, including what could worsen your symptoms, how to keep them under control and what to do if they flare up. You may also receive instruction on taking your medicine properly and how to use inhalers and supplemental oxygen.</li>
	<li>Strategies to conserve energy: If you learn easier ways to do everyday activities, you may feel less short of breath. Physical and occupational therapists can teach you how to minimize reaching, lifting and bending, all of which can contract your abdominal muscles and make breathing more difficult.</li>
	<li>Stress reduction: Stress and anxiety can zap your energy and make breathing more difficult. Pulmonary rehab may also cover ways to relax and avoid stress.</li>
	<li>Breathing techniques: Pulmonary rehab specialists can teach you how to perform breathing exercises, such as pursed lip breathing and belly breathing, to help you breathe more efficiently. Pursed-lip breathing involves inhaling through the nostrils and exhaling slowly through slightly pursed lips. For belly breathing, people inhale through the nose then exhale more slowly through the mouth while paying attention to how their belly rises and falls with each breath. This can help people with COPD, in particular, who may have a buildup of stale air in their lungs. Getting this old air out of the lungs increases oxygen levels and enables the diaphragm to work better.</li>
	<li>Emotional support: Chronic lung disease, like COPD, increases the risk for depression and anxiety. Limiting your activities, frequently feeling tired and having trouble breathing can take an emotional toll, which could affect your ability to follow your treatment plan and lead to symptom flare ups. Counseling and support groups can help you ease stress and stay positive.</li>
</ul>

Some programs also help people stop smoking, but some may require patients to quit before they can start pulmonary rehab. These programs won&rsquo;t reverse the damage that&rsquo;s caused by smoking, and quitting is an essential part of helping you breathe easier and get stronger.

One size doesn&rsquo;t fit all 
Pulmonary rehab is not the same for everyone. Each progam is personalized or tailored to a patient&rsquo;s specific needs and abilities. Before the program begins, members of your healthcare team will perform a detailed evaluation to help them formulate the plan.

&ldquo;First, the team will help figure out what the patient&rsquo;s goals are and how they&rsquo;ll be able to help this person the most,&rdquo; Stephens says. &ldquo;They&rsquo;ll also do some initial assessments of the patient: how far they&rsquo;re able to walk, how low their oxygen levels get, how strong they are and how quickly they tire to help tailor the program to their individual needs.&rdquo;

After enrolling in pulmonary rehab, your lung function and fitness level would be evaluated in a walk test or other assessment. Your treatment plan, stress level, eating habits and muscle mass would likely be considered as well.

Most pulmonary rehab programs last 6 to 12 weeks and are conducted in small group settings, but some people can receive this therapy at home. Others may engage in pulmonary rehab while they are in the hospital. Outpatient group sessions may be held anywhere from one to three days per week. Hospitalized patients may receive pulmonary rehab more frequently.

&ldquo;I think a lot of people think they just won&rsquo;t have time for it, but I always tell my patients to at least give it a chance,&rdquo; Stephens says. &ldquo;It can be as short as four weeks, and it offers major benefits. It&rsquo;s the single best intervention we have for improving quality of life in patients with chronic lung disease.&rdquo;

Stephens also notes that pulmonary rehab doesn&rsquo;t really end after the last session. &ldquo;Pulmonary rehab gives patients the skills and coping mechanisms they need to maintain their level of function even after completing the program,&rdquo; she explains. &ldquo;They&rsquo;ll know exercises they can do at home and how to use their energy more efficiently.&rdquo;

Will it really help? 
The ultimate goal of pulmonary rehab is to help people who struggle to be active and independent due to chronic lung disease improve their quality of life and avoid hospitalization.

It&rsquo;s important to remember, however, that there is currently no cure for COPD, asthma, cystic fibrosis and some other chronic lung diseases. But pulmonary rehab can help many people with these conditions maximize the lung function they still have while decreasing fatigue levels and boosting strength&mdash;all of which can make a big difference in their outlook and daily lives.

A 2015 review of 65 studies involving more than 3,800 people published in The Cochrane Database of Systematic Reviews concluded that pulmonary rehab helps people feel more in control of their lives and improves their emotional well-being. Researchers also found the rehab programs included in their analysis, most of which lasted for eight to 12 weeks, significantly eased symptoms, like shortness of breath and fatigue.

Is pulmonary rehab right for you? 
Your doctor will determine if you qualify for pulmonary rehab and if you&rsquo;ll benefit from this program. Several factors should be considered, including how far your disease has progressed, your level of physical activity and your willingness and ability to participate.

Being frail or having advanced-stage lung disease doesn&rsquo;t necessarily mean that you won&rsquo;t qualify for pulmonary rehab. But some people with heart disease or an irregular heart beat, severe arthritis, cognitive impairment and certain mental health issues may not be good candidates for this type of program.

If you have chronic lung disease and you struggle with shortness of breath and have trouble performing normal daily activities, talk to your doctor about pulmonary rehab and whether it may be right for you.

Do I Need Pulmonary Rehab?

The National Heart, Blood and Lung Institute defines chronic obstructive pulmonary disease (COPD) as a respiratory disease that makes it difficult for a person to breathe and gets worse over time.

It is estimated that more than 16 million people in the United States have COPD. The disease is the third leading cause of death among Americans, behind heart disease and cancer, and both heart disease and cancer (especially lung cancer) can occur alongside COPD.

Below are some basic but important facts about this disease.

Several diseases 
COPD is actually an umbrella term for two chronic respiratory illnesses, emphysema and chronic bronchitis. In a person with emphysema, the lung&#39;s air sacs, called alveoli, are damaged, reducing the surface area of the lungs and depriving the bloodstream of oxygen. With chronic bronchitis, the walls of the bronchial tubes become inflamed and thickened and produce excess mucus. People with COPD can have a combination of both emphysema and chronic bronchitis.

Risk factors 
Cigarette smoking is the number one risk factor for COPD, and the risk increases the longer someone has smoked and the more they&#39;ve smoked. Pipe smokers, cigar smokers and people exposed to secondhand smoke are also at risk of COPD. However, plenty of nonsmokers also get COPD. Regularly inhaling fumes or dust from chemicals, grain, cotton, wood, fuel or mining materials can make you more likely to develop COPD.

Symptoms 
Shortness of breath or difficulty catching your breath is a symptom of COPD, especially if it progressively worsens or persists for months. People may experience <a href="https://www.sharecare.com/health/copd/article/how-being-overweight-affects-copd">shortness of breath</a> after physical activity or while at rest. Other symptoms include coughing, wheezing, frequent respiratory infections and producing excess amounts of phlegm. People with COPD may also experience a fast heartbeat, fatigue and mental fogginess.

Treatments 
While treatment cannot cure COPD, it can ease symptoms and slow the progression of the disease. Treatment for COPD will depend on a number of factors, including the severity of the disease, but may include:

<ul>
	<li>Quitting smoking. For anyone who has COPD and smokes, <a href="https://www.sharecare.com/health/smoking-treatment/slideshow/guide-nicotine-replacement-therapy">quitting smoking</a> is extremely important to slowing the progression of the disease, and your healthcare provider may prescribe a smoking cessation program to help you quit.</li>
	<li>Nutrition. COPD can make it difficult to eat, and getting adequate calories and nutrients are an important focus of COPD treatment.</li>
	<li>Medications. Bronchodilators may help lessen your cough and shortness of breath. Steroids also may help reduce inflammation and help you breathe more easily. In many cases, a combination of medications are used.</li>
	<li>Pulmonary rehabilitation. This is a rehabilitation program tailored to the needs of the patient, and can include exercise, breathing training, smoking cessation and nutritional guidance, as well as <a href="https://www.sharecare.com/health/copd/article/mental-health-hospital-readmission-copd">psychological</a> and social support.</li>
	<li>Oxygen. Severe COPD may require supplemental oxygen, either for a period of time each day or throughout the entire day.</li>
	<li>Surgery. In severe cases, and when other treatments are not effective, a patient may undergo a lung volume reduction, in which a surgeon removes small pieces of damaged lung tissue. A lung transplant may also be be considered.</li>
</ul>

An Overview of Chronic Obstructive Pulmonary Disease (COPD)

If you get your <a href="https://www.sharecare.com/health/nutrition-diet/how-much-fiber-each-day" target="_blank">recommended amount of dietary fiber each day</a>, you&rsquo;re one of the elite few. Less than 3% of Americans eat enough fiber. For everyone else, it&rsquo;s time to start getting more. Fiber can help stave off heart disease and stroke, and help prevent or control diabetes. It&rsquo;s good for your waistline, too, since fiber may fill you up and keep your weight down.

Need another reason to get more fiber? A study published in the Annals of the American Thoracic Society in 2016 has shown fiber may also help your lungs work better.

Another benefit of fiber 
The study analyzed the data of more than 1,900 men and women in the National Health and Nutrition Examination Surveys (NHANES). The researchers looked at people&rsquo;s fiber intakes and at lung function using a device called a <a href="https://www.sharecare.com/video/sharecare-experts/clifford-bassett/what-is-spirometry" target="_blank">spirometer</a>.

The researchers found that people who ate the most fiber had lung function measurements that were 2.4% and 2.8% better than those who ate the least. They also found that the source of the fiber mattered. Eating lots of fruits, vegetables and legumes was associated with increased lung function, but eating whole grains was not. Other studies, however, suggest that whole grains&mdash;and particularly cereal grains&mdash;are great for lungs, too. One large study of more than 367,000 people published in BMC Medicine in 2015 showed that consuming more whole grains lowered the chance of death from respiratory ailments and several other causes.

How fiber helps 
The study authors think fiber bolsters lung function for two reasons. The first is that <a href="https://www.sharecare.com/health/eating-and-nutrition-for-diseases/what-foods-reduce-inflammation-body" target="_blank">fiber fights inflammation</a>. Inflammation is a key characteristic of asthma and chronic obstructive pulmonary disease (COPD). Fiber helps keep C-reactive protein, a molecule that&rsquo;s a sign of inflammation and that&rsquo;s been linked to worse lung function, in check,

For the second way fiber helps, you have to travel a little south of the lungs. Eating enough fiber changes the mix of microorganisms that live in your gut. This results in more production of short-chain fatty acids, which protect lungs, according to the researchers.

Eat for your lungs 
The good news is that some very healthy ways of eating, such as the <a href="https://www.sharecare.com/video/heart-health/hypertension/what-is-the-dash-diet" target="_blank">DASH Diet</a> and the <a href="https://www.sharecare.com/health/general-weight-loss-diets/what-is-a-mediterranean-diet" target="_blank">Mediterranean diet</a>, already call for lots of fiber.&nbsp;

Many fiber-rich foods deliver lots of antioxidants, which also have been shown to help breathing. Antioxidants are micronutrients that prevent cell damage. Examples include vitamin C, beta-carotene and selenium.

Fiber doesn&rsquo;t have to mean boring bran. <a href="https://www.sharecare.com/health/nutrition-diet/foods-high-in-fiber" target="_blank">Foods like these are also packed with it</a>:

<ul>
	<li>Beans</li>
	<li>Artichokes</li>
	<li>Sweet potatoes</li>
	<li>Peas</li>
	<li>Berries</li>
	<li>Apples</li>
	<li>High-fiber breakfast cereal</li>
	<li>Brown rice or quinoa</li>
	<li>Whole-grain pasta and bread</li>
</ul>

Eat More Fiber for Healthier Lungs

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5 Terms that E-Asthma Patients Should Understand

Chronic obstructive pulmonary disease (COPD), a progressive lung disorder that makes breathing difficult, affects more than 16 million Americans and is the third leading cause of death in the United States. In addition to the physical toll COPD takes on the body, research shows that the disease also reduces quality of life and can negatively impact the mental health of patients and their families. Research also shows that COPD patients with psychological conditions have higher rates of hospital readmission.

A study from the University of Texas Medical Branch at Galveston tracked a decade&#39;s worth of hospital admission rates for Medicare recipients with COPD. The data showed that COPD patients with one or more psychological risk factors (such as depression or anxiety) were 5 to 14 percent more likely than other COPD patients to be readmitted to a hospital within 30 days of discharge. The rate of readmission was even higher in patients who had psychological conditions such as <a href="https://www.sharecare.com/diet-nutrition/alcohol-health/binge-drinking-america-health-issue">alcohol problems</a> or psychosis, or who had at least two simultaneous conditions.

The study findings make sense, according to Philip Diaz, MD, professor of medicine and director of the COPD programs at The Ohio State University College of Medicine in Columbus.

&ldquo;It&rsquo;s consistent with some other data that would support that concept,&rdquo; he says, noting that people with any kind of disabling, chronic condition are prone to depression and anxiety. With COPD, this is probably due at least in part to the fear generated by breathing difficulties.

&ldquo;[With COPD] your lung mechanics are such that you have difficulty getting air out,&rdquo; says Diaz, explaining that people with COPD often have trouble exhaling. This may cause them to hyperventilate out of panic and end up calling an ambulance.

&ldquo;What starts as a psychological issue may make a physiological problem much worse.&rdquo; Diaz added that people who are <a href="https://www.sharecare.com/mental-health-behavior/bipolar-disorder/more-than-the-blues">depressed</a> or anxious may be less likely to adhere to treatment plans and medication schedules, which can also lead to symptoms becoming worse and result in the need for hospital readmission.

In Diaz&rsquo;s practice, he likes to enroll COPD patients in pulmonary rehabilitation, also called pulmonary rehab or PR. Pulmonary rehabilitation is a program that works to improve a person&rsquo;s ability to breathe through a number of different approaches. While programs are tailored to the needs of a patient, it can include education about the respiratory system and how it is impacted by disease, as well as training in relaxation techniques, breathing strategies, nutrition and exercise. It can also include psychological counseling and meetings with support groups. Pulmonary rehabilitation is used alongside medical treatments for COPD.

Lung Health