COPD is a lung disease that makes it hard to breathe. It is caused by
damage to the lungs over many years, usually from smoking.
is often a mix of two diseases:
COPD gets worse over time. You can't undo the damage to
your lungs. But you can take steps to prevent more damage and to feel
COPD is almost always caused by
smoking. Over time, breathing tobacco smoke irritates the airways and destroys
the stretchy fibers in the lungs.
Other things that may put you
at risk include breathing chemical fumes, dust, or air pollution over a long
period of time. Secondhand smoke also may damage the lungs.
It usually takes
many years for the lung damage to start causing symptoms, so COPD is most
common in people who are older than 60.
You may be more likely to
get COPD if you had a lot of serious lung infections when you were a child.
People who get emphysema in their 30s or 40s may have a disorder that runs in
families, called alpha-1 antitrypsin deficiency. But this is rare.
The main symptoms
As COPD gets worse, you may be short of breath even when
you do simple things like get dressed or fix a meal. It gets harder to eat or
exercise, and breathing takes much more energy. People often lose weight and
At times, your symptoms may suddenly flare up and get
much worse. This is called a COPD exacerbation (say "egg-ZASS-er-BAY-shun"). An
exacerbation can range from mild to life-threatening. The longer you have COPD,
the more severe these flare-ups will be.
To find out if you have
COPD, a doctor will:
If there is a chance you could have COPD, it is very
important to find out as soon as you can. This gives you time to take steps to
slow the damage to your lungs.
The best way to slow COPD is to
quit smoking. This is the most important thing you can do. It is never too late
to quit. No matter how long you have smoked or how serious your COPD is,
quitting smoking can help stop the damage to your lungs.
Your doctor can prescribe
treatments that may help you manage your symptoms and feel better.
People who have COPD are more likely to get lung
infections, so you will need to get a
flu vaccine every year. You should also get a
pneumococcal shot. It may not keep you from getting
pneumonia. But if you do get pneumonia, you probably won't be as
There are many things you can do at home to stay as healthy
as you can.
Dealing with flare-ups: As COPD gets worse, you may have flare-ups when
your symptoms quickly get worse and stay worse. It is important to know what to
do if this happens. Your doctor may give you an action plan and medicines to help you breathe if you have a flare-up. But if the
attack is severe, you may need to go to the emergency room or call
Managing depression and anxiety: Knowing that you have a disease that
gets worse over time can be hard. It's common to feel sad or hopeless
sometimes. Having trouble breathing can also make you feel very anxious. If
these feelings last, be sure to tell your doctor. Counseling, medicine, and
support groups can help you cope.
Health Tools help you make wise health decisions or take action to improve your health.
Learning about chronic obstructive pulmonary disease (COPD):
Living with COPD:
COPD is most
often caused by smoking. Most people with COPD are long-term smokers, and
research shows that smoking cigarettes increases the risk of getting
COPD is often a mix of two
chronic bronchitis and
emphysema. Both of these diseases are caused by
smoking. Although you can have either chronic bronchitis or emphysema, people
more often have a mixture of both diseases.
Other possible causes of COPD
When you have
Many people with COPD have attacks called
"egg-ZASS-er-BAY-shuns"). This is when your usual symptoms
quickly get worse and stay worse. A COPD flare-up can be dangerous, and you may
have to go to the hospital.
These attacks are most often caused by infections—such as
acute bronchitis and
pneumonia—and air pollution.
your doctor to make a plan for
dealing with a COPD flare-up. If you are prepared, you
may be able to get it under control. Try not to panic if you start to have a flare-up.
Quick treatment at home may help you manage serious breathing problems.
Tobacco smoking is the most important risk factor for COPD. Compared to smoking,
other risks are minor.
To learn more, see the topic Quitting Smoking.
people may be more at risk than others for getting the disease, especially if
they have low levels of the protein alpha-1 antitrypsin (alpha-1 antitrypsin deficiency), a disorder that runs in families.
Preterm babies usually need to have long-term oxygen therapy because their lungs are not fully developed. This therapy can cause lung damage (neonatal chronic lung disease) that can increase the risk for COPD later in life.
Asthma and COPD are different diseases, even though both of them involve breathing problems. People with asthma may have a greater risk for getting COPD, but the reasons for this are not fully understood.
Call 911 or other emergency services now if:
Call your doctor immediately or go
to the emergency room if you have been diagnosed with
COPD and you:
If your symptoms (cough, mucus, and/or shortness of breath)
suddenly get worse and stay worse, you may be having a
COPD flare-up, or exacerbation. Quick treatment for a
flare-up may help keep you out of the hospital.
Call your doctor soon for an appointment if:
you have been diagnosed with COPD, talk with your doctor at your next regular
Health professionals who can diagnose
COPD and provide a basic treatment plan include:
You may need to see a specialist in lung disease, called
pulmonologist (say "pull-muh-NAWL-uh-jist"),
COPD, your doctor will probably do the following
Because COPD is a disease that
keeps getting worse, it is important to schedule regular checkups with your
doctor. Checkups may include:
Tell your doctor about any changes in
your symptoms and whether you have had any
flare-ups. Your doctor may change your medicines based
on your symptoms.
The sooner COPD is diagnosed, the
sooner you can take steps to slow down the disease and keep your quality of
life for as long as possible. Screening tests help your doctor diagnose COPD
early, before you have any symptoms.
Talk to your doctor about
COPD screening if you:
The U.S. Preventive Services Task Force (USPSTF) doesn't recommend COPD screening for adults who are not at high risk for COPD.footnote 2 And some experts recommend that screening be done only for people who have symptoms of a lung problem.footnote 3
The goals of
treatment for COPD are to:
Pulmonary rehabilitation (rehab) can help you meet these goals. It helps train your mind, muscles, and heart to get the most out of
damaged lungs. The program involves a team of health professionals who help prevent or manage the problems caused by
COPD. Rehab typically combines exercise, breathing therapy, advice for eating well, and other education.
Much of the treatment for COPD includes things you can do for yourself.
Quitting smoking is the most important thing you can do to slow the disease and improve your quality of life.
Other things you can do that really make a difference including eating well, staying active, and avoiding triggers. To learn more, see Living With COPD.
The medicines used to treat COPD can be long-acting to help prevent symptoms or short-acting to help relieve
them. To learn more, see Medications.
If COPD gets worse, you may need other treatment, such as:
COPD flare-ups, or exacerbations, are
when your symptoms—shortness of breath, cough, and mucus production—quickly get
worse and stay worse.
Work with your doctor to make a plan for
dealing with a COPD flare-up. If you are prepared, you
may be able to get it under control. Don't panic if you start to have one.
Quick treatment at home may help you prevent serious breathing problems.
A flare-up can be life-threatening, and you may need to go to your
doctor's office or to a hospital. Treatment for flare-ups includes:
The best way to keep
COPD from starting or from getting worse is to not
There are clear benefits to quitting, even after years of
smoking. When you stop smoking, you slow down the damage to your lungs. For
most people who quit, loss of lung function is slowed to the same rate as a
Stopping smoking is
especially important if you have low levels of the protein
alpha-1 antitrypsin. People who have an alpha-1 antitrypsin deficiency may lower their risk for severe COPD if they get regular shots of alpha-1 antitrypsin. Family members of someone with alpha-1 antitrypsin deficiency should be tested for the condition.
Other airway irritants (such as air pollution, chemical fumes, and
dust) also can make COPD worse, but they are far less important than smoking in
causing the disease.
If you have COPD, you need to get a
flu vaccine every year. When people with COPD get the
flu, it often turns into something more serious, like
pneumonia. A flu vaccine can help prevent this from
Also, getting regular flu vaccines may lower your chances
People with COPD often get
pneumonia. Getting a shot can help keep you from getting very ill with
pneumonia. People younger than 65 usually need only one shot. But doctors sometimes recommend
a second shot for some people who got their first shot before they turned 65.
Talk with your doctor about whether you need a second shot. Two different types of pneumococcal vaccines are recommended for people ages 65 and older.
Pertussis (also called whooping cough) can increase the risk of having a COPD flare-up. So making sure you are current on your pertussis vaccinations may help control COPD.
gets worse over time.
Shortness of breath gets worse as COPD gets
It's very important to stop smoking. If you keep smoking after being diagnosed with COPD,
the disease will get worse faster, your symptoms will be worse, and you will
have a greater risk of having other serious health problems.
lung damage that causes symptoms of COPD doesn't heal
and cannot be repaired. But if you have mild to moderate COPD and you stop
smoking, you can slow the rate at which breathing becomes more difficult. You
will never be able to breathe as well as you would have if you had never
smoked, but you may be able to postpone or avoid more serious problems with
Other health problems from COPD may
Palliative care is a kind of care for people who have a serious illness. It's different from care to cure your illness. Its goal is to improve your quality of life—not just in your body but also in your mind and spirit.
You can have this care along with treatment to cure your illness.
Palliative care providers will work to help control pain or side effects. They may help you decide what treatment you want or don't want. And they can help your loved ones understand how to support you.
If you're interested in palliative care, talk to your doctor.
information, see the topic
Treatment for COPD is
getting better and better at helping people live longer. But COPD is a disease
that keeps getting worse, and it can be fatal.
A time may come when treatment for your illness no longer seems like a good choice. This can be because the side effects, time, and costs of treatment are greater than the promise of cure or relief. But you can still get treatment to make you as comfortable as possible during the time you have left. You and your doctor can decide when you may be ready for hospice care.
For more information, see
When you manage COPD,
It's never too late to quit smoking. No matter how long you have had COPD or how serious it is,
quitting smoking will help slow down the disease and improve your quality of
Although lung damage that already has
occurred doesn't reverse, quitting smoking can slow down how quickly your COPD
symptoms get worse.
One Man's Story:
"I tried to quit cold turkey, but after just a few days
I could tell that wasn't going to work. I realized that I needed to try
something else. So I tried the patch, and that made a big difference. I can
feel a difference in my breathing. And I feel hopeful that quitting will give
me a few more years on my feet."—Ned
Read more about how Ned quit smoking.
You may think that nothing can help you quit. But today
there are several treatments shown to be very good at helping people stop
smoking. They include:
Today's medicines offer lots of help for people who want to quit. You
will double your chances of quitting even if medicine is
the only treatment you use to quit, but your odds get even better when you
combine medicine and other quit strategies, such as counseling.
For more information, see the topic Quitting Smoking.
Do all you can to make
"There was a time when I couldn't take 10 steps without
running out of breath. Now I walk an hour around my neighborhood every
day—without needing my oxygen. I feel better than I have in years."—Cal
Find out how Cal was able to build up his strength.
Good nutrition is important to keep up
your strength and health. Problems with
muscle weakness and weight loss are common in people
with severe COPD. It's dangerous to become very underweight.
Treating more than the
disease and its symptoms is very important. You also need:
One Woman's Story:
"Not being the person I used to be—it makes me really
sad sometimes. There are lots of days I don't want to even get up, but then I
think about taking my walk or seeing my friends, and I want get out there. COPD
may slow me down, but it isn't going to stop me."—Sarah
Read more about how Sarah deals with her emotions.
COPD is used to:
Most people with COPD find that medicines make breathing
Some COPD medicines are used with devices called
nebulizers. It's important to learn how to
use these devices correctly. Many people don't, so they don't get the full
benefit from the medicine.
The first time you use a bronchodilator, you
may not notice much improvement in your symptoms. This doesn't always mean
that the medicine won't help. Try the medicine for a while before you decide
if it is working.
Many people don't use their inhalers right, so they don't get
the right amount of medicine. Ask your health care provider to show you what to do.
Read the instructions on the package carefully.
Most doctors recommend using
spacers with metered-dose inhalers. But you should not use a spacer with a dry
Lung surgery is rarely used to treat
COPD. Surgery is never the first treatment choice and
is only considered for people who have severe COPD that has not improved with
Other treatment for
CitationsLovasi GS, et al. (2010). Association of environmental tobacco smoke exposure in childhood with early emphysema in adulthood among nonsmokers. American Journal of Epidemiology, 171(1): 54–62.U.S. Preventive Services Task Force (2008). Screening for chronic obstructive pulmonary disease using spirometry: U.S. Preventive Services Task Force recommendation statement. Annals of Internal Medicine, 148(7): 529–534.Qaseem A, et al. (2011). Diagnosis and management of stable chronic obstructive pulmonary disease: A clinical practice guideline update from the American College of Physicians, American College of Chest Physicians, American Thoracic Society, and European Respiratory Society. Annals of Internal Medicine, 155(3): 179–191.Other Works ConsultedCriner GJ, Sternberg AL (2008). A clinician's guide to the use of lung volume reduction surgery. Proceedings of the American Thoracic Society, 5(4): 461–467.Global Initiative for Chronic Obstructive Lung Disease (2014). Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease. http://www.goldcopd.org/guidelines-global-strategy-for-diagnosis-management.html. Accessed May 21, 2014.King DA, et al. (2008). Nutritional aspects of chronic obstructive pulmonary disease. Proceedings of the American Thoracic Society, 5(4): 519–523.Qaseem A, et al. (2011). Diagnosis and management of stable chronic obstructive pulmonary disease: A clinical practice guideline update from the American College of Physicians, American College of Chest Physicians, American Thoracic Society, and European Respiratory Society. Annals of Internal Medicine, 155(3): 179–191.
ByHealthwise StaffPrimary Medical ReviewerE. Gregory Thompson, MD - Internal MedicineSpecialist Medical ReviewerKen Y. Yoneda, MD - Pulmonology
Current as ofMay 23, 2016
Current as of:
May 23, 2016
E. Gregory Thompson, MD - Internal Medicine & Ken Y. Yoneda, MD - Pulmonology
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Last modified on: 23 August 2016