Treatment Options

Chronic obstructive pulmonary disease (COPD) is a long-term condition that can’t be completely cured. However, by managing your condition, you can improve your quality of life, relieve your symptoms, and slow progress of the disease. Other treatment goals include preventing and treating related complications, improving your ability to stay active, and improving your overall health. In most cases, COPD is preventable and early treatment can make a difference.

COPD is treatable by medication and surgical options, but according to the Mayo Clinic, lifestyle changes—in particular, quitting smoking—represent the most important and effective treatment for COPD. A study in the British Medical Journal found that this lifestyle change alone results in substantial improvements in lung function soon after quitting that continue over time. The American College of Physicians (ACP) recommends that doctors treat COPD by helping patients who smoke to stop. The ACP guidelines also suggest a range of additional interventions, including medicines, education, and exercise. Successful treatment usually involves a combination of medical interventions and behavioral changes.

If you have symptoms of COPD, your doctor will likely have you take a simple breathing test called spirometry, which measures how much air you can blow out in one second. This test is used to diagnose COPD and assess its severity. After a COPD diagnosis, your doctor will help determine which of the following treatment options, or combination of options, are right for you. Your doctor may also advise that you see a pulmonologist to help with a specialized treatment plan.

Lifestyle Changes

Cigarette smoking is the leading cause of COPD in the United States, and the best way to prevent it is not to smoke. Current smokers can consider a number of resources to help them quit. In addition to smoking cessation products, many hospitals, clinics, and organizations offer programs designed to help people stop smoking. If you’re not a smoker, you’re not immune from the damaging effects of cigarette smoke. Non-smokers need to avoid secondhand smoke, which may be in the air they breathe if they are near other people smoking.

Other lifestyle shifts that may help you manage the effects of COPD include:

  • Avoiding lung irritants in addition to cigarette smoke, including air pollution, chemical fumes, and dust
  • Following a structured physical fitness program
  • Practicing strengthening exercises for the upper-body muscles needed for breathing
  • Maintaining a nutritious, varied diet
  • Controlling stress
  • Protecting yourself from infection through frequent hand-washing, good oral hygiene, and avoiding crowds during cold and flu season

Medications

A variety of medicines are available to treat COPD. Your doctor can determine whether you might benefit from medication based on your condition’s severity. Some types of medications include:

  • Bronchodilators. Bronchodilators help to relax the muscles around your airways to relieve shortness of breath. Most bronchodilators are delivered using an inhaler device, which allows the medicine to go directly to your lungs. Depending on your symptoms, your doctor may either prescribe a short-acting bronchodilator (which lasts about four to six hours and is used only when needed for mild symptoms) or a long-acting bronchodilator (which lasts 12 hours or more and is used daily for moderate to severe COPD).

  • Steroids. A type of steroid called corticosteroids can be used to reduce swelling and mucus production inside the airways. Steroids are anti-inflammatory medicines that are usually inhaled, although some types can be taken in pill form. Steroids are generally only recommended when you have moderate to severe COPD with worsening symptoms or recurrent hospitalization. Your doctor may advise a trial period of steroids—from six weeks to three months—to see if they reduce symptom flare-ups.

  • Antibiotics. Because people with COPD can have symptoms that may be caused by bacterial or viral infections, your doctor may want to prescribe an antibiotic in the event of an infection. In some cases, your doctor may prefer that you keep an antibiotic or antiviral prescription on hand to fill only if needed.

Pulmonary Rehabilitation

If you have difficulty completing basic tasks because of your symptoms, your doctor may recommend pulmonary rehabilitation. Rehabilitation programs can improve exercise capacity, reduce hospitalization rate, and improve quality of life for patients with COPD. The typical length of a program ranges from six to 10 weeks, during which participants focus on managing the disease through physical activity and counseling in a medically supervised group setting. A primary goal of pulmonary rehabilitation is to learn how to be more active and carry out your daily activities with less shortness of breath.

Oxygen Treatment

If you have severe COPD and low levels of oxygen in your blood, home oxygen therapy can help improve physical and mental functioning and shortness of breath. This treatment option, which involves receiving supplemental oxygen through nasal prongs or a mask, is generally reserved only for more severe cases of the condition. Depending on symptom severity, your doctor might suggest that you use oxygen treatment only at certain times, or all the time. For severe cases, using extra oxygen for most of the day may be necessary to protect your heart and other organs from damage.

Managing Complications

Screening for and managing associated conditions arising from complications of COPD is crucial. If you have COPD, you’re particularly vulnerable to complications from bacterial and viral pneumonia. Management of these complications includes getting pneumococcal and flu vaccinations. Being underweight and experiencing depression are also associated with COPD. If you suffer from either of these conditions, your management technique may include nutritional counseling or psychotherapy.

Surgery

In rare cases, surgery may help improve breathing for people with severe symptoms of COPD, but it’s generally only considered after other treatments have been tried unsuccessfully. Surgical options include lung volume reduction and lung transplants. Lung volume reduction is done to reduce the size of the lungs by removing 20 to 30 percent of the most diseased lung tissues. Lung transplants are used only in cases of irreversible lung failure.

Although COPD can never be cured, the condition is often preventable and treatable. Learning about treatment options can help you feel more in control as you work with your doctor to effectively manage your symptoms and improve your quality of life.