What to know about COPD treatment

More than 16 million people in the United States are affected by chronic obstructive pulmonary disease (COPD). This chronic respiratory condition makes it difficult to breathe and 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, important structures in the lungs are destroyed. These include the elastic tissue that aids in exhaling air as well as the walls between the tiny air sacs in the lungs. In chronic bronchitis, the walls of the airways known as 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.

That said, up to 30 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
• A genetic disorder called alpha-1 antitrypsin deficiency (A1AD), responsible for 1 to 2 percent of cases of COPD

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 are inhaled medications that open the airways. They are a mainstay of COPD 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 they may be prescribed as pills or injections 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, avoiding secondhand smoke, 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 also encouraged to monitor weather and air quality. Depending on the severity of their disease, people may need to avoid vigorous activity outdoors or stay indoors during episodes when air quality is poor.

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 exercises, nutrition, patient education, and smoking cessation. Social and psychological counseling and support are also an important focus, as patients with COPD are at a higher risk for anxiety and depression.

Nutrition

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 affects the way the body metabolizes food, many COPD patients end up underweight.

Getting adequate amounts of calories and nutrients is important for maintaining energy levels and is also essential to immune function. People with COPD may work with a healthcare provider (HCP) to follow a special eating plan. They may also need vitamins and nutritional supplements.

Vaccines

Certain respiratory illnesses can worsen COPD. Talk to your HCP about getting an annual flu shot, as well as vaccinations and boosters for other infections such as pneumonia, tetanus, whooping cough, shingles, and COVID-19. If you are age 50 or older, discuss the RSV vaccine, as well.