Chronic Obstructive Pulmonary Disease (COPD) Treatment

Even the simplest tasks — walking up a few stairs, going out to get the mail, picking up the laundry — can feel like trying to run an uphill marathon if you have chronic obstructive pulmonary disease (COPD). With a solid treatment plan tailored to fit your specific needs, you can delay the progress of COPD and improve your quality of life.

COPD is most often caused by long-term exposure to irritants such as smoke, dust or chemical fumes. The most common cause of COPD is cigarette smoking. The irritants cause damage to the lungs, which results in swelling and inflammation of the delicate lung tissues. Chronic bronchitis is inflammation in the lining of the tubes (called bronchi) that take air in and out of the lungs. This inflammation causes increased mucus and blocks adequate airflow. Emphysema is when the tiny air sacs of the lungs are damaged so that not enough oxygen can pass into the bloodstream. While there is no cure for COPD, you can manage your COPD symptoms and improve lung function with the right treatment.

Treatment for COPD depends on factors such as your overall lung function, how severe symptoms are, your general health and other factors.

Lifestyle adjustments for COPD treatment

Besides stopping smoking, there are other lifestyle changes you can make to improve your symptoms.

Learn breath control. Your doctor or respiratory therapist can show you methods for breathing more efficiently throughout the day, body positions that make breathing easier, ways to conserve your energy when you need to and ways to relax when you have trouble catching your breath.
Take care of your airways. Symptoms of COPD include extra mucus, and it can build up in the air passages, making it harder to breathe. Staying hydrated and using a humidifier may help.
Get exercise. It may seem hard to get active if you can’t breathe, but regular physical activity can increase your strength and endurance. Your health care professional can help you determine what activities are right for you.
Maintain a healthy weight. Extra weight can make it harder to breathe, so reducing body weight may help relieve some symptoms. Getting exercise and eating healthy foods can help with this.
Avoid fumes, dust, smoke and irritants. Besides quitting smoking, stay away from places where others are smoking. Check the forecast in your area for air-quality alerts. Identify triggers for that could worsen your breathing difficulties.
Get regular checkups. See your doctor even when you feel OK. It is important to monitor your lung function, get vaccines, such as flu, pneumonia, COVID-19 and RSV, and monitor your overall health.

COPD medications

The goal of medication for COPD symptoms is to make breathing easier. Some medicines are given via an inhaler or nebulizer, which turns the medication into a mist, allowing you to breathe it directly into the lungs. There are different kinds of medication therapy, including:

Bronchodilators relax the muscles around the airways in the lungs, which allows for more air to pass through. These can be short-acting for immediate relief or long-acting for ongoing COPD symptom management.
Corticosteroids, often just called steroids, lessen inflammation in the lungs and can be helpful if you have frequent flare-ups.
Combination therapy can include more than one bronchodilator or corticosteroid.
Oral steroids are given via a pill and can be used for a short period during an extended exacerbation (flare-up).
Additional oral medicines could be considered after discussion with your doctor.

If you have chronic bronchitis or other respiratory infection, you also may be given antibiotics.

Other therapies for COPD

These treatments are noninvasive and may slow the progression of the disease, improve symptoms, and delay more intensive treatments such a surgery.

Oxygen therapy gives you extra oxygen when the lungs are not functioning well. Some people may need oxygen during activities. Some use it all the time. Some may need it only during sleep. There are small, portable oxygen tanks that make it easier to carry oxygen where you need it.

Pulmonary rehabilitation usually combines education on your health, exercises, breathing techniques, mental health counseling and nutrition information. Pulmonary rehabilitation may be done after a severe exacerbation and may reduce the chance of having to go to the hospital for future flare-ups. This therapy also may improve your quality of life and allow you to participate in more activities.

Noninvasive ventilation therapy can prevent symptoms from getting worse and can be done at home. A bilevel positive airway pressure device (BiPAP) may reduce your need for a hospital stay. This machine forces oxygenated air into your lungs and reduces the amount of carbon dioxide in your lungs.

Surgical treatment for COPD

Your health care provider may talk to you about surgery if your symptoms are not relieved by noninvasive treatments. For some people, surgery slows disease progress, improves quality of life and may help them live longer. Surgery options include:

Lung volume reduction surgery removes small pieces of damaged lung tissue from the upper lungs. This allows the remaining healthy tissue to expand into that space. It also allows the thick sheet of muscle under the lungs, called the diaphragm, to work more effectively to help you breathe.

Endobronchial valve surgery is a minimally invasive procedure in which a surgeon places a tiny one-way valve in the lung. This allows air to flow out of the damaged part of the lung, but does not let air in. The damaged part of the lung shrinks to allow the healthier tissue to expand.

A lung transplant may be an option for people who meet certain criteria. While this surgery may make breathing easier and allow for a more active lifestyle, it is a major surgery with significant risks. These include organ rejection and infection. Lung transplant patients also take medication to weaken the immune system and reduce the chance of organ rejection.

Bullectomy removes bullae from the lungs to allow better airflow. Bullae form when the inner walls of the alveoli are damaged, leaving one large air sac instead of clusters of smaller ones. The bullae can become large and trap old air and carbon dioxide in the lungs.