There's currently no cure for chronic obstructive pulmonary disease (COPD). But treatment can help slow the progression of the condition. It can also help to control the symptoms.
- stopping smoking – if you have COPD and you smoke, stopping smoking is the most important thing you can do
- inhalers and medications – to help make breathing easier
- pulmonary rehabilitation – a specialised programme of exercise and education
- surgery or a lung transplant – although this is only an option for a small number of people
Your doctor (this could be your GP or hospital doctor) will discuss the various treatment options with you.
If you smoke, stopping is the best way to stop COPD from getting worse.
Any damage done to the lungs and airways cannot be reversed. But giving up smoking can help prevent further damage.
This may be all the treatment that's needed in the early stages of COPD. It's never too late to stop smoking. Even people with more advanced COPD can benefit from quitting.
If your COPD is affecting your breathing, you'll usually be given an inhaler. This is a device that delivers medication into your lungs as you breathe in.
Your doctor or nurse will show you how to use your inhaler and how often to use it.
There are several different types of inhalers for COPD.
Short-acting bronchodilator inhalers
For most people with COPD, short-acting bronchodilator inhalers are the first treatment used.
Bronchodilators are medicines that make breathing easier by relaxing and widening your airways.
You should use short-acting inhalers when you feel breathless, up to a maximum of 4 times a day.
Long-acting bronchodilator inhalers
If you have symptoms throughout the day, you will need a long-acting bronchodilator inhaler.
This works in a similar way to a short-acting bronchodilator. But each dose lasts for at least 12 hours, so you only need to use them once or twice a day.
Your doctor may include a steroid inhaler as part of your treatment. This type of inhaler is given to you if you still get short of breath when taking long-acting inhalers or have frequent flare-ups.
Steroid inhalers contain corticosteroid medication. This can help reduce the inflammation in your airways.
Steroid inhalers are normally prescribed as part of a combination inhaler. These also include one of the long-acting medications mentioned above.
If your symptoms are not controlled with inhalers, your doctor may recommend taking tablets or capsules also. This medicine may also be used if you have asthma as well as COPD.
Some patients may be prescribed theophylline by their respiratory specialist.
You may need to have regular blood tests during treatment. This is to check the level of medication in your blood.
This will help your doctor work out the best dose to control your symptoms while reducing the risk of side effects.
Possible side effects include:
- feeling and being sick
- difficulty sleeping (insomnia)
- noticeable heart pounding, fluttering or irregular heartbeats (palpitations)
Sometimes a similar medication called aminophylline is also used.
The use of theophylline in the treatment of acute exacerbations (flare-ups) is not recommended.
If you have a particularly bad flare-up, your doctor may prescribe a short course of steroid tablets. This is to reduce the inflammation in your airways.
A 5-day course of treatment is usually recommended. Long-term use of steroid tablets can cause side effects such as:
- weight gain
- mood swings
- weakened bones (osteoporosis)
Your doctor may give you a supply of steroid tablets to keep at home. You may need to take these as soon as you start to experience a bad flare-up.
Your doctor may prescribe a short course of antibiotics if you have signs of a chest infection.
These signs may include:
- coughing up yellow or green phlegm
- a fever (high temperature - 38 degrees Celsius or above)
- a rapid heartbeat
- chest pain or tightness
- feeling confused and disorientated
Sometimes you may be given a course of antibiotics to keep at home. These should be taken as soon as you experience symptoms of an infection.
Pulmonary rehabilitation is a specialised programme of exercise and education led by a physiotherapist. This is designed to help people with lung problems such as COPD.
It can help improve how much exercise you're able to do before you feel out of breath. It can also improve your symptoms, self-confidence and emotional well being.
Pulmonary rehabilitation programmes usually involve 2 or more group sessions a week for at least 6 to 8 weeks.
A typical programme includes:
- assessment of your levels of physical activity and breathing symptoms
- physical exercise training tailored to your needs and ability. These could include walking, cycling and strength exercises
- education about your condition for you and your family
- dietary advice
- stress techniques
- learning how to cope with a lung disease
Physiotherapy for breathing conditions
Physiotherapy can help people with chronic obstructive pulmonary disease (COPD) and asthma
Physiotherapy uses different techniques to help with problems such as:
- difficulty getting air into or out of your lungs (shortness of breath)
- trouble getting oxygen into or around your body
- a build-up of phlegm
- fluid in your lungs
- growth of a tumour in or around your lungs
You may need extra treatment if you have severe symptoms or a particularly bad flare-up.
Nebulised medication may be used in severe cases of COPD if inhalers have not worked.
This is where a machine is used to turn liquid medication into a fine mist. You breathe in the mist through a mouthpiece or a face mask. It helps you take a large dose of medicine in one go.
You'll usually be prescribed a nebuliser device to use at home after being shown how to use it.
Long-term oxygen therapy
If your COPD results in a low level of oxygen in your blood, you may need to have oxygen at home through nasal tubes or a mask.
This can help stop the level of oxygen in your blood from becoming dangerously low. It's not a treatment for the main symptoms of COPD, such as shortness of breath.
You should use long-term oxygen treatment as prescribed by your specialist doctor. You will usually use it for at least 16 hours a day.
The tubes from the machine are long, so you will be able to move around your home while you're connected. Portable oxygen tanks are available if you need to use oxygen away from home. These will also be prescribed by your specialist doctor.
Ambulatory oxygen therapy
Some people with COPD will benefit from ambulatory oxygen. This is oxygen you use when you walk or are active in other ways.
The oxygen is in a portable device which can last for a number of hours. These devices can be small cylinders or devices which can be plugged in and recharged.
Your specialist doctor will prescribe the device most suitable for you once they have assessed your oxygen needs.
Non-invasive ventilation (NIV)
If you're taken to hospital because of a bad flare-up, you may have a treatment called non-invasive ventilation (NIV).
This is where a machine connected to a face mask or nasal mask is used to support your lungs and make breathing easier.
This machine is usually used for a period of time when your lungs need it. But in some cases, your specialist doctor may prescribe it for use at home.
Sometimes medication may not be able to control severe COPD symptoms. In these cases surgery may be recommended in a small number of cases.
The 3 main operations that can be done are:
- lung volume reduction surgery
- lung transplant
If your doctors feel surgery is an option for you, they will talk to you about what the procedure involves and the benefits and risks.