Sudden Worsening of COPD

Am Fam Physician. 2010;81(5):616

See related article on COPD exacerbations

What is COPD?

Chronic obstructive pulmonary disease, or COPD, is also known as emphysema (em-feh-SEE-ma) or chronic bronchitis (bron-KI-tis). It is a lung problem that is usually caused by cigarette smoking. The air spaces in the lung are damaged, and it is hard for air to go in and out.

What happens when it suddenly gets worse?

When COPD gets worse it is called an exacerbation (ex-zass-er-BAY-shun). During an exacerbation you may suddenly feel short of breath, or your cough may get worse. You may also cough up phlegm, and it may be thicker than normal or an unusual color.

What causes exacerbations?

COPD can get worse from an infection (such as a cold or pneumonia), from being around someone who is smoking, or from air pollution. Other health problems, such as congestive heart failure or a blood clot in the lungs, can make COPD worse. Sometimes no cause can be found.

What should I do if I feel worse?

Call your doctor right away if your symptoms get worse. He or she may want to change your medicines. You may need an antibiotic or a medicine to help reduce the swelling in your airways. Some people with very bad COPD need to be treated in a hospital.

If your doctor is not available and you feel short of breath, your cough gets worse, or you have a fever, go to the emergency room.

What can I do to prevent an exacerbation?

Stop smoking, and stay away from other people while they're smoking. It is never too late to quit smoking, even if you have COPD. You should also have pneumonia and influenza (“flu”) shots to prevent infections. Talk to your doctor about medicines and exercise programs that can help prevent exacerbations.