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Chronic obstructive pulmonary disease, commonly called COPD, is a group of lung diseases that block airflow, causing difficulty in breathing. COPD is the fourth leading cause of death in the United States, with 16 million people diagnosed—and many undiagnosed. There are two main forms of COPD: chronic bronchitis and emphysema. While a COPD diagnosis can be overwhelming, proper treatment of symptoms using medication and natural remedies can manage the condition and improve the overall quality of life.
What is COPD?
COPD is a progressive lung disease where the lungs become inflamed and thickened, making it difficult to breathe and cause a decrease in lung function. There are two main forms of COPD: chronic bronchitis, inflammation and irritation of the bronchial tubes characterized by a long-term cough with mucus, and emphysema—damage to the air sacs in the lungs resulting in shortness of breath. Most people have a combination of both conditions.One of the major causes of COPD is smoking tobacco: 75% of people with COPD smoke or used to smoke. Vaping may appear to be connected to COPD. Those with long-term exposure to harmful airborne irritants, such as chemicals, fumes, air pollution, and dust, are also more at risk.
There is currently no cure for COPD, but there are treatments to help the symptoms, such as medication, pulmonary rehabilitation, oxygen use, and quitting smoking. New treatments, such as precision therapy, are also being trialed, which is showing promising results for treatment-resistant COPD.
How is COPD diagnosed?
“The most at risk are anyone who smokes cigarettes by far. There is a rare genetic form of COPD, but this is not common and found at an earlier age,“ according to Dr. Danielle DonDiego of Your Doctors Online.Women are also more at risk of developing COPD. According to the American Lung Association, women are 37% more likely to have COPD than men.
Symptoms of COPD start mild in the early stages and progress over time. Common symptoms of COPD include:
- Shortness of breath
- Frequent coughing
- Wheezing
- Excessive mucus, especially noted during coughing (sputum)
- Difficulty taking a full breath
- Decreased energy
- Blue lips or fingernails
- Frequent infections of the respiratory tract
- COPD starts later in life, typically after the age of 40
- Symptoms slowly progress
- COPD is generally associated with a history of tobacco use
- Do you or have you ever smoked?
- Have you had prolonged exposure to secondhand smoke?
- Have you had prolonged exposure to irritants in the air, such as chemicals, fumes, dust, or exhaust?
- How often do you experience shortness of breath?
- How long have you had these symptoms?
- Do you have difficulty taking a full breath?
- Do daily activities make you short of breath, like walking or climbing a flight of stairs?
- Arterial blood gas analysis: Determines the blood's pH levels and carbon dioxide and oxygen within the artery. This blood test takes blood directly from the artery, unlike most blood tests which carry blood from a vein.
- Diagnostic imaging: May be performed to get a visualization of the lungs.
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- Chest X-Rays can detect if a person has emphysema, one of the main types of COPD. A chest X-ray can also rule out other conditions, such as heart failure.
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- CT scans can also detect emphysema. Other lung issues may be seen during these tests, such as lung cancer.
- Electrocardiograms (EKG or ECG): May be performed to rule out any heart-related issues that can lead to shortness of breath.
- Echocardiography (Echo): Heart failure exacerbation may have similar symptoms as COPD. Echocardiography is an ultrasound of the heart to rule out heart failure.
- Laboratory testing: Lab tests are not used to diagnose COPD but may be performed to rule out other conditions. One test sometimes performed is genetic testing, which determines if the patient has alpha-1 antitrypsin deficiency or AAt deficiency. In some cases, AAt deficiency can cause COPD when someone is diagnosed with COPD at a young age and has a family history of the disease.
- Pulmonary (lung) function tests: Measure how much air is used during an inhale and exhale. This will tell the doctor if your lungs are intaking enough oxygen. There are different pulmonary function tests:
- Spirometry: Measures how much air your lungs can hold and how fast you can blow out the air. During this test, you will need to blow into a tube. Spirometry is very helpful in the detection of COPD and also helps track the progression of the disease over time.
- Pulse Oximetry: A simple test where a small machine is placed on your finger and reads blood oxygen levels. A typical person has O2 levels of 95-100%, whereas people with COPD may have levels of 88-92%.
- Sputum examination: Performed to rule out respiratory infections or lung cancer. Sputum is a mixture of saliva and mucus, which can be coughed up from the lungs.
- What is the best treatment for COPD?
- How can I stop the progression of COPD?
- What is the best medication for COPD?
- What does the course of medication look like?
- What lifestyle changes can I make to improve my symptoms?
- Are there any clinical trials I can join?
- Do I need to use oxygen?
- Can I lead a normal life with COPD?
COPD treatment options
COPD can progress over time and lead to death if not managed properly. Worldwide, 3.2 million people died from COPD in 2015. A COPD diagnosis can be scary, but there are many treatment options to help those diagnosed. People with COPD can lead a healthy and fulfilling life. There is no cure for COPD, but there are medications and treatments to help improve symptoms of COPD.Common medications prescribed to treat COPD include inhalers of bronchodilators and steroids, phosphodiesterase-4 inhibitors to decrease lung inflammation, or theophylline to improve breathing. Besides medicine, other standard treatments for COPD include stopping smoking or vaping, lung therapies, oxygen, or surgery.
COPD medications
Your healthcare provider may prescribe various medications to treat COPD; some are used regularly, and others as needed. The following is a list of potential drugs for those diagnosed with COPD.Bronchodilators
Bronchodilators help manage COPD symptoms by relaxing the muscles around the airways, making breathing easier. Typically, bronchodilators are inhalers or nebulized treatments. Long-term bronchodilators may be prescribed for those needing help breathing all day. Common long-acting bronchodilators include Brovana (arformoterol), Spiriva (tiotropium), Serevent Diskus (salmeterol), and Tudorza (aclidinium).Short-acting or short-term bronchodilators are used before activities or as needed for shortness of breath. Commonly prescribed short-term bronchodilators include Ventolin HFA (albuterol) and Xopenex (levalbuterol). Common side effects of short-acting bronchodilators include increased heart rate, shakiness, and nervousness.
Inhaled Steroids
A corticosteroid inhaler can help decrease inflammation in the lungs, improving the ability of air to move in and out of the lungs. Pulmicort Flexhaler (budesonide) is a commonly prescribed inhaled steroid. Side effects of inhaled steroids include hoarseness or oral fungal infections. Rinsing with water (and spitting) after using an inhaled steroid can reduce the risk of getting an oral fungal infection. Inhaled corticosteroids increase the risk of serious pneumonia in people with COPD.Oral steroids like prednisone may also be prescribed in short courses. Though more effective, oral steroids have more side effects than inhaled steroids.
Combined Bronchodilator/Steroid Inhalers
Some inhalers for COPD come in a combination of two different bronchodilators or a bronchodilator and corticosteroid combination as a combination therapy. Bronchodilator combination inhalers include Stiolto Respimat (tiotropium/olodaterol) and Anoro Ellipta (umeclidinium/vilanterol). Bronchodilator and corticosteroid combination inhalers include Advair (fluticasone/salmeterol), Breo Ellipta (fluticasone/vilanterol), and Symbicort (budesonide/formoterol).Phosphodiesterase-4 inhibitor
Daliresp (roflumilast) is a phosphodiesterase-4 inhibitor that can be used to lower the risk of COPD exacerbations associated with chronic bronchitis and a history of exacerbations. This oral tablet is taken once daily with or without food. Common side effects include diarrhea, nausea, headache, and weight loss.Xanthines
Theophylline is a drug in the methylxanthines or xanthines, drug class. This drug helps relax the airway muscles. Common side effects include headache, upset stomach, or trouble sleeping.Mucolytics
Mucolytic drugs are used to break up mucus in the lungs, making it easier to cough out. Acetylcysteine is a mucolytic drug that is commonly used as an inhaled nebulizer treatment for COPD.Oxygen Therapy
Some people with COPD have a low level of oxygen, so oxygen therapy can help these individuals breathe better, have a better quality of life, and live longer. Long-term oxygen treatment should be used for at least 15 hours per day, with as few interruptions as possible.What is the best medication for COPD?
There is no overall best medication for COPD. The best medication for COPD depends on a patient’s medical condition, medical history, and current medications they may already be taking that could interact with COPD medications, as well as their response to treatment. You should always discuss with your healthcare provider the best medication for you. This table includes some examples of commonly prescribed COPD medications.Best medications for COPD
| Drug name | Learn more | See SingleCare price |
|---|---|---|
| Advair Diskus | advair-diskus details | Get free coupon |
| Atrovent HFA | atrovent-hfa details | Get free coupon |
| Breo Ellipta | breo-ellipta details | Get free coupon |
| Brovana | brovana details | Get free coupon |
| Daliresp | daliresp details | Get free coupon |
| Serevent Diskus | serevent-diskus details | Get free coupon |
| Spiriva Handihaler | spiriva-handihaler details | Get free coupon |
| Symbicort | symbicort details | Get free coupon |
| Theophylline | theophylline details | Get free coupon |
| Trelegy Ellipta | trelegy-ellipta details | Get free coupon |
| Ventolin Hfa | ventolin-hfa details | Get free coupon |
Dosage is determined by your doctor based on your medical condition, response to treatment, age, and other individual factors. Other possible side effects exist. This is not a complete list.
What are the common side effects of COPD medication?
Common side effects of COPD medication vary between drug classes. Common side effects of bronchodilators include increased heart rate, shakiness, and nervousness. The most common side effects of inhaled steroids include hoarseness, oral infections, or runny nose. Daliresp has common side effects of diarrhea, headache, and weight loss. Headache, upset stomach, or trouble sleeping are common side effects of theophylline.This is not a full list of side effects. Please discuss possible adverse events and drug interactions with a healthcare professional.
Surgical interventions for COPD
A small number of people with COPD will benefit from lung surgery. Types of surgery include:- Bullectomy: Emphysema, a form of COPD, causes air sacs to become overinflated. Very large air sacs are called bullae. These sacs press on healthy lungs, preventing proper function. Bullectomy is a surgery that removes bullae that occupy more than ⅓ of the right or left chest. It is uncommon for people to have these giant bullae; most people with emphysema have smaller areas of damaged air sacs and would not benefit from bullectomy.
- Lung volume reduction surgery (LVRS): Some individuals with emphysema have more air sac damage in the upper parts of the lungs and healthier air sacs in the bottom parts. In these individuals, LVRS can remove the upper parts of both lungs. However, this procedure may remove some good air sacs. This surgery may help you breathe better. This is a major, high-risk surgery. Those who undergo LVRS must have a strong heart and healthy remaining lungs after the surgery for potential benefits to outweigh the risks. Patients must also commit to smoking cessation and completing a pulmonary rehabilitation program.
- Lung transplant: A lung transplant replaces one or both lung(s) with a lung or lungs from an organ donor. Candidates for this surgery should have no other major health problems—and have severe lung disease. Most individuals with COPD (especially people who are over 70 years) are not good candidates for this surgery due to the risk of complications.
What are the best natural remedies for COPD?
There are many options to manage symptoms of COPD besides medication. One of the first and most important treatment options for COPD is to quit smoking or vaping immediately. Other natural remedies include:- Lung therapies: These help those with moderate to severe COPD. There are two major types of lung therapies.
- Oxygen therapy is used for those not getting enough oxygen into their blood. Supplemental oxygen can be worn on a portable device and is typically received through a face mask or nasal cannula. Supplemental oxygen can be used during activities, while sleeping, or throughout the day. Oxygen therapy can improve quality of life and extend life.
- Pulmonary rehabilitation programs use exercise, education, counseling, and nutrition to support the patient’s needs. These programs can help people participate in everyday activities. A pulmonologist or primary care doctor can help you find a program in your area.
- Breathing exercises: Improve breathlessness and help improve exercise capacity in those with COPD. Common breathing exercises include pursed-lip breathing and diaphragmatic breathing.
- Improving air quality: Vacuuming or using an air filtration system within the home. This can decrease irritants (which may exacerbate COPD) in the air.
- Eating a balanced diet: Shown to help COPD patients. You may want to consult a registered dietitian for more information about designing a plan that works with your lifestyle.
- Exercising: Can help improve the ability of patients to endure physical activities. One study has shown that water-based exercises have better results for those with COPD. Consult your healthcare provider before beginning any type of exercise program.
- Managing stress: This is important in those with COPD. Panic attacks can be very dangerous for those with COPD. Counseling, breathing exercises, and yoga are good options for COPD patients.
- Vitamin D: Vitamin D deficiencies can be common in those with severe symptoms of COPD. Exacerbation of symptoms can improve with this supplement. Ask your healthcare provider if you need vitamin D supplementation.
- Avoiding lung infections: Get flu and pneumococcal vaccines. Lung infections in those with COPD can lead to serious problems.
- Maintaining a healthy weight: Important for those with COPD. Being underweight with COPD increases your chance of mortality.
- Acupuncture: Acupuncture (in combination with prescription medications) may help with COPD symptoms such as shortness of breath.
Monitoring and managing COPD
When living with COPD, you can take steps to protect your lungs and stay as healthy as possible. Some tips include:- Stop smoking or vaping—and avoid secondhand tobacco smoke, including cigarette smoke.
- Maintain a healthy diet
- Stay up to date on vaccines, especially flu, COVID-19, and pneumonia.
- Avoid chemicals as much as possible. Opt for unscented products when purchasing things like hairspray and cleaning products.
- Monitor the outdoor air quality in your area. On hot, sunny, and humid days, harmful chemicals may linger in the air and worsen air quality. It’s important to stay inside on Air Pollution Action Days.
- Manage other medical conditions.
- Find support by connecting with others online or in person at a support group or becoming an advocate. Therapy may be helpful as well.
New treatments and future directions of COPD treatment
A new lung valve treatment, Zephyr Valves, improves breathing in people with severe COPD and emphysema. It is less risky than having surgery.There are always studies being done for COPD. A current search of clinicaltrials.gov shows almost 4,500 clinical trials for COPD treatments. Some examples include:
- A biologic called Dupixent is being studied for COPD exacerbations.
- A human monoclonal antibody called itepekimab is being studied to treat COPD in patients who do not currently smoke.
- Stem cell therapy studies