Chronic obstructive pulmonary disease (COPD) is treatable through several different methods. The treatment goal is to slow the loss of lung function in patients. Treatment also focuses on reducing symptoms. People who are informed and who follow their physician’s recommendations have an excellent chance of living a fairly normal lifestyle.

Treatment for individuals who have both asthma and COPD is likely to be largely independent for each condition, because asthma usually involves inflammation and COPD usually involves lung destruction. However, some medications, (e.g., corticosteroids) may be beneficial in treating both conditions. Avoidance of smoke and other irritants will also help patients with both types of conditions.

Treatments for COPD include:

• Lifestyle changes
  
• • Protecting oneself from airborne irritants and quitting smoking
    
  • Protecting oneself from contracting another lung disease
    
  • Exercise
    
  • Eating a healthy diet
    
  • Stress management
    
    
• Medication
  
  
• Oxygen-replacement therapy
  
  
• Experimental surgery

Lifestyle changes are important in the treatment of COPD. Patients need to protect themselves from all airborne irritants. Exhaust fumes, coal dust, air pollution, chimney smoke, hair spray and even perfumes may trigger a coughing fit. Physicians regularly tell their COPD patients that it is essential for them to quit smoking if they have not already done so. They may also ask family members who smoke near the patient to quit smoking as well.

Additionally, it is important for COPD patients to protect themselves as much as possible from contracting another lung disease, such as pneumonia. For this reason, it is very important for COPD patients to wash their hands frequently, keep their homes well-ventilated and free of mold, and get both an annual flu shot and regular pneumonia vaccines. Some COPD patients may consider moving to a warmer climate. If a lung disease is contracted despite the best preventive efforts, it is essential for the patient to seek medical attention as soon as possible.

Another strategy for treating COPD is exercise. However, patients should not overexert themselves. Exercise is helpful in strengthening the respiratory muscles and building tolerance to physical activity. COPD patients are often asked to take several short walks over the course of a day. Other low-impact activities, such as water aerobics and riding a stationary bike, may also be beneficial. COPD patients should consult with a physician before starting a new exercise routine.

COPD patients may also do breathing exercises, in which they practice inhaling as deeply, and exhaling as forcefully, as possible. These exercises help strengthen the muscles used for breathing and make it easier to move air in and out of the lungs, which ultimately helps decrease shortness of breath.

For patients coughing up heavy mucus, it is important to drink plenty of fluids and maintain a high humidity level in the home. Patients can also gently strike their own chest, or have a family member gently strike the back while they are sitting bent over, because this may help to loosen the mucus. Hand-held devices that cause a vibration through the airway can also be used to help loosen mucus. Uncontrolled fits of coughing and tight, restrictive clothing around the chest should be avoided as much as possible.

A healthy diet may help the patient reach and maintain a normal body weight. It should be limited in salt, and high in protein, calcium and potassium. Foods rich in vitamin C may also be helpful because they may thin the patient’s mucus. Avoiding foods that increase the production of mucus, such as dairy products, is another strategy.

Stress management plays an important role in the treatment of COPD. It is extremely stressful for a patient when his or her throat closes, forcing the patient to gasp for air and worry about another trip to the emergency room. A program of stress management can help the patient learn to deal with feelings of fear, depression, anger and the hopelessness that people often feel when first diagnosed with a chronic illness. There may also be local COPD support groups that the patient can join.

Sometimes a number of different medications are prescribed for a COPD patient, and the use of a pillbox can help to make sure that all are taken as prescribed. Medications that may be prescribed for COPD include:

• Anticholinergic agents. These help the muscles around the lungs (bronchial muscles) to relax. This is often the first line of treatment.
  
  
• Bronchodilators. These widen the airways of the lungs so that more oxygen can be obtained.
  
  
• Corticosteroids. These appear to have strong anti-inflammatory effects in the lungs, at least in the short term. However, studies have suggested limiting long-term use of steroids and because of their side effects, they are recommended only in patients who are not benefiting from other therapy. Research on the use of inhaled corticosteroids with fewer side effects is ongoing.
  
  
• Expectorants (mucolytics). These thin the mucus and make it easier to cough up. Although expectorants may increase the patient’s comfort, they have not been shown to increase airflow.
  
  
• Leukotriene modifiers. These are anti-inflammatory drugs currently prescribed only for asthma, but which may eventually play a role in the treatment of COPD.

Other medications may be prescribed which do not address the COPD itself, but which help to relieve some of the symptoms that COPD patients experience. These medications include:

• Analgesics. These slow the overworked breathing functions of COPD patients. Commonly known as painkillers, these medications may be prescribed for patients having severe difficulty catching their breath.
  
  
• Diuretics. These treat swelling (edema) by flushing fluids and minerals, especially sodium, from the body. They are also used to treat high blood pressure (hypertension).
  
  
• Inotropes. These strengthen the heart’s pumping ability.
  
  
• Vasodilators. These expand blood vessels, allowing blood to flow more freely and the heart to pump more efficiently. These medications may be prescribed for COPD patients who are experiencing fluid buildup or heart disease.

The other major nonsurgical treatment for COPD is oxygen-replacement therapy, which has largely replaced a more uncomfortable COPD treatment: drawing blood (phlebotomy) to rid the body of its oversupply of red blood cells. Oxygen-replacement therapy allows patients to receive additional oxygen from either oxygen cylinders/tanks or electric concentrators, which take the oxygen directly from the air.

Patients breathe the oxygen through either a face mask or a thin plastic tube with two small prongs that go directly into the nostrils (nasal cannula). For patients who have a surgically created hole in their windpipe (following a tracheostomy), another option is a thin plastic tube that goes directly into that hole (transtracheal cannula).

Regardless of how the oxygen is delivered, continuous oxygen-replacement therapy is the only intervention shown to help advanced COPD patients live longer, and oxygen is frequently used during acute episodes. Other patients may benefit from using oxygen therapy only as needed, particularly during physical activity or sleep. Although portable oxygen tanks allow COPD patients far greater mobility, it should be noted that the oxygen is a fire hazard and is barred from some establishments.

To date, surgical treatments for emphysema are only experimental and rarely covered by insurance.