There is 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 so you can live a normal life.
Treatments include:
- stopping smoking - if you have COPD and you smoke, stopping smoking is the most important thing you can do
- inhalers and medicines - to help make breathing easier
- pulmonary rehabilitation - a specialised programme of exercise and education
- surgery or a lung transplant - this is only an option for a small number of people
Your doctor will discuss the various treatment options with you.
Stop smoking
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.
Smoking can affect how well COPD treatments work. Many of these treatments work better in non-smokers.
It's never too late to stop smoking. Even people with more advanced COPD can benefit from quitting.
Inhalers
If your COPD is affecting your breathing, you'll usually be given an inhaler. This is a device that delivers medicine into your lungs as you breathe in.
Your doctor or nurse will show you how to use your inhaler and tell you how often to use it.
There are many different types of inhalers for COPD.
Short-acting bronchodilator inhalers
Bronchodilators are medicines that make breathing easier by relaxing and widening your airways.
You can 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 during the day, you will need a long-acting bronchodilator inhaler.
This works in a similar way to a short-acting bronchodilator. But the dose lasts for longer so you only need them once or twice a day.
Steroid inhalers
If you have frequent flare-ups, your doctor may suggest including a steroid inhaler as part of your treatment.
Steroid inhalers are not recommended for everyone with COPD. Your doctor may do blood tests to see if you might benefit from a steroid inhaler.
Steroid inhalers contain corticosteroid medicine. This can help reduce the inflammation in your airways. They are usually prescribed together with 2 long-acting bronchodilator medicines.
How to use an inhaler (videos) - Asthma Society of Ireland
Medicines
Your doctor may recommend taking tablets or capsules.
This can happen if:
- your symptoms are not controlled with inhalers
- you have a flare-up of symptoms (exacerbation)
- you have asthma as well as COPD
Steroid tablets
If you have a 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 is not recommended for COPD.
Your doctor may give you a supply of back-up steroid tablets to keep at home. You may need to take these as soon as symptoms of a flare-up start.
Antibiotics
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 back-up antibiotics to keep at home. These should be taken as soon as you have symptoms of an infection.
Azithromycin
Azithromycin is a long-term, preventative antibiotic. It also has anti-inflammatory properties.
Azithromycin is sometimes used if you are having lots of flare-ups of COPD. It works best if you are not smoking.
It is only prescribed by specialists in COPD. You take it in combination with inhaler treatments.
Mucolytic medicines
Mucolytic medicines are sometimes recommended if you have a lot of phlegm.
Pulmonary rehabilitation
Pulmonary rehabilitation is a specialised programme of exercise and education. It is led by a physiotherapist and 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 wellbeing.
How pulmonary rehabilitation works
You may have 2 or more group sessions a week. A programme usually lasts 6 to 8 weeks.
A typical programme includes:
- assessment of your levels of physical activity and breathing symptoms
- physical exercise tailored to your needs and ability - this could include walking, cycling and strength exercises
- education about your condition for you and your family
- dietary advice
- learning ways to deal with stress
- learning how to cope with your condition
Your GP or hospital team can refer you for pulmonary rehabilitation.
There are also COPD exercise classes being run nationwide by COPD Support Ireland. You can sign yourself up for these classes, or your GP or hospital team can refer you.
Pulmonary rehabilitation programme
Physiotherapy for breathing conditions
Physiotherapy can help people with 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
Other treatments
There are also other treatments available.
Nebulised medicine
Nebulised medicines may be used in severe cases of COPD or during a flare-up. They usually include short-acting bronchodilators.
Nebuliser machines turn liquid medicine 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 1 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. Oxygen will only relieve shortness of breath that is caused by low oxygen level.
You should use long-term oxygen treatment as prescribed by your 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. Your doctor can prescribe them.
Oxygen is a fire risk and cannot safely be prescribed if you smoke.
Ambulatory oxygen therapy
Some people may be prescribed 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 some hours. These devices can be small cylinders or devices that you can plug in and recharge.
Your specialist doctor will prescribe the device most suitable for you when they have assessed your oxygen needs.
Non-invasive ventilation (NIV)
You may be treated for a flare-up with non-invasive ventilation (NIV). This is usually given in hospital.
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 doctor may prescribe it for use at home.
Surgery
Sometimes medicine may not be able to control severe COPD symptoms. In these cases surgery may be recommended.
The 2 main types of surgery are:
- lung volume reduction - this can be done either by placing a valve in a part of the lung where excess air is trapped, or surgery to remove part of the lung
- lung transplant
Surgical options are not suitable for everyone with COPD. If your doctors feel surgery is an option for you, they will talk to you about the benefits and risks.
