Barrel Chest: Expanded Rib Cage Often Found in COPD

Lung function test by using Triflow. Jan-Otto/ GettyImages

People with "barrel chest" have a chest and rib cage that's rounded and bulging out — in fact, the chest looks somewhat like a barrel (hence the name).

There are a number of possible causes for barrel chest, including arthritis and just plain aging. But it's also very common in people suffering from advanced chronic obstructive pulmonary disease. In COPD, it occurs when your lungs are over-inflated with air.

When you have barrel chest, your rib cage stays partially expanded, as if you're always breathing in deeply.

You won't be diagnosed with barrel chest, since it's not an actual disease — it's a symptom of a disease or of the aging process. But since it's quite obvious, your doctor may notice it when conducting a physical exam, and may mention it to you.

Barrel Chest in COPD

When you have chronic obstructive pulmonary disease, you have trouble breathing because your air passages are blocked by mucus or inflammation. When this occurs, you can't always exhale all the air you breathe in — some of it may become trapped in your lungs.

Barrel chest results from this trapped air. The air keeps your rib cage expanded (as if you were drawing a very deep breath) without allowing it to deflate as it normally would when you breathe out. Ultimately, your rib cage — which is supposed to be wider at the sides and narrower in the front and back — will expand at the front and back, and begin to resemble that barrel.

This doesn't usually occur in the early stages of COPD. Instead, you're more likely to experience it in the later stages when you're also experiencing other symptoms of late-stage COPD, such as constant shortness of breath during everyday activities such as getting dressed and using the bathroom.

Treating Barrel Chest When You Have COPD

There's no treatment that specifically targets barrel chest.

Instead, your doctor will want to get the underlying cause of barrel chest — your chronic obstructive pulmonary disease — under better control. Doing that may help reduce the barrel-like appearance of your expanded chest and rib cage somewhat.

If you want to reduce the size of your expanded chest some (and hopefully breathe better, as well), your best bet is to follow your doctor's instructions on medications, exercise and therapy for your COPD. If the appearance of your chest bothers you, talk about it with your doctor — she may have some suggestions that could help.

Other Possible Causes of Barrel Chest

COPD isn't the only cause of barrel chest.

Sometimes, arthritis can cause barrel chest. This occurs because the joints in your rib cage — which attach the rib cage to your spine — become less flexible and eventually remain mostly in the "deep breath" expanded position. Some people just develop a barrel chest as they age, even without obvious signs of arthritis.

Severe asthma may also cause your chest to expand into that noticeable barrel shape, even in children.

In this case, treatment may allow the lungs to deflate fully and permit the rib cage to expand and contract normally again.

Finally, some people — mainly men — are simply born with a chest that's broad, round and powerful-looking. Men who look like this often have plenty of upper-body strength.

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