What Is a COPD Exacerbation?

Learn How to Manage and Prevent COPD Exacerbations

Coughing man that could have a copd exacerbation
What are COPD exacerbations, how are they treated, and how can you prevent them?. White Packert/The Image Bank/Getty Images

If you have emphysema or chronic bronchitis you may be wondering about COPD exacerbations -- and that's a good thing. Because of the seriousness of an exacerbation, it's important for you to know how they develop, the symptoms that suggest they are happening, what you can do to treat them, and most importantly, how to prevent them, if possible, in the first place.

COPD Exacerbation: Defined

In simple terms, an exacerbation is defined as a worsening of COPD symptoms.

The Global Initiative for Obstructive Lung Disease (GOLD) defines it as "an event in the natural course of the disease characterized by a change in the patient's baseline dyspnea (sensation of shortness of breath,) cough and/or sputum, that is beyond normal day-to-day variations, is acute in onset, and may warrant a change in medication in a patient with underlying COPD".

Causes of COPD Exacerbation: Infection and Air Pollution

The top two causes of COPD exacerbation are bacterial or viral lung infections and air pollution. In one-third of all exacerbation cases however, the cause cannot be identified.

Easily Preventable Causes of Exacerbations

Learning about COPD exacerbations can be frightening, but take back the reigns. There are some - at least in the scheme of things - reasonably simple ways to reduce your risk. Studies have found that a few easily correctable things are associated with more frequent episodes of COPD exacerbation.

These include:

Therefore, it is important that if you've been prescribed treatment for your disease, that you stick to the program and follow your doctor’s orders.  Actually, that's too harsh of a way to comment.

  Instead of the paternalistic relationship between doctors and patients of the past, most people with COPD are working side by side with their physicians to come up with a treatment plan that works specifically for their needs.  It's important to stick with decisions made as a part of this combined decision making, and to speak up if the choices no longer seem to fit your needs as ideally as possible.

Signs and Symptoms of a COPD Exacerbation

The primary symptom of an acute exacerbation of COPD is increased breathlessness which is often accompanied by the following:

Treatment of COPD Exacerbation

Often, either hospitalization or a home-care nurse are necessary for managing an exacerbation. According to GOLD, nurse-administered home care can be a practical - and effective - alternative to hospital care in certain patients with COPD exacerbation. The exact criteria used to determine who would benefit most from this approach, however, is uncertain and varies according to the health care setting.

If your COPD exacerbation cannot be managed safely at home, you will be admitted to the hospital. Once there, your treatment, as determined by your health care provider, may include:

Preventing COPD Exacerbations

Prevention is the best approach for managing acute episodes of COPD exacerbation. Preventative strategies for COPD exacerbations that may help you accomplish this goal are as follows:

  • Get vaccinated. Make sure you get both your pneumonia vaccine and your annual flu vaccine.  This is probably the single most effective thing you can do to lower your risk. A flu shot can decrease the risk of serious illness and death by as much as 50% for patients with COPD.  Learn about which pneumonia vaccine is best for people with COPD and about the different types of flu shots available.
  • Learn proper handwashing technique - You're probably tempted to skim by this one quickly.  After all, doesn't anyone over the age of 4 know how to wash their hands?  In truth, it's been found that even among health care professionals many people are not washing their hands in a way that most effectively lowers the number of disease causing bacteria and viruses present.  Check out these steps for proper handwashing in health care.
  • Make sure you are using your inhalers and nebulizers properly. It may seem straightforward, but there is really a high chance that any one person is using their inhalers improperly.  This not only increases your risk of an exacerbation, but wastes money!
  • Eat a balanced diet. Being either overweight or underweight raises the risk of problems with COPD, plus our bodies need a broad range of nutrients to not only live as well as possible, but to do the repair work needed in the case of illnesses such as COPD.  Check out these basic nutritional guidelines for people with COPD.
  • Get a sufficient amount of exercise and activity in your daily life.  Learn about the best exercises for people with COPD.
  • Get enough GOOD sleep.
  • Pay attention to environmental irritants that not only include secondhand smoke, but air pollution. Learn to pay attention to air quality alerts in your town or the region in which you are traveling. Don't forget about making sure your indoor air is of the best quality possible as well.
  • Avoid crowded places especially during cold and flu season. From crowded planes to crowded malls, you never know exactly what you may be exposed to that could ultimately cause an exacerbation of your COPD.

Bottom Line on COPD Exacerbations

COPD exacerbations are debilitating. The toll they take on your body can lead to severe illness, disability and death. Paying close attention to your body, taking better care of yourself, and taking steps toward prevention will ultimately help you avoid being hospitalized for COPD exacerbation while preserving your existing lung function.

For further information about COPD exacerbation, be sure to talk with your primary care provider.


Dhamane, A., Moretz, C., Zhou, T. et al. COPD exacerbation frequency and its association with health care resource utilization and costs. International Journal of Chronic Obstructive Pulmonary Disease. 2015. 10:2609-18.

Global Strategy for the Diagnosis, Management and Prevention of COPD, Global Initiative for Chronic Obstructive Lung Disease (GOLD) Accessed 03/30/16. http://goldcopd.org

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