Health encyclopaedia

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Treatment of Chronic obstructive pulmonary disease

The best way to prevent COPD is not to smoke cigarettes or if you already smoke, to give up as soon as possible, as the progress of the disease can be slowed. It is also important to avoid other people’s smoke and smoky environments. Your GP can refer you to a smoking cessation service or you can call the NHS Smoking Helpline on 0800 169 0 169.

As there is no cure for COPD, treatment is mainly used to treat and relieve symptoms:

• Regular exercise will help to strengthen the heart and lungs and improve breathing.
• A balanced diet, including vitamin C and zinc, is very important for keeping the immune system healthy.
• Drinking lots of fluids, especially water will help to reduce phlegm and mucus.
• Symptoms of COPD such as mucus and generally feeling ‘blocked up’ and unable to breathe properly can be relieved with steam inhalation or a humidifier in the home.
• Physiotherapy can helps to clear mucus and phlegm. The physiotherapist will be able to teach you exercises to do at home. Arm exercises can improve symptoms and are not as tiring as leg exercises.
• People living with COPD are at risk of catching other illnesses so it is important to have the flu vaccine every year and the pneumonia vaccine every 5-10 years.

Medicines:

Bronchodilators are the main treatment for relieving symptoms of COPD. They widen the airways and are usually taken by inhaler (but can be taken in tablet form). They are also used for asthma.

Corticosteroids/steroids make the airways less inflamed and are also taken by inhaler or in tablet form. Antibiotics can be taken in conjunction with steroids when the condition flares up.

Mucolytics are taken in capsules or tablets and make the phlegm and mucous thinner. They are only available on prescription. Mucolytics are especially beneficial for flare-ups or irregular worsening of your condition.

A nebuliser can be used for very severe COPD. A fine mist is sprayed in liquid form, which means that a larger dose of medication can be taken at one time. Before starting this treatment, your GP or specialist will test to make sure the nebuliser is suitable for you.

Long-term oxygen therapy:

In extreme cases, when the oxygen in the blood is low, oxygen may be taken from an electronically operated ‘oxygen concentrator’ through nasal tubes or a mask. It must be taken for at least 15 hours a day, but the tubes from the machine are very long and you will be able to move around your home while connected. Portable oxygen tanks are also available and liquid oxygen may be available in the future. It is vital not to smoke whilst you are taking oxygen, not only because it will affect your treatment, but also because of the fire risk.

Pulmonary Rehabilitation programmes:

This is a tailored form of therapy that improves respiratory symptoms and sleep, and increases exercise capacity, mobility and self-confidence. The programme involves education, exercise, psychological support, smoking cessation advice and nutritional assessment. It takes place in a group setting and lasts about six weeks. Patients learn more about their disease and how to control their symptoms. Pulmonary rehabilitation can greatly improve your quality of life.

Hospitalisation:

This may be necessary if you have lost a lot of weight or are finding it very difficult to breathe. A stay in hospital is nearly always more effective than resting at home as your respiration levels can be constantly monitored.

Lung transplantation:

This is rare and usually only suggested for patients with a life expectancy of less than two years. The operation can be very successful, but the patient will need to take anti-rejection drugs for the rest of their life (these help the body accept a new organ but can have unpleasant side effects).

LVRS (Lung Volume Reduction Surgery):

Damaged parts of the lung are removed during surgery. This can help symptoms, but patients are at risk from catching pneumonia or developing an air leak where the lung is re-sealed.

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