When you have chronic obstructive pulmonary disease (COPD) and it suddenly gets worse, it's called a flare-up. Having a COPD flare-up can be alarming for both you and your loved ones. You may be successfully managing your COPD symptoms (or may not even be experiencing any symptoms at all) when suddenly your condition worsens. When a flare-up occurs, you may be unable to do your usual activities or – even worse – have life-threatening symptoms that require hospitalization.
Symptoms of a COPD flare-up
A COPD flare-up may start with just a slight worsening of typical symptoms, according to the Cleveland Clinic. It's recommended that you contact your doctor if you notice any of the following COPD flare-up symptoms:
- Shortness of breath that gets worse or more frequent
- More mucus that changes in thickness or color, includes blood or has an odor
- Increased wheezing and coughing
- Fatigue or restlessness
- Confusion or forgetfulness
Other possible symptoms of a COPD flare-up may include:
- Trouble sleeping
- Abdominal pain
- Difficulty speaking
- Gray or pale skin
- Trouble catching your breath
Symptoms lasting for two days or longer, which are stronger in intensity are a sign of a flare up.
In some cases, a flare-up can continue to get worse and may require immediate emergency assistance. If you or a loved one has any of the following severe COPD symptoms, call 911:
- Severe shortness of breath that your rescue medication isn't helping
- Breathing that becomes harder, faster or increasingly shallow
- Dark thick mucus
- Chest pain
- Blue fingers or lips
- Growing disorientation, confusion and slurred speech
How to tell if you're having a COPD flare-up
In some cases, it can be hard to tell whether you're having a COPD flare-up or just the usual shortness of breath and other symptoms typical of the condition. However, the COPD Foundation has a simple recommendation to help you determine whether you're having a COPD flare-up: Make a note of your resting heart rate and respiration rate for one minute when you're feeling your best. Then, when something doesn't feel right, measure both again. If either rate is increased, call your doctor as this could be a sign of a flare-up.
Triggers for a COPD flare-up
Why does a disease that's under control suddenly flare up and become unmanageable? Though several things can cause a COPD flare-up, a viral or bacterial infection is by far the most common COPD trigger, according to the American Thoracic Society. Anyone can react adversely to these infections, but people with COPD are particularly susceptible to complications because of their compromised airways. Unfortunately, if you have COPD, it also means you're also more likely to develop these infections in the first place.
Other possible triggers of a COPD flare-up include:
- Smoking or exposure to secondhand smoke
- Poor air quality
- On-the-job exposure to chemical fumes, vapors or dust
- Exposure to fumes from fuel or other sources in a poorly ventilated home
- Blood clots in the lungs
- Fluid buildup in the lungs (pulmonary edema)
- Changes in the weather
- Getting run down from over activity
- Stress or anxiety
Preventing COPD flare-ups
Sometimes it's possible to prevent a COPD flare-up simply by avoiding the irritant, particularly smoking and secondhand smoke. The U.S. National Library of Medicine also recommends taking additional steps to avoid COPD triggers and prevent flare-ups, starting with getting an annual flu shot. Also, keep other recommended vaccinations - especially pneumonia - up to date.
- Wash your hands -- or use hand sanitizer -- regularly
- Keep your home well-ventilated and free of potential irritants
- Stay out of cold, dry air
- Take frequent breaks to rest throughout the day
Treating a COPD flare-up
If you notice the early signs and symptoms of a COPD flare-up, it’s important to stay calm. Getting stressed out or panicking can only make symptoms worse. With your lips pursed, breath in and out in a slow and even manner to regulate your breathing. This can help you calm down and relax. Also, be sure to take any prescribed rescue medication as directed by your doctor.
Your doctor may also recommend other medications to help prevent a COPD flare-up, such as oxygen, antibiotics or steroids.
The bottom line
Remember, a COPD flare-up can worsen quickly and become quite serious. Because of this, it's vital that you avoid triggers, and are aware of the symptoms of a flare up and monitor these if they appear. If you ever suspect that you're having a flare-up, contact your doctor right away. Seek immediate medical attention if your symptoms do not improve or continue to get worse.
- What is an Exacerbation?, COPD Foundation https://www.copdfoundation.org/Learn-More/I-am-a-Person-with-COPD/Avoiding-Exacerbations-and-Pneumonia.aspx
- COPD: When to Call the Doctor About Your Symptoms, 2019, https://my.clevelandclinic.org/health/articles/8704-copd-when-to-call-the-doctor-about-your-symptoms
- Exacerbation of COPD, American Thoracic Society, 2018, https://www.thoracic.org/patients/patient-resources/resources/copd-exacerbation-ecopd.pdf
- COPD, Mayo Clinic, 2019, https://www.mayoclinic.org/diseases-conditions/copd/symptoms-causes/syc-20353679
- COPD Flare-Ups, U.S. National Library of Medicine, 2019, https://medlineplus.gov/ency/patientinstructions/000698.htm