Overview

At times, your symptoms may suddenly flare up and get much worse. This is called a COPD exacerbation (say "ig-ZAS-ur-BAY-shun"). When this happens, your usual symptoms quickly get worse and stay bad. This can be dangerous, and you may have to go to the hospital.

Symptoms of a flare-up include:

• Coughing more than usual.
• A change in the amount, colour, or thickness of mucus.
• More shortness of breath than usual.

What causes them?

The two most common causes of a COPD flare-up, or attack, are respiratory tract infections, such as acute bronchitis or pneumonia, and air pollution. Having other health problems, such as heart failure or an abnormal heartbeat (arrhythmia) may also trigger a flare-up. In some cases, the cause is not known.

What happens during a flare-up?

When you have a COPD flare-up, your lungs may suddenly produce more mucus. Or the airways of your lungs (bronchial tubes) may suddenly get narrower. These two things reduce the airflow in your lungs. That makes it harder to breathe and makes your coughing worse.

How are they treated?

Treatment of a COPD flare-up, or attack, depends on how bad the flare-up is. Mild flare-ups may be treated by following your doctor's instructions for using a quick-relief (short-acting) inhaler or oral steroid medicines. More severe flare-ups may involve visits to your doctor's office or clinic. Or you may need to be treated in the hospital. Treatments include:

• Quick-relief inhaled bronchodilators. These medicines relax the bronchial tubes and make it easier to breathe.
• Oral steroid medicines. They reduce the swelling in your airways.
• A machine to help you breathe better or to breathe for you. These are called ventilation machines.
• Oxygen, to increase the amount of oxygen in your blood.

Treatment may also include:

• Intravenous (I.V.) fluids to treat dehydration.
• Other bronchodilators.
• Antibiotics. Your doctor may prescribe antibiotics to help treat a bacterial infection.