Chronic Obstructive Pulmonary Disease (COPD)

Other treatments in chronic obstructive pulmonary disease


This is an option in a very small number of cases. Removing a section of lung that has become useless may improve symptoms. Sometimes large air-filled sacs (called bullae) develop in the lungs in people with COPD. A single large bulla might be suitable for removal with an operation. This can improve symptoms in some people. Lung transplantation is being studied, but is not a realistic option in most cases.

What can I do to help?

Get immunised

Two immunisations are advised:

  • A yearly ‘flu vaccine (Inj Vaxgrip) each autumn protects against possible influenza and any chest infection that may develop due to this.
  • Immunisation against pneumococcus (a germ that can cause serious chest infections). This is a one-off injectionand not yearly like the ‘flu vaccine’.

Try to do some regular exercise

Studies have shown that people with COPD who exercise regularly tend to improve their breathing, ease symptoms, and have a better quality of life. 
Any regular exercise or physical activity is good. However, ideally the activity that you do should make you at least a little out of breath, and be for at least 20-30 minutes, at least 4-5 times a week. If you are able, a daily brisk walk is a good start if you are not used to exercise. But, if possible, try to increase the level of activity over time. You may be referred for pulmonary rehabilitation or be under the care of a community respiratory team. You will be given exercises and advice to try to help you stay as fit as possible. This is important because, effectively, you may become disabled due to your breathlessness.

Try to lose weight if you are overweight

Obesity can make breathlessness worse. If you are overweight or obese it is harder to exercise, and exercise makes you more breathless. It becomes a bit of a vicious cycle. If you are obese the chest wall is made heavy by fat. This means that you have to work much harder to breathe in and take a good breath, to inflate the lungs and expand the chest. A dietician may be able to give you advice on healthy eating and weight loss.

Chronic obstructive pulmonary disease and flying

If you have COPD and plan to fly then you should discuss this with the airline. Some airlines may request a fitness to fly assessment. Your respiratory specialist may be able to help or alternatively you may need to see a specialist in aviation medicine.
When travelling by air you should keep your medicines, especially your inhalers, in your hand luggage. If you are on LTOT, you will need to inform the airline. It is possible to use your own oxygen in-flight but individual circumstances may differ. Some people with COPD are more likely to need in-flight oxygen. Some people are more at risk of a punctured lung (pneumothorax) at altitude, despite the fact that the aircraft cabin is pressurised.

Regular follow-up

If you have COPD, your doctor will probably call you yearly for a check-up or annual review. You can discuss your medication and the GP or nurse might assess your inhaler technique. Regular review allows monitoring of the severity of your COPD, and gives an opportunity for health promotion such as help with stopping smoking or weight control. Reviews should happen more often if you have frequent exacerbations or complications, if you have very severe COPD, or if you have recently been discharged from hospital.

In summary

  • COPD is usually caused by smoking.
  • COPD should be considered as a possible diagnosis in anyone aged over 35 years old who smokes, or has ever smoked and has persistent problems such as cough with lots of phlegm, breathlessness or wheeze, and recurrent chest infections.
  • Symptoms usually become worse if you continue to smoke.
  • Symptoms are unlikely to get much worse if you stop smoking.
  • Treatment with inhalers often eases symptoms, but no treatment can reverse the damage to the airways.

Increasing the dose of usual treatments may help a flare-up of symptoms, often during a chest infection. This may be combined with a short course of steroid tablets and/or antibiotics.

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