Have Trouble Eating with COPD?

This article was reviewed by Senior Director of Community Engagement and COPD360social Community Manager, Bill Clark, as well as certified staff Respiratory Therapists on February 4, 2020.

Dear COPD Coach,
I have stage 4 emphysema. It is impossible to eat without immediately feeling chest tightness or bloated like I am about to explode. I read about how the diaphragm gets pushed by the stomach and how it changes shape as COPD worsens. Does this mean that eventually I won’t be able to eat?

Thank you,

Dear Worried,

Thanks for writing. As a patient myself at stage 4, I also experience this. The mechanism you described is exactly correct! To answer your question, you will always be able to eat, however you are going to have to eat a little differently. As your lungs deteriorate, they become larger which then pushes against your stomach. When you eat large meals, your stomach pushes against your lungs and diaphragm which restricts your breathing. The key here is not to eat large meals or large portions, but instead eat smaller meals throughout the day. Also do not eat foods that can cause bloating or gas. Drinking plenty of water during the meals will also help ease the bloating. If you use supplemental oxygen, make sure you use it while you eat. When my wife and I go out to dinner, I tend to eat too much and have a difficult time returning to the car. I have since learned to order smaller portions, especially if I have to walk a long distance after the meal. I also make sure to eat throughout the day, several times a day, even if it is just a light snack. When I do this, I feel far less bloated.

Another thing that can help is to eat slowly. People with COPD can have a tendency to chew and swallow food too quickly which causes two problems: 1) difficult and slower digestion of meals 2) increased likelihood that you can choke or aspirate on your food which can cause a lung infection. Slow down, and make sure you are chewing your food thoroughly before you swallow to keep these issues from becoming a problem.

For information on what is best to eat, go to the COPD Foundation’s website and check out the information under the Learn More tab. There is a section there all about nutrition for people with COPD and includes information related to bloating. There you will find a list of the best foods along with lots of other useful lifestyle tips.

It is important to remember that when you eat large meals, you burn lots of calories in order to digest. You also burn calories just trying to breathe! So, the foods you eat must contain not only enough calories to augment what you are using up. In other words, learn to eat smart!

Hope this helps,
-The COPD Coach

Coaches Corner is aimed at providing information for individuals with COPD to take to your doctor, and is not in any way intended to be medical advice. If you would like to submit a question to the Coaches Corner email us at coachescorner@copdfoundation.org. We would love to hear your questions and comments. You can address your emails to The COPD Coach.


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  • My husband has this problem. He is also at stage 4. Its great to get this advice and Its encouraging to know that other people have this difficulty. We need to know a lot more!
    I found out on the internet that COPD causes glycogen starvation which affects the muscles
    which deteriorate and cause this terrible exhaustion and weakness. Therefore it seems more calories and protein are needed and small meals several times a day with snacks in between . Hopefully without putting on weight which will slow things up even more! The trouble is he also has liver cirrhosis which can be affected by too much protein!
    • the internet may provide enough knowledge about symptoms and more, but just wanna hear from you or may you share with me what symptoms did your husband show on it's early stages.. this might help me more understand COPD, that if it won't be that much to be asking from you Marion.. Thanks and hoping to hear from you.
  • This site can’t be reached

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  • Here is a working link for the Big Fat Reference Guide:

  • How nuts this is. I was recently diagnosed with Severe COPD. I already knew that I had it, but didn't get it evaluted until recently. FEV1 at 1.77 or 45%, Diffusion at 16.24 or 54%. Was feeling good, just ate a sandwich and a half of salmon salad....simple mayo mixed with salmon on rye bread. Stuff all gassy and tight in lungs and stuff in no time flat with all the bloated crap. It's STUPID. Love to know all the mechanisms at play here. Has to be more than space at the diaphragm base on how it presents? But I hear ya....nuts..the way it goes down after eating.

    • One thing that happens after eating is more blood flows to the GI tract and away from other parts of your body ( including the muscles of breathing). While this is not important in most people, those with COPD have an increased "work of breathing", utilizing far more energy to breath than a person without COPD. I suspect this may be a factor in what you describe.