What is a COPD Exacerbation?

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Dear COPD Coach,
I was recently diagnosed as having COPD. The doctor who diagnosed me said that my condition is still not very severe, but could get worse if I were to start having exacerbations. I understood him to mean that an exacerbation means time that I would end up in the hospital because of not being able to breathe. What exactly is an exacerbation and how do you avoid having one?

—Newly Diagnosed

Dear Newly Diagnosed,
An exacerbation is when there is an increase in the severity of the symptoms of a chronic disease.

The main symptoms of a COPD exacerbation are an increase in breathlessness accompanied by increased wheezing, a tightness in your chest or soreness when breathing, increased mucous production with a change in its color (usually a darker yellow or green) or thickness, and a fever. Oftentimes, severe exacerbations may result in pneumonia. Each time a person with COPD gets an exacerbation, lung damage can occur and it is quite possible that some or all of the damage can be permanent. Repeated exacerbations can accelerate the progression of COPD. The two most common causes for a COPD exacerbation are viral or bacterial lung infections or exposure to pollutants.

Treatments for an exacerbation might include supplemental oxygen, antibiotics, corticosteroids, bronchodilators or in the case of a major exacerbation, ventilation either by a mask or a tube inserted into the windpipe. Exacerbations are the most common cause for a person with COPD to be admitted to a hospital.

It should be fairly obvious that having COPD and experiencing an exacerbation is not a good thing! While a tendency towards some type of exacerbation is pretty likely, we can take measures to avoid getting one, or at least minimizing the severity of the exacerbation by following some common sense steps:

  • Take your medicines as prescribed – make sure you’re taking inhaled medications correctly by showing a respiratory therapist your technique.
  • Avoid irritants, especially second hand smoke or chemicals or dust.
  • Remain as active as your condition will safely allow (Pulmonary Rehabilitation is a big help)
  • Avoid exposure to people who are sick
  • Wash your hands frequently with anti-bacterial soap, especially after exposure to illness. Also consider wearing a mask when out, especially during flu season.
  • Keep your flu and pneumonia vaccinations up-to-date.
  • Maintain a healthy diet.
  • Take extraordinarily good care of yourself!

The best tool for limiting the severity of an exacerbation is recognizing the early signs (outlined above) and immediately seeking medical help. Too often, people with COPD try to self-manage their care (taking over-the-counter medications) or simply deny their symptoms. Immediate treatment can often reduce or eliminate the need for hospitalization, and minimize resulting lung damage.

It is possible to avoid most exacerbations – or at least help them be less serious. Learning how to do this will play a large part in helping you have your best possible quality of life.

I hope this helps.

–The COPD Coach

Ask the Expert 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 atcoachescorner@copdfoundation.org. We would love to hear your questions and comments. You can address your emails to any of the following: COPD Coach, Caregiver Coach, COPD Doctor or COPD RT.


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  • The most important thing is to get to your doc ASAP. I usually find that women "don't want to bother" their doc and guys think they can "tough it out". Both are quick ways to a hospital bed. What's an annoying cold to your kid or spouse can put you in the hospital, so teach those folks to practice good hygiene and don't bring bugs home! If you do get something get to your doc ASAP. One of my good doc friends, Dr. Brian Tiep, says, "Think of an exacerbation as a party and make sure I get the very first invitation!" You doc would much prefer to work with you over the phone, via email or even in his office rather than see you in the hospital.

    • Thank you Jean just got out of hospital 3 wks ago pneumonia. I'm already getting suck after weaning off of steroids

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