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Back Acknowledgements This portal could not have been developed without the support of several people. We would like to acknowledge the following people for their contributions. EUFOREA Core team Dr Sophie Scheire (project lead, coordinator, content development) Tania Lopes (audiovisual content and portal development) Stéphanie Gailly (audiovisual content and portal development) Remie Bruggeman (audiovisual content) Dr Xander Bertels (proof-reading) Vanessa Stockton (proof-reading) Katie Tassell (proof-reading) Prof Dr Peter Hellings (project supervisor) Additionally, a special thanks to following experts for their role in the development of the Expert videos for current and upcoming modules. Prof Dr Alvar Agusti (University of Barcelona, Spain) Assisted by Mrs Gemma Roque Guerin (RN) and Mr Eloy Martinez De Las Heras Prof Dr Wim Janssens (University Hospitals Leuven, Belgium) Prof Dr Stephanie Everaerts (University Hospitals Leuven, Belgium) Mrs Iris Coosemans (University Hospitals Leuven, Belgium) Prof Dr Frederik Trinkmann (Thoraxklinik Heidelberg, Deutschland) Dr Manon Blauwblomme (Ghent University Hospital, Belgium) Mrs. Isabelle Heyens (Ghent University Hospital, Belgium) Assisted by Mrs Ellen Van der Steen (Ghent University Hospital, Belgium) We would like to extend a special thanks to following experts for the review of the content: Prof. Dr. Thérèse Lapperre (University of Antwerp, Belgium) Dr Sebastian Riemann (Ghent University Hospital, Belgium) Prof Dr Glenis Scadding (Royal National ENT Hospital, United Kingdom) Prof Dr Frederik Trinkmann (Thoraxklinik Heidelberg, Deutschland) Lastly, we sincerely thank all COPD patients who shared their feedback and helped refine the content of this patient portal. Funding The EUFOREA Patient Portal is supported by an unrestricted grant by Sanofi-Regeneron. EUFOREA has and maintains full editorial control over the content and publication decisions. References Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease (2025 report). Global Initiative for Chronic Obstructive Lung Disase. Available from www.goldcopd.org EUFOREA CRS and Asthma Patient Portal. Available from www.euforea.org/patient-portal COPD Patient Care Map. Available from https://gaapp.org/introducing-the-copd-patient-care-map-a-tool-for-education-advocacy-and-policy-change UpToDate – Patient Education: Chronic obstructive pulmonary disease (COPD) (Basics and Beyond the basics). Available from www.uptodate.com UpToDate – Patient Education: Lowering your risk of COPD. Available from www.uptodate.com UpToDate – Patient Education: COPD and diet. Available from www.uptodate.com National Heart, Lung, and Blood Institute (NIH) – How do I help the person I’m caring for manage COPD – The COPD Caregiver’s toolkit. Available from https://www.nhlbi.nih.gov/education/copd-learn-more-breathe-better/copd-caregivers-toolkit Asthma & Lung UK – Chronic obstructive pulmonary disease. Available from: https://www.asthmaandlung.org.uk/conditions/copd-chronic-obstructive-pulmonary-disease American Lung Association – Chronic obstructive pulmonary disase. Available from: https://www.lung.org/lung-health-diseases/lung-disease-lookup/copd Mayo Clinic – Chronic obstructive pulmonary disease. Symptoms and causes/ Diagnosis & treatment. Available from: https://www.mayoclinic.org/diseases-conditions/copd World Health Organisation. Fact sheets: chronic obstructive pulmonary disease. Available from: https://www.who.int/news-room/fact-sheets/detail/chronic-obstructive-pulmonary-disease-(copd) Cleveland Clinic – Chronic obstructive pulmonary disease. Available from: https://my.clevelandclinic.org/health/diseases/8709-chronic-obstructive-pulmonary-disease-copd NIH: National Heart, Lung, and Blood institute. COPD. Available from: https://www.nhlbi.nih.gov/health/copd NHS – Chronic obstructive pulmonary disease (COPD). Available from: https://www.nhs.uk/conditions/chronic-obstructive-pulmonary-disease-copd/ European Lung Foundation (ELF). Available from: https://europeanlung.org Lung Foundation Australia. Available from: https://lungfoundation.com.au COPD Foundation. Available from: https://www.copdfoundation.org/ A complete list of the scientific publications used to develop the content of this patient portal is available upon request. Logbook November 19, 2025: Launch of the COPD module on the Patient Portal   Disclaimer This website does not provide medical advice. The information, including but not limited to, text, graphics, images, and other material contained on this website is for informational purposes only. No material on this site is intended to be a substitute for professional medical advice, diagnosis, or treatment and/or medical treatment of a qualified physician or healthcare provider. EUFOREA is not a medical organisation and cannot provide specific medical advice to patients via the Internet and/or E-mail. All patients are encouraged to direct their specific questions to their personal physicians. EUFOREA presents this information to patients so that patients can understand and participate in their own medical care. EUFOREA strongly emphasises that the information contained on this website is not a substitute for thorough evaluation and treatment by a qualified healthcare provider. Copyright © 2025 – EUFOREA – All rights reserved. All content on this portal, such as text, graphics, logos and images, is the property of EUFOREA. They may not be reproduced, copied, published, stored, modified or used in any form, online or offline, without prior written permission of EUFOREA. Overview AcknowledgementsFundingReferencesLogbook

About COPD

Back What are airways, and why do we have them? Your airways start at the entrance to your nostrils and go down to tiny sacs in your lungs called alveoli, via a series of tubes, like an upside- down tree. They are your respiratory system whose function is to obtain oxygen from the inspired air and to pass out a waste product, carbon dioxide. Your airways fulfil the following roles: Transport air into and out of the lungs Regulate the temperature and humidity of the air we breathe Protect your lungs from harmful particles, such as dust and germs Work together with other parts of the body to enable speech and smell For your lungs to function well in all these tasks, it is important to keep your airways healthy. This includes avoiding exposure to smoke, chemicals, and other substances that can irritate or damage them. What is COPD? Chronic obstructive pulmonary disease, or COPD, is a term used to describe a group of lung diseases caused by damage to the lungs. The damage leads to swelling and irritation, also called inflammation. This inflammation and narrowing of the airways makes it harder for air to flow in and out, also referred to as airflow obstruction. This can leave you feeling breathless. COPD is a common condition that affects millions of people and is sadly the fourth leading cause of death worldwide. Let’s break down the word COPD: C stands for Chronic – meaning the condition is long-term and does not go away. O stands for Obstructive – meaning the airways are partly narrowed, making it harder for air to flow out. P stands for Pulmonary – which is the medical term for anything related to the lungs. D stands for Disease – meaning it is a medical condition. COPD is a lung disease that makes it hard to breathe. It includes emphysema and chronic bronchitis,  which can often occur together. In emphysema, the thin walls of the air sacs of the lungs, called alveoli, become damaged over time. In healthy lungs, the elastic air sacs stretch and fill with air when you breathe in, and help get the air out when you exhale. When the air sacs are damaged, they lose their elasticity and the evacuation of air becomes difficult, leaving less room for fresh, oxygen-rich air to enter your lungs. This process causes shortness of breath and a wheezing sound upon exhaling. Because the overall surface area for gas exchange is reduced, the lungs also become less efficient at taking up oxygen. Chronic bronchitis on the other hand refers to a lung condition where the lining of the tubes that bring air into the lungs, called bronchi, are affected by inflammation. Due to the inflammation, the bronchi are swollen and narrowed. Moreover, extra mucus is being produced caused by the irritation, leading to blockage of the airways. A persistent cough results from trying to evacuate this mucus from the airways. While COPD can often be prevented, once it develops, it cannot be cured. The breathing problems tend to get gradually worse over time. The good news is that COPD is treatable. There are treatments to help improve your symptoms and quality of life. Proper management also lowers the risk of other conditions that are linked to COPD, such as heart disease. However, it is important to know that even if you are receiving treatment, you may sometimes notice a sudden worsening of your symptoms. This is called a flare-up or exacerbation. Causes of COPD COPD happens when the lungs become inflamed, damaged, and narrowed. The most common cause in developed countries is tobacco smoking. The risk of developing COPD goes up the longer and the more a person smokes. In developing countries, COPD is often the result of indoor (for example cooking fumes or heating fuels in poorly ventilated rooms) or outdoor air pollution. While smoking is the leading cause of COPD, it is important to know that about 1 in 4 people with COPD never smoked. Other risk factors of COPD may include: Other lung irritants, such as exposure to dust and/or fumes at work or secondhand smoke (passive exposure to smoke). A rare genetic disease, called alpha-1-antitrypsin deficiency, which results in a deficiency in a protein that protects the lungs. Impaired lung growth and development: Conditions affecting the lungs of children, either during pregnancy or childhood, can increase the risk. Examples include maternal smoking during pregnancy, frequent respiratory infections as a child or childhood asthma. Age (>40yrs), as lung function declines with increasing age Infections: Having HIV or tuberculosis can raise your risk of COPD Asthma: having asthma and being a smoker increases the risk of COPD even more Differences between men and women For a long time, COPD was thought to be a disease that mostly affected older men, because men smoked more. But recent data show a shift: COPD is now common in women, and in many developed countries is actually more frequent in women than in men. Women seem to be at a greater risk of developing COPD. They may develop COPD at a younger age and can have just as much lung damage as men, with fewer years of smoking. This suggests that women’s lungs may be more sensitive to the harmful effects of smoking. Sadly, women also seem to be at a higher risk of hospitalisation and even death related to the disease. The reasons behind this are largely unknown, but some theories exist. It might be linked to female hormones (estrogen), smaller airways, and increased exposure to tobacco smoking and cooking fumes/fuels. Women with COPD also often experience worse lung function, more frequent flare-ups, and poorer quality of life compared to their male counterparts. The good news is that current COPD treatments work just as well for women as they do for men. COPD myths debunked Myth: Only people who smoke develop COPD Truth: Although smoking is the main cause of COPD, about one in four people with the disease have

Symptoms of COPD

Back Typical symptoms Early detection of COPD is essential, as it allows treatment to begin sooner and may help prevent further loss of lung function. By learning how to recognize the symptoms and early warning signs, you can take steps to reduce their impact and maintain an active, independent lifestyle. Typical symptoms of COPD include: Breathlessness, especially during physical activity. It often develops gradually, so activities that were once manageable, such as climbing stairs or taking long walks, may become increasingly difficult over time. An ongoing cough, often accompanied with coughing up sputum (phlegm). This is often the first symptom of COPD. Recurring chest infections, such as acute bronchitis or pneumonia Breathlessness, especially during physical activity. It often develops gradually, so activities that were once manageable, such as climbing stairs or taking long walks, may become increasingly difficult over time. If you recognize any of these symptoms and they have been persistent, it is important to discuss them with your doctor to check for COPD, particularly if any of the following apply to you: You smoke, have a history of smoking or are exposed to secondhand smoke You are over the age of 40 You are/were frequently exposed to smoke/dust/fumes in your workplace You had airway problems as a kid, such as asthma or frequent respiratory infections If asthma runs in your family Other, less common symptoms of COPD, that usually only develop in the later stages of the disease include: Fatigue Unintentional weight loss Swelling in ankles, feet or legs, due to fluid build-up, also called oedema COPD flare-up Without treatment, symptoms usually worsen gradually. Even while on treatment, you may sometimes experience a sudden worsening of symptoms, known as a flare-up or exacerbation. A flare-up may present as: Coughing more than usual, or coughing up yellow or green phlegm, or larger amounts of phlegm than normal. Feeling more short of breath than usual You need to use your inhaler more often than usual These can occur several times a year, particularly during the winter months. During a flare-up, breathing often becomes more difficult, and you might also develop a fever or start coughing up yellow or green phlegm. A flare-up may require additional treatment for a few days or weeks. A COPD flare-up can be triggered by many factors. A COPD trigger is anything that irritates your airways and amplifies your symptoms, and these triggers can vary from person to person. Common COPD triggers include: Respiratory infections, such as the common cold, the flu, an RSV-infection or coronavirus disease (COVID-19) Cold air Indoor or outdoor air pollution Smoking and vaping Red-flag symptoms If you have COPD, go to the emergency department or call emergency services immediately if you notice any of the following: You have severe shortness of breath (more difficulty than usual in catching your breath or speaking) You developed a high fever accompanied by other warning signs Your lips or fingernails have turned blue or gray, a sign of a low oxygen level in your blood You experience a rapid or irregular heartbeat, or your breathing rate increases You are restless, irritable, confused or you are having trouble concentrating You have chest pain that spreads to your arm, back, neck and/or jaw When to see a GP? No diagnosis: In the early stages, COPD may cause no or only mild symptoms. As the disease progresses, symptoms may become more noticeable. You may think that some of the symptoms are part of normal aging, and without realising it, you may start avoiding certain activities as they become increasingly difficult. As lung function gradually declines, breathing becomes harder, staying active more challenging, and the things you enjoy doing may become affected. If your ability to be physically active is limited by breathing difficulties, or if you have noticed one or more of the typical COPD symptoms (see above) and they have been persistent, contact your GP as soon as possible. Early detection is crucial, as it allows treatment to begin sooner and may help prevent further loss of lung function. If your doctor thinks you might have COPD, you will need to have a simple lung function test called spirometry. Formal diagnosis: Call your doctor right away if your breathing suddenly gets worse or you notice signs of an infection (= flare-up, see above). Sometimes, severe symptoms require hospital care. It is a good idea to see your GP regularly for a COPD review. These appointments are an opportunity to discuss your symptoms, how well your treatment is working, any side effects, and any challenges you may have in managing your condition. During these visits, your GP will also recommend certain vaccinations. Because people with COPD are at higher risk of becoming seriously ill from respiratory infections such as the flu or COVID-19, vaccination can help reduce the risk of complications, including worsening symptoms or further loss of lung function. When to see a specialist? Seeing a specialist is important in the following situations: The formal diagnosis of COPD: your GP may refer you to a respiratory specialist for further testing. To confirm COPD, a breathing assessment with spirometry is required, but not all GP practices are able to offer this breathing test. It is also important to note that asthma can develop after the age of 40 and may cause similar symptoms. Identifying the cause of your breathing problems is important to tailor the treatment to your needs.   Your COPD symptoms remain troublesome despite treatment from your primary care provider, or your symptoms keep interfering with your daily activities. You show signs of other conditions that often occur alongside COPD (see below). In these cases, you may be referred to a relevant specialist—for example, a cardiologist to check your heart or an ENT (ear, nose, and throat) specialist to check your nose and sinuses. Is COPD related to other health conditions? Respiratory infections: People with COPD are more likely to get respiratory infections such as colds, the flu or an RSV (respiratory syncytial virus) infection

Preparing your COPD consultation

Back Preparing for your first consultation If you have signs that might be compatible with COPD, it is important to see a doctor. They can figure out what is wrong, start a treatment plan, or send you to a specialist if needed. This guide will help you get ready for your first visit so you can make the most of it. It can be helpful to bring someone with you, like a family member or friend. They can ask questions you might forget, write down important information, and help you remember what the doctor says. If you feel nervous or overwhelmed, having someone with you can also help you feel supported. You can also ask permission to record the consultation on your mobile phone, so you don’t forget anything. Here you’ll find a guide to prepare for your first consultation. Download the First Consultation Guide Preparing for your follow-up consultation We’ve also developed a separate patient guide to help you get ready for your next visit with your doctor (follow-up). It explains when to see your doctor, helps you reflect on your health, decide what’s important to you to discuss, and check how well your treatment is working—including both benefits and any side effects. It also reminds you what items to bring to your follow-up appointment. By preparing, you can feel more confident, use your time with your doctor efficiently, and take charge of your health. Download the Follow-Up Consultation Guide Bring your COPD Action Plan to your consultation Download the COPD Action Plan Tools to evaluate how well your symptoms are controlled Sometimes, your doctor might ask you to fill out a survey to understand your symptoms better. These surveys help your doctor see how your condition is affecting you. For COPD, the most common tools are the COPD Assessment Test (CAT) and the modified Medical Research Council (mMRC) dyspnea scale. The CAT measures how much COPD influences your daily activities and overall well-being, while the mMRC scale helps assess the level of breathlessness you experience during everyday tasks. Another useful tool to consider before your appointment is a COPD symptom diary. Even though a symptom diary hasn’t been formally studied in research, it may still help you remember how you felt at different times and make it easier to discuss your COPD with your doctor. Your healthcare provider will work with you to review your symptoms and to adjust your treatment plan accordingly. Download the Symptom Diary Disclaimer This website does not provide medical advice. The information, including but not limited to, text, graphics, images, and other material contained on this website is for informational purposes only. No material on this site is intended to be a substitute for professional medical advice, diagnosis, or treatment and/or medical treatment of a qualified physician or healthcare provider. EUFOREA is not a medical organisation and cannot provide specific medical advice to patients via the Internet and/or E-mail. All patients are encouraged to direct their specific questions to their personal physicians. EUFOREA presents this information to patients so that patients can understand and participate in their own medical care. EUFOREA strongly emphasises that the information contained on this website is not a substitute for thorough evaluation and treatment by a qualified healthcare provider. Copyright © 2025 – EUFOREA – All rights reserved. All content on this portal, such as text, graphics, logos and images, is the property of EUFOREA. They may not be reproduced, copied, published, stored, modified or used in any form, online or offline, without prior written permission of EUFOREA. Overview Preparing for your consultationYour follow-up consultationBring your COPD Action Plan to your consultationTools to evaluate how well your symptoms are controlled

Diagnosis of COPD

Back Importance of early recognition Although COPD is a common condition, many people remain undiagnosed. Symptoms often develop gradually, and people may not realise they have the disease until it has reached a more advanced stage. This delay in diagnosis is frequently due to the slow progression of symptoms, which are sometimes attributed to aging or long-term smoking. Some people may also hesitate to seek medical help because they feel guilty about smoking. Another reason could be that the GP does not initially link the symptoms to COPD, as they can resemble those of other conditions. As a result, spirometry — which is essential for confirming COPD — may be postponed, further delaying diagnosis. Knowing the early warning signs of COPD is important, especially if you’re at higher risk of developing COPD (see our module on Symptoms). The earlier COPD is diagnosed, the sooner treatment can begin, which will help slow down lung damage. If you notice any symptoms, talk to your healthcare provider. On this page, you’ll learn how COPD is diagnosed, what tests may be used for diagnosis, and how COPD is classified into different stages. How is COPD diagnosed? To diagnose COPD, your healthcare provider will ask you a range of questions, perform a physical exam, and offer specific tests to diagnose the condition. Depending on the availability of the materials in their office, your provider might also refer you to a specialist for further testing. Your GP may ask you questions such as: What symptoms you experience, what seems to trigger them (for example, physical activity or respiratory infections), and how long you’ve had them. You may also be asked how often your symptoms have worsened and how these flare-ups were treated in the past, especially if this was managed by a different healthcare provider. Whether your symptoms change from day to day How your symptoms affect your daily life Whether you have risk factors for COPD, such as smoking or exposure to dust and fumes at work Your medical history, including frequent chest infections or allergic conditions like hay fever, eczema, or asthma Whether close family members have COPD, other lung conditions or liver disease Any hospital visits you’ve had for breathing problems To feel optimally prepared for your first consultation, check out our PDF guide here. If your doctor thinks you might have COPD, a few tests might be proposed, which can be broadly divided into three big groups: lung function tests, imaging, and lab tests. Lung function tests (also called pulmonary function tests): Spirometry: a type of lung test that measures the amount of air you can blow out in a single forced breath. Spirometry is used to diagnose lung diseases, including COPD and asthma. This test is required to confirm whether you have COPD. It should always be carried out, either by your GP or by a respiratory specialist after referral.In COPD, the inflammation and narrowing of the airways makes it harder to blow air out quickly. If your results are lower than expected, the test is repeated after you inhale a medication called a bronchodilator, which helps open the airways. In people with asthma, lung function can return to normal after this step, while in COPD it typically only improves partially. Spirometry is repeated regularly to monitor the progression of your COPD and to evaluate how well your treatment is working. Pulse oximetry: A small device that is put on the tip of the finger to measure oxygen levels in your blood. Lung volume test: this test measures how much air your lungs can hold at different points while breathing in and out. The test is usually done in a small booth (similar to a phone booth) where you breathe through a mouthpiece. In people with COPD, lung volume may be increased because not all the air can leave the lungs, due to airway narrowing or air trapping caused by lung damage. Lung diffusion test: this test measures how efficiently two gases, oxygen and carbon dioxide, move between the lungs and the bloodstream. In people with emphysema, this gas exchange is usually reduced. 6-minute walk test: This simple and inexpensive test is used to evaluate your exercise capacity. For this test, you will be asked to walk as far as possible along a flat corridor for 6 minutes. In this test, your pulse, difficulty breathing, and blood oxygen levels are usually measured in addition to the distance walked. The test is useful to track your disease progression, to evaluate the effects of a pulmonary rehabilitation programme, and to evaluate your response to treatment. Exercise stress test: This test measures how well your heart and lungs work during physical activity. While you exercise on a treadmill or stationary bike, your heart is monitored, and your lung function is evaluated to see how effectively they cope with the effort. Other tests used in the diagnosis of asthma: It is important to rule out asthma when assessing for COPD. This can be done through specific tests such as a bronchial challenge test or a FeNO (fractional exhaled nitric oxide) test. The results of spirometry can also help distinguish between COPD and asthma. You can find more information about how asthma is diagnosed here. Imaging: Chest X-ray: A chest X-ray can show lung changes caused by COPD. It can also help to rule out other lung diseases. A CT scan can show changes in the lungs caused by COPD, such as emphysema or thickening or widening of the larger airways due to inflammation. It can also help rule out other lung diseases. In some cases, the results can guide treatment decisions—for example, showing whether interventions like lung volume reduction with valves or surgery might be helpful. Many people with COPD also qualify for lung cancer screening with a low-dose CT scan. Lab tests: Arterial blood gas test measures how well your lungs deliver oxygen to your blood and how effectively they remove carbon dioxide. For this test, a small blood sample is taken from

Lifestyle & Prevention of COPD

Back Quit smoking Quitting smoking is the single most powerful thing you can do to take control of your COPD. Why quitting smoking is one of the best things you can do for your lungs: Protect your lungs: Stopping smoking helps prevent further loss of lung function Slow the progression: COPD can’t be cured, but quitting smoking can slow the progression and help you stay active for longer. Improve your breathing: You’ll notice improvements in symptoms like coughing, phlegm, and breathlessness. Fewer flare-ups: You will be less likely to experience COPD flare-ups and hospital visits. That said, we know that quitting smoking is challenging and many people had to go through multiple attempts in order to finally quit for good. The fact that you’re taking the time to read this and even consider quitting is already a big step forward. Even if you’re not ready to quit today, it is helpful to start thinking about when might be the right time for you in the near future. Talk to your healthcare provider to learn more about stop-smoking programmes in your area, prescription medicines that can support you, and nicotine replacement therapies you could try. You might also find it helpful to connect with others who are going through the same process by joining a support group. Involving your family and friends can make a big difference too. They can encourage you and support you when things get tough. Finally, try to avoid being around smokers or smoke — not just to reduce temptation, but also because any kind of smoke (including second-hand smoke or smoke from wood fires) can make your COPD symptoms worse. Nutrition A healthy lifestyle benefits everyone, but it is especially important when you have COPD. Eating nutritious foods helps you stay strong. Think of food as fuel for your muscles. Because your lungs have to work harder to breathe, your body uses more energy. This means you may need more calories or protein to keep your muscles working well. You may also need more calcium- and vitamin D-rich foods to keep your bones strong. When your body is well-nourished, it is also better at fighting infections, which can help lower your risk of flare-ups or hospital visits. Maintaining a healthy weight is equally important for two key reasons: Unintentional weight loss Some people with COPD lose weight without meaning to. This can happen for different reasons. Eating may make you feel short of breath, or preparing meals might feel too tiring. Food may also taste different because of mucus you cough up. Sometimes, side effects like nausea or vomiting can make eating harder. Being overweight Carrying extra weight can make breathing more difficult, add strain on your lungs and makes obstructive sleep apnea (OSA), a condition that often occurs alongside COPD, more likely. Tips and tricks on how to eat enough: Eat together with friends and family Eat 5 to 6 small meals, instead of 3 larger meals If you need to gain weight, try adding foods like oil, nuts, protein powder, or cream to your meals to boost calories and protein. It is best to work with a dietitian to create a plan that helps you gain weight in a healthy way. Make your food tasty, by adding spices or condiments If preparing meals is difficult, you can buy pre-cooked or ready-made meals, or cook larger portions and freeze them for later. You could also ask someone to help or look into meal delivery services in your area. Try to limit how much you drink during meals, and instead have plenty of fluids between meals. This helps you avoid feeling full too quickly, so you can eat enough food. Check this excellent resource to learn more about specific nutritional recommendations for people with COPD. If you need support with healthy eating or your weight, your healthcare provider might be able to refer you to a dietitian. You may also see a dietician as part of a pulmonary rehabilitation programme. If necessary, your provider might recommend taking vitamins or nutritional supplements to meet your nutritional needs. Exercise/physical activity The amount of exercise that you can tolerate is specific to your individual circumstances. You might become slightly breathless during exercise, but you should not strain yourself too much. You might feel worried or anxious about exercising, because you’re afraid of getting breathless. This can cause you to avoid physical activity, which in  time leads to the loss of muscles strength. Weaker muscles require more oxygen, which in turn can lead to more breathlessness. This is often referred to as the cycle of inactivity. That’s why staying active is so important when you have COPD. Regular physical activity helps improve your overall strength, endurance, and strengthens your breathing muscles, making it easier to manage your symptoms and enjoy a better quality of life. The amount of exercise you can handle depends on your own health and fitness level. It is normal to feel a bit breathless when you exercise, but you should avoid pushing yourself too hard. Talk to your healthcare provider about which activities are best for you. You may be advised to participate in a pulmonary rehabilitation programme, which is a specialized physiotherapy programme that includes both exercise and education on the condition. Air travel Nowadays, travelling by airplane is accessible to many people. Nonetheless, air travel comes with its own challenges for people with COPD. Although flying with COPD is possible, careful preparation may be needed for safety and comfort If you are planning a trip by airplane, it is a good idea to discuss this with your healthcare provider. You might be referred for “fit-to-fly” test, also called a Hypoxic Challenge Test (HCT) or High Altitude Simulation Test (HAST). The level of oxygen onboard of an airplane is lower than the level on the ground. HAST measures how well you can cope with less oxygen in the air. It can give an indication for your need for on-board oxygen therapy. If you’re already

Treatment of COPD

Back Aims of treatment There is currently no cure for COPD. There are two main goals of treatment. The first is to help control your symptoms and improve exercise tolerance, so you can carry on with your daily activities and improve your overall health status. The second goal is to reduce the risk of complications, by slowing down the disease progression, and by preventing and treating COPD flare-ups. Your healthcare provider will work with you to review your symptoms and to adjust your treatment plan accordingly. If you want to keep an overview of how well your symptoms are under control, you may want to keep a symptom diary at home. Even though this symptom diary hasn’t been formally studied in research, it may still help you remember how you felt at different times and make it easier to discuss your COPD with your doctor. Examples of these documents can be downloaded here for personal use (permission to distribute for personal use only!). Quitting smoking If you haven’t already, then the most essential step in your treatment plan for COPD will be to quit smoking. Although the damage to your lungs that has already been done can’t be reversed, quitting smoking will prevent further loss of lung function. No matter how long you have had COPD, quitting smoking can help slow progression of the disease. Your symptoms, like breathlessness, coughing, and phlegm will improve and you will be less likely to experience COPD flare-ups. Find out more about quitting smoking in our Lifestyle and Prevention module. Inhalers Most COPD medicines are taken using an inhaler. These small, hand-held devices deliver the medicine directly into the lungs, so it doesn’t need to travel through the bloodstream to reach its target. Some medicines are taken using a nebuliser, which is a machine that turns liquid medicine into a fine mist that you can breathe in through a mask or a mouthpiece. Nebulizers are mainly used in hospitals during severe flare-ups to deliver higher doses of medicine. In some cases, they can also be used at home for people with more advanced COPD, especially if inhalers are no longer effective or too difficult to use. Bronchodilators Bronchodilators are medicines to help open up your airways. They are considered the cornerstone of treatment for patients with COPD. Bronchodilators are categorized based on the duration of effect. Short-acting bronchodilators work within a few minutes to relax the muscles in your airways and relieve your symptoms. They are prescribed for use ‘as needed’ when symptoms flare-up. There are two types of short-acting bronchodilators: Short-acting beta agonists (SABA, for example: salbutamol/albuterol): they quickly relieve symptoms and can be used as needed. They are often prescribed as ‘reliever’ or ‘rescue’ inhalers. Some people may feel a bit shaky or notice a faster heartbeat after using a SABA. These side effects are usually short-lived but can feel uncomfortable. If you’re ever concerned about side effects, talk to your healthcare provider. Short-acting muscarinic antagonists (SAMA, for example: ipratropium): they are prescribed in case your symptoms are mild and infrequent, to use as needed. SAMAs are sometimes prescribed if you experience bothersome side effects of SABA use, like feeling shaky or a rapid heart rate. There are very few common side effects of SAMA use, but headaches, a sore throat or a dry mouth have been described. Correct inhaler technique and frequently taking a sip of water can help reduce the risk of side effects. If you’re ever concerned about side effects, talk to your healthcare provider. You might be prescribed a combination of SABA and SAMA, depending on the severity and frequency of your symptoms. If you experience breathlessness on a daily basis, your doctor will probably prescribe a long-acting bronchodilator. These medicines help relax and open up the muscles in your airways, making it easier to breathe. They act more slowly than short-acting bronchodilators, but their effects last much longer, usually between 12 and 24 hours. When taken regularly, they help keep your airways open and support your breathing throughout the day. There are two types of long-acting bronchodilators: Long-acting beta agonists (LABA, for example: vilanterol or olodaterol). There are very few common side effects. You might notice headaches, a faster heart rate or feeling shaky. If you’re ever concerned about side effects, talk to your healthcare provider. Long-acting muscarinic antagonists (LAMA, for example: tiotropium or umeclidinium). Side effects are uncommon, but you might notice having a dry mouth. Drink plenty of water to help ease your discomfort from a dry mouth. If you’re ever concerned about side effects, talk to your healthcare provider. Many people with COPD who experience breathlessness use a combination of two long-acting medicines: a LABA and a LAMA. The combination can be prescribed as two separate inhalers or as a single combination inhaler, which is often more convenient and more effective than multiple inhalers, but sometimes a bit more expensive. Expected side effects are those of the separate medicines. Inhaled steroids Steroids, also called corticosteroids, are medicines that help reduce inflammation. When inhaled, they act directly in the lungs to decrease swelling and irritation. Not everyone with COPD needs inhaled steroids (ICS). These inhalers are usually prescribed for people who have frequent COPD flare-ups or higher levels of a certain type of white blood cells called ‘eosinophils’. They are also recommended for people who have both COPD and asthma. Inhaled steroids only work properly when used on a regular basis, so it is important to use them as prescribed.  It is also important to know that this treatment mainly helps reduce the number of flare-ups, but it has less effect on day-to-day symptoms compared with other inhalers such as LAMA or LABA. In terms of expected side effects, it is important to know that inhaled steroids work locally in the airways, at the site of the inflammation. Hence, only a little enters the blood stream, leading to few side effects. Oral thrush (a yeast infection in the mouth) is the most common side

COPD Patient Journey

Back Patient Journey Understanding the different steps of your COPD care journey can feel overwhelming. What can you expect from your healthcare provider at each stage? What treatment options might be available to you? This module breaks the patient journey into clear phases and guides you through each one. Step 0: Self-management Some aspects of COPD care apply across all stages, no matter where you are in your journey. Self-management strategies include smoking cessation—one of the most important steps you can take in managing your disease. They also involve learning about healthy lifestyle choices, staying up to date with vaccinations (including a yearly flu shot and a pneumococcal vaccine to prevent chest infections), using your treatments correctly, and avoiding exposure to lung irritants. It is also important to know how to recognize and manage a sudden worsening of your breathing symptoms, known as a flare-up or exacerbation. Some flare-ups can be managed at home, but others warrant urgent medical attention. Shared decision-making with your healthcare team—where your voice is considered at every step of your disease management—is essential to high-quality care. Your care team will also monitor for other health conditions that often occur alongside COPD, known as comorbidities, and will refer you to a specialist if needed. If you experience signs of a severe COPD flare-up, also called a COPD exacerbation, your patient journey skips these steps – you need emergency care right away! Find out in the graphic below which symptoms indicate a severe COPD flare-up and how to proceed. Don’t forget to follow up with your regular doctor to review your treatment plan after an emergency room visit or a hospital stay for a COPD flare-up. The information below covers care at both the primary care level (your family doctor or general practitioner) and the specialist care level. For the best experience, we recommend reviewing the earlier modules on this Patient Portal to become familiar with key terms. You can also consult our Glossary for additional support. Keep in mind that access to certain healthcare providers and medications can vary depending on your country and local healthcare policies. The chart below gives a general overview, but the exact steps or options may be different where you live. Step 1A: General practitioner: diagnosis If you experience symptoms such as a cough that keeps coming back (with or without phlegm), breathlessness – especially during physical activity – wheezing, or frequent chest infections, it is important to visit a doctor to find out what is going on. This is especially important if you smoke or used to smoke, are over 40, or have a history of exposure to risk factors for COPD. You’ll likely visit your general practioner (GP) first. Your GP will assess you by asking specific questions about your symptoms and medical history, perform a physical exam, and – if available, perform a lung function test called spirometry. Your doctor might also order additional tests, such as a blood test. It is important to know that asthma must be ruled out before a COPD diagnosis is made, as the two conditions require different treatment approaches. Spirometry is the most important test for diagnosing both asthma and COPD. Your doctor may also check for heart conditions, such as heart failure, because these can cause similar symptoms and often occur alongside COPD. After the evaluation, a clear treatment plan will be provided, and follow-up care can usually continue with your GP. One of the most important parts of COPD treatment—besides quitting smoking if this applies to you—is using one or more inhalers. The type and number of inhalers you need depend on how severe your symptoms are and how likely you are to have flare-ups. These inhalers contain medications called bronchodilators, which help open your airways and make breathing easier. If you have a high level of eosinophils in your blood (a type of white blood cell involved in inflammation), you may be prescribed an inhaler that also contains inhaled corticosteroids (ICS). ICS are not helpful for everyone with COPD, so your healthcare provider will carefully evaluate whether they are appropriate for you. Step 1B: General practitioner: Follow-up It’s important to attend a regular COPD review with your GP, at least every six months. This check-up helps make sure your COPD action plan is still right for you, that you’re on the best treatment and dose for your current situation, and that you’re using your inhaler correctly. Get optimally prepared for your follow-up visit with our “How to Prepare for Your Follow-Up Consultation” PDF. If your COPD is well controlled, your treatment may stay the same—or be reduced (called “stepping down”) to the lowest dose that still keeps your symptoms under control. If you experience persistent breathlessness or you have recurrent flare-ups, your GP will evaluate your smoking status and exposure to lung irritants, whether you’re using your inhaler the right way, and whether you are able to stick to the treatment plan. Your lung function may be tested again. All of this helps guide the next steps in your treatment. That might mean switching to a different inhaler, adding another medication, or adjusting your current dose (called “stepping-up”) to better manage your symptoms. Your GP may also suggest that you attend a pulmonary rehabilitation programme (depending on your healthcare system) or refer you to a lung specialist, also known as a pulmonologist or respiratory physician. Pulmonary rehabilitation is a programme designed to improve your lung health and physical fitness. It combines exercise training with education about your condition and often involves different healthcare providers working together in a multidisciplinary team. If you’ve had a COPD flare-up that you managed at home with your rescue medications, you should see your GP as soon as possible—ideally within two days of starting the rescue pack, or sooner if your symptoms get worse despite treatment. If your flare-up required a visit to the emergency room or a hospital stay, you should book a follow-up appointment with your GP within two days after

COPD Patient Initiatives

Back Patient initiatives Every patient’s and carer’s experience is unique, and every story matters. Here, you can explore the initiatives that bring the Chronic Obstructive Pulmonary Disease (COPD) community together, highlight patient voices, and shine a light on what it means to live or care for someone with this disease. Be inspired by the journeys, ideas, and efforts of patients and carers shaping the conversation around COPD every day. Your voice matters! Be part of the conversation and make a real impact for people living with airway diseases. Visit our Get Involved page to discover opportunities to share your experiences, contribute to surveys, advisory boards and other activities with EUFOREA. World COPD Day Organised by Global Initiative for Chronic Obstructive Lung Disease.  Each year, this day shines a light on COPD and the patient experiences behind it. It’s a chance to learn more about the disease and see the work being done to support patients worldwide. Learn more about World COPD Day 2025 See a list of allergy and airway diseases awareness days Did you know? To mark World COPD Day 2025, on 19 November 2025, EUFOREA launched this COPD patient portal. A new space designed to empower patients and carers through knowledge, connection, and shared experience. Speak up for COPD Organised by Global Allergy & Airways Patient Platform (GAAPP) This global campaign calls on policymakers and healthcare systems to recognise the impact of COPD and take action to improve prevention, early diagnosis, and care. It reflects the global effort to ensure that the voices of people with COPD are heard. Learn more about the campaign Patient Stories & Testimonials Learn from others’ experiences Read or watch stories from patients living with or carers for someone with COPD. Each story helps bring awareness to the everyday realities of the condition and inspires understanding in others. https://vimeo.com/1138108281https://vimeo.com/1138107375https://vimeo.com/1138106554https://vimeo.com/1138106374 View all stories Patient organisations Find reliable patient organisations Explore organisations that provide disease-specific information, updates on patient initiatives, and ways to stay connected with the COPD community. Disclaimer This website does not provide medical advice. The information, including but not limited to, text, graphics, images, and other material contained on this website is for informational purposes only. No material on this site is intended to be a substitute for professional medical advice, diagnosis, or treatment and/or medical treatment of a qualified physician or healthcare provider. EUFOREA is not a medical organisation and cannot provide specific medical advice to patients via the Internet and/or E-mail. All patients are encouraged to direct their specific questions to their personal physicians. EUFOREA presents this information to patients so that patients can understand and participate in their own medical care. EUFOREA strongly emphasises that the information contained on this website is not a substitute for thorough evaluation and treatment by a qualified healthcare provider. Copyright © 2025 – EUFOREA – All rights reserved. All content on this portal, such as text, graphics, logos and images, is the property of EUFOREA. They may not be reproduced, copied, published, stored, modified or used in any form, online or offline, without prior written permission of EUFOREA. Overview Patient initiativesWorld COPD DaySpeak up for COPDPatient Stories & TestimonialsPatient organisations

Common questions about COPD

Back Our FAQs address detailed and common questions about COPD. If you still have unanswered questions after reviewing this portal, feel free to contact our team at contact@euforea.org. Please note that we cannot answer personal inquiries. COPD diagnosis How is COPD diagnosed? The diagnosis of COPD may be suspected based on your symptoms (breathlessness, long-term coughing, recurrent chest infections) and the presence of certain risk factors, such as a history of smoking or long-term exposure to dust, fumes, or chemicals at work. To confirm the diagnosis, your doctor will perform a breathing test called spirometry. During this test, you blow into a tube connected to a machine that measures how much air you can exhale and how quickly. This reveals whether your lungs have difficulty pushing air out, a key sign of COPD. Sometimes, additional tests are performed to confirm the diagnosis or to check for other conditions that may occur together with COPD. Unfortunately, many people with COPD go undiagnosed because symptoms develop slowly and are often mistaken for normal aging or the effects of smoking. Some people also delay seeing a doctor because they feel guilty about smoking, and doctors may not immediately suspect COPD since symptoms resemble other conditions. If you experience long-term breathing issues, talk to your healthcare provider. I always thought COPD only happened to smokers, but I’ve never smoked in my life. How can that be? First of all, we understand that being diagnosed with a long-term health condition can bring feelings of powerlessness, frustration, or disappointment. These feelings are completely valid, and it is normal to need time to adjust and to wonder why you developed this condition. It is important to know that anyone can develop COPD. Although it is often referred to as a “smoker’s disease,” this is not always the case — about one in four people with COPD have never smoked. Other risk factors include long-term exposure to lung irritants (such as air pollution, secondhand smoke, dust, fumes, or chemicals at work), as well as frequent chest infections, maternal smoking during pregnancy, and being born prematurely. In rare cases, COPD is caused by a genetic condition called alpha-1 antitrypsin deficiency. What is the difference between asthma and COPD? Asthma and COPD both cause breathing problems like coughing, wheezing, and shortness of breath, but they are different conditions. Asthma often starts earlier in life and symptoms usually come and go. In between attacks, breathing is often normal. COPD usually affects people over 40 and is linked to long-term exposure to lung irritants like cigarette smoke or air pollution. In COPD, symptoms tend to be present most of the time and gradually get worse. Lung function tests and your medical/family history help your doctor tell the difference, although telling them apart is not always easy. Asthma can sometimes appear later in life, and some people have features of both conditions. This overlap can make diagnosis tricky, which is why lung function testing is so important for getting an accurate diagnosis. I was recently diagnosed with COPD. How long do I have to live? COPD is a long-term health condition that currently cannot be cured, but it can be treated and managed. Over time, the disease usually gets gradually worse, but the rate of progression varies from person to person. When you ask your healthcare provider about life expectancy, it can be difficult to get a clear answer. This is because it depends on many factors, such as the stage of your COPD, your age, overall health, and whether you smoke. You can take important steps to help manage your COPD: quit smoking if you haven’t already, go to regular check-ups, avoid lung irritants, use your COPD medicines as prescribed, stay up to date with vaccinations, and maintain a healthy lifestyle with regular exercise and a balanced diet. COPD treatment Why am I not on oxygen therapy, despite feeling breathless? The feeling of shortness of breath does not necessarily mean you need oxygen therapy. The need for supplemental oxygen depends on the level of oxygen in your blood. This can be measured with a blood test, called an arterial blood gas test. Most people with COPD can manage their breathlessness with inhalers and breathing exercises. Breathlessness can have multiple causes including lung disease, heart disease, deconditioning (loss of physical fitness and muscle strength due to inactivity or bed rest), and psychological reasons. Why do I need to quit smoking if the damage to my lungs is already done? Even though it might feel pointless to quit smoking now, stopping it is the most important thing you can do to help manage your condition. You can still get major health benefits, such as slowing lung damage, improving your quality of life, and lowering your risk of lung cancer. The tobacco smoke you inhale also irritates lungs and can make your COPD symptoms worse, so quitting will help you breathe easier. It is never too late to quit! Why has my healthcare provider recommended to participate in a pulmonary rehabilitation programme? Pulmonary rehabilitation is designed for people living with long-term lung conditions who find that breathing problems affect their daily life. The programme includes exercises to improve your fitness and breathing, as well as education about the disease and management strategies. Scientific research shows that pulmonary rehabilitation can help many people with COPD, even for people with more advanced disease. It improves breathing, increases energy, and enhances overall quality of life. Can COPD be cured? Unfortunately, COPD cannot be cured, but it can be managed with the right treatment and lifestyle changes. In general, COPD is considered to be a progressive disease, which means it may gradually worsen over time. However, recognising early warning signs and getting diagnosed early allows you to start treatment sooner. This helps slow disease progression and improve your quality of life. Living with COPD Why is it important to watch my weight? Maintaining a healthy weight is important for several reasons. Eating well helps your body stay strong

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