COPD Flare-Up Causes

by John Bottrell Health Professional

Chronic Obstructive Pulmonary Disease (COPD) is one of those diseases, like asthma, that flares up from time to time.
When this happens your breathing and coughing symptoms suddenly get worse.
What causes them and what exactly happens?

There are essentially four things that might cause a COPD flare-up, or what many refer to as COPD exacerbations.

Common COPD triggers

COPD lungs tend to be very sensitive due to chronically inflamed air passages, and for this reason they tend to be very sensitive to things that are innocuous (harmless) to other people, such as air pollution, strong smells, temperature changes, gastrointestinal reflux, grasses, trees, pollen, dust, mold, and cold and dry air.

Generally, what happens is the chronically inflamed air passages become even more inflamed, and this causes them to spasm or constrict, thus resulting in narrowed air passages.
This causes air to become trapped inside your lungs, making it hard to breathe.
Medicines like albuterol, xopenex and duoneb can open up air passages, and systemic corticosteroids may reduce inflammation, both of which may make breathing easier.

Lung infections

Especially if you have chronic bronchitis, large amounts of secretions often become trapped in your lungs.
This can make it easy for common viruses and bacteria to collect in your lungs.
Some infections may lead to pneumonia, which may make breathing even worse.
Lung infections are the most common cause of COPD flare-ups. While antibiotics may help resolve bacterial infections, most infections are caused by viruses.

Heart failure

Especially during the end stages of the disease, the heart can become pooped out from working so hard to pump blood through diseased lungs, thus becoming a weak pump.
A pooped out heart is unable to keep up with the bodies demands.
This causes fluid (blood) to back up into the lungs, thus making it hard to breathe.
Various medicine can help remove fluid from your lungs, and strengthen your heart, to make breathing easier.


Sometimes the cause is never learned; it remains a mystery. Sometimes the cause is all three of the above, or any combination.
Because it's unknown, treatment may involve assuming all three causes and treating them all.
When this happens, it may also never be known which medicine worked.

So you can see that there are four basic causes of COPD flare-ups.
Which treatment your doctor prescribes may depend on which one they presume to be the cause.

John Bottrell
Meet Our Writer
John Bottrell

John Bottrell is a registered Respiratory Therapist. He wrote for HealthCentral as a health professional for Asthma and Chronic Obstructive Pulmonary Disease (COPD).