7th December, 20202 min read

Acute exacerbation of chronic obstructive pulmonary disease (COPD)

Medical reviewer:
Dr Ann Nainan
Dr Ann Nainan
Dr Lauretta Ihonor
Dr Lauretta Ihonor
Last reviewed: 01/12/2020
Medically reviewed

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An exacerbation of chronic obstructive pulmonary disease (COPD) is when someone with COPD has a sudden worsening of their symptoms, such as breathlessness, coughing and coughing up phlegm (sputum). It’s also known as a COPD flare-up.

Your COPD symptoms can suddenly get worse for many reasons, including if you have a chest infection, are exposed to lots of pollution or if your COPD isn't well controlled.

How is a COPD flare-up diagnosed?

You should see a doctor or go to the emergency department immediately if your COPD symptoms seem to be getting worse. A doctor will usually be able to diagnose a flare-up based on your symptoms, previous history of COPD and a physical examination.

Sometimes, you may need some tests, including:

  • measurement of the amount of oxygen in your blood using a probe placed on your finger
  • chest X-ray
  • blood test
  • electrocardiogram (ECG)

Your doctor may also send a sample of your phlegm to a laboratory for tests.

How to treat a COPD flare-up

If you have a flare-up of COPD, a doctor may give you treatments to take or use at home, but if the flare-up is really bad, you may be admitted to hospital for treatment.

Treatment may include:

  • oxygen to help your breathing
  • antibiotics – if your doctor thinks you may have a bacterial infection in your lungs
  • inhaled medications that help open your airways
  • steroid tablets

You can reduce the risk of a future flare-up by not smoking (read more about how to stop smoking if you currently smoke), making sure you take your COPD medications as directed by your doctor and having regular check-ups to make sure your COPD is well controlled.

You should also have the recommended flu and pneumococcal vaccinations to help reduce your risk of a chest infection.


  1. Tidy C. Acute Exacerbations (Flare-ups) of COPD [Internet]. Patient.info. 2020 [cited 3 December 2020]. Available here.
  2. [Internet]. Dynamed.com. 2020 [cited 3 December 2020]. Available here.
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