Sometimes your symptoms may get worse over a short time and stay bad. This is called a COPD exacerbation (say "ig-ZAS-ur-BAY-shun") or flare-up. A flare-up can be dangerous, so it's important to know what to do and take action. Your doctor can help you make a plan to manage flare-ups.

Symptoms of a flare-up include:

• More shortness of breath than usual.
• Coughing more than usual.
• A change in the amount, color, or thickness of mucus.

What causes them?

Many irritants or triggers can cause your symptoms to get worse over a short time. Common causes of a COPD flare-up are respiratory tract infections such as colds, flu, and pneumonia. Other causes include indoor and outdoor air pollution such as smoke, fumes, and soot.

What happens during a flare-up?

When you have a COPD flare-up, your airways get irritated. Airflow in and out of your lungs is reduced. It gets harder to breathe. Your symptoms get worse over a short time and stay bad. Symptoms may get better with medicines and care at home. Sometimes care is needed in the hospital.

How are they treated?

Treatment of a COPD flare-up, or exacerbation, depends on how bad the flare-up is. Mild flare-ups may be treated by following your doctor's instructions for using a quick-relief (short-acting) inhaler or oral steroid medicines. More severe flare-ups may involve visits to your doctor's office or clinic. Or you may need to be treated in the hospital. Treatments include:

• Quick-relief inhaled bronchodilators. These medicines relax the bronchial tubes and make it easier to breathe.
• Oral steroid medicines. They help your lungs work better.
• Oxygen, to increase the amount of oxygen in your blood.
• A machine to help you breathe better or to breathe for you. These are called ventilation machines.

Treatment may also include:

• Intravenous (I.V.) fluids to treat dehydration.
• Other bronchodilators.
• Antibiotics. Your doctor may prescribe antibiotics to help treat a bacterial infection.