Many, if not most, individuals with COPD have experienced a flare-up or worsening of shortness of breath and/or a productive cough. The medical word for a flare-up is an exacerbation. Generally, the causes of a flare-up include a respiratory infection, either viral or bacterial, and environmental - such as inhaling pollutants in the air. Other possible causes include heart disease, inflammation in the lungs, and psychologic factors - such as anxiety or a panic attack. Appropriate treatment requires the correct diagnosis.

To reduce the chances of another flare-up: do not smoke and avoid inhaling airborne irritants; be up to date on vaccines; do regular exercise; use an inhaled medication approved by FDA that reduces the chances of flare-ups. Furthermore, four medical conditions should be considered: 1) Aspiration - when food, saliva, liquids, or vomit slips into the lungs; 2) Bronchiectasis - a chronic lung condition in which the walls of the large airways (breathing tubes) become damaged and widened; 3) Common Variable Immune Deficiency - a deficiency of Immunoglobulin G makes someone more susceptible to a bacterial infection; and 4) Vitamin D deficiency.

Indoor particulate matter (air pollution) is associated with worse COPD outcomes. In a research study, former smokers with moderate to severe COPD received either active or sham (pretend) high-efficiency particulate air cleaners for 6 months. Those who had an air filter experienced a greater reduction in respiratory symptoms, lower albuterol rescue use, and a lower rate of moderate but not severe flare-ups (exacerbations) compared with the sham group. Possible concerns of using an air cleaner include a higher electricity cost and possible noise when used in the bedroom if you are a "light" sleeper.

Vitamin D boosts the body's immune system and reduces inflammation. The major natural source of Vitamin D is the skin that is dependent on exposure to ultraviolet rays from the sun. Only a few foods, such as fatty fish (salmon and tuna) contain significant amounts of vitamin D. In an analysis of 42 different studies, taking vitamin D reduced the risk of acute respiratory infections by 9% compared with placebo. Daily doses ranged from 400 to 1,000 international units (IU). There were no reported serious side effects associated with Vitamin D supplementation.Add excerpt here