This article was reviewed by Senior Director of Community Engagement and COPD360social Community Manager, Bill Clark, as well as certified staff Respiratory Therapists on February 4, 2020.
Dear COPD Coach,
I have stage 4 emphysema. It is impossible to eat without immediately feeling chest tightness or bloated like I am about to explode. I read about how the diaphragm gets pushed by the stomach and how it changes shape as COPD worsens. Does this mean that eventually I won’t be able to eat?
Thanks for writing. As a patient myself at stage 4, I also experience this. The mechanism you described is exactly correct! To answer your question, you will always be able to eat, however you are going to have to eat a little differently. As your lungs deteriorate, they become larger which then pushes against your stomach. When you eat large meals, your stomach pushes against your lungs and diaphragm which restricts your breathing. The key here is not to eat large meals or large portions, but instead eat smaller meals throughout the day. Also do not eat foods that can cause bloating or gas. Drinking plenty of water during the meals will also help ease the bloating. If you use supplemental oxygen, make sure you use it while you eat. When my wife and I go out to dinner, I tend to eat too much and have a difficult time returning to the car. I have since learned to order smaller portions, especially if I have to walk a long distance after the meal. I also make sure to eat throughout the day, several times a day, even if it is just a light snack. When I do this, I feel far less bloated.
Another thing that can help is to eat slowly. People with COPD can have a tendency to chew and swallow food too quickly which causes two problems: 1) difficult and slower digestion of meals 2) increased likelihood that you can choke or aspirate on your food which can cause a lung infection. Slow down, and make sure you are chewing your food thoroughly before you swallow to keep these issues from becoming a problem.
For information on what is best to eat, go to the COPD Foundation’s website and check out the information under the Learn More tab. There is a section there all about nutrition for people with COPD and includes information related to bloating. There you will find a list of the best foods along with lots of other useful lifestyle tips.
It is important to remember that when you eat large meals, you burn lots of calories in order to digest. You also burn calories just trying to breathe! So, the foods you eat must contain not only enough calories to augment what you are using up. In other words, learn to eat smart!
Hope this helps,
-The COPD Coach
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