The most important difference between COPD and asthma is the prognosis (future course) of the diseases. Most asthma is controllable with correct medications and lifestyle changes. Many patients with asthma can enjoy normal lung function and normal levels of activity when their asthma is under control. For most patients with COPD however, the course is more complicated, especially if they continue to smoke. Patients with COPD often continue to lose lung function over time. The lungs remain chronically inflamed, and small infections, like chest colds or the flu, can become major illnesses. The chronic inflammation of COPD is also linked, gradually to other health problems, like heart disease, lung cancer, and chronic weight loss, sometimes to the point where patients with COPD lose so much muscle mass that they have difficulty breathing and performing normal activities. COPD can also cause heart failure, especially of the right side of the heart.
Importantly, making a distinction between asthma and COPD is crucial, because the treatments can be different. Many patients with asthma should be treated with inhaled steroids (long-acting anti-inflammatories) whereas only patients with the most severe COPD should be on this treatment. It is also important to recognize that stopping smoking is fundamental to slowing lung function loss.
Many primary care providers, may be uncomfortable making the diagnosis of COPD, partly because it is hard to distinguish from asthma, and partly because they may feel that the diagnosis of “COPD” carries a stigma due to its close association with cigarette smoking. If you or someone you know might have COPD, it is important to see your health care provider and get appropriate testing, which should include a thorough medical history and physical exam, a chest x-ray and breathing tests. All smokers should be screened with a breathing test, according to the National Lung Health Study.
Future blogs will discuss breathing tests, known formally as Pulmonary Function Tests or PFTs, how they are performed, and what they measure. I will also discuss how breathing tests can determine your “lung age” and what this means.
Have you or someone you know performed breathing tests? Have your health care providers screened smokers or former smokers you know with breathing tests? What is your experience?
