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Asthma

Asthma and Chronic Obstructive Pulmonary Disease

10/22/2007

Question:

I`m in my mid-50s and have had asthma since I was a child. I have a peak flow meter at home and I have noticed that my morning peak flows are really pretty low. My morning peak flow is usually only about 50% of my personal best. I am not wheezing, or at least you can only hear a wheeze if I breathe out really hard on purpose, then you can hear plenty of wheeze, but not just by normal breathing. After I take my morning asthma meds the peak flow is better than 80% but it almost never gets up to 100% any more. I read a long time ago that asthma can cause Chronic Obstructive Pulmonary Disease. Is that true? How can you tell if you are getting Chronic Obstructive Pulmonary Disease? I have to admit I have not always been real great about taking all the asthma medications my dr. prescribes because a lot of them make me feel sick to my stomach. Could that cause asthma to turn into something else over many years?

Answer:

Asthma is a disease characterized by obstructed airflow that is reversible, meaning when given certain medications the obstruction gets better.  Chronic Obstructive Pulmonary Disease (COPD) is primarily a disease with irreversible airflow obstruction, meaning when given certain medications the obstruction does not improve.  It has been established that some patients with asthma for many years, 25-30 years, can develop airflow obstruction that is irreversible, i.e. COPD.  Why this occurs and why it only occurs in some and not all asthma patients is currently unclear.  Currently the recommendations to take prescribed controller medications every day are in part due to the thinking that daily use of these medications will suppress inflammation-induced scarring which may contribute to the development of COPD.  There is still much research to be done in this area.

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Response by:

John G Mastronarde, MD John G Mastronarde, MD
Clinical Professor of Pulmonary, Allergy, Critical Care & Sleep
College of Medicine
The Ohio State University