Asthma and COPD both cause airflow obstruction and breathlessness, but they are different diseases with different causes, different physiologies, and different treatment priorities. Asthma typically has a significant allergic component, presents across all ages including in childhood, and is characterised by reversible airway obstruction that responds to bronchodilators. COPD is overwhelmingly caused by smoking or biomass fuel exposure, produces largely irreversible airflow limitation, and tends to present in middle age and beyond. Spirometry is the essential investigation that distinguishes them: the degree of reversibility after a bronchodilator, together with the pattern of the flow-volume loop, tells me far more than the clinical history alone.
Written by Dr. Subhajit Sen, MBBS, MD (Pulmonology/Respiratory Medicine), Consultant Pulmonologist, West Bengal. 12+ years of clinical experience. Phone: +91 8282857661.
