The sceptic might ask, 'Is there any benefit in making this distinction'? Both conditions are forms of airflow limitation that are treated by inhaled bron-chodilators. Both have an element of inflammation, so that particularly in the more severe cases, the patients receive inhaled steroids. If the treatment is the same, why bother making a distinction?
However, the causes and pathological processes underlying the two conditions are quite different. The natural history and the outcomes of treatment are very different, and thus guidelines suggest that both the management plan and the monitoring of treatment should not be the same.
Differentiation can be made in terms of clinical presentation, physiology, and pathology.
COPD is rarely present under the age of 40. Thus, younger patients with wheezing and airflow obstruction are almost always going to have asthma or occasionally one of the less common causes of airway obstruction, such as bronchiolitis. In patients over the age of 40, the overlap between the two con-
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If you suffer with asthma, you will no doubt be familiar with the uncomfortable sensations as your bronchial tubes begin to narrow and your muscles around them start to tighten. A sticky mucus known as phlegm begins to produce and increase within your bronchial tubes and you begin to wheeze, cough and struggle to breathe.