Obstructive pulmonary disease: what is it

Obstructive pulmonary disease: what is it

Publication date: 03-11-2021

Updated on: 14-02-2023

Topic: Lung diseases

Estimated reading time: 1 min

The pulmonologist from the St. Anna Clinical Institute explains what main respiratory disease is caused by cigarette smoking

Chronic obstructive pulmonary disease (COPD) is a degenerative and irreversible disease of the respiratory system characterized by persistent obstruction of the airways. Together with Dr. Piera Ranieri, pulmonologist at the St. Anna Clinical Institute, we found out what it is and how it can be treated.

Symptoms and causes

“COPD mainly manifests itself with persistent respiratory symptoms and limitation to the air flow (i.e., wheezing). A consequence, due to chronic and persistent inflammation of the airways, mainly caused by the damage of cigarette smoke and / or prolonged exposure to harmful environmental or work particles,” explains Dr. Ranieri.

Main risk factors

The factor that predisposes the most to the onset of this disease is tobacco smoke, but not only:

“Also, other types of smoke (such as pipes, cigars, marijuana) are risk factors for COPD, and even non-smokers can develop this disease as well.”

Another aspect not to be overlooked is the prolonged exposure to sources of pollution resulting from the use of biomass fuels. In fact, COPD is the result of a complex interaction of long-term exposure to harmful gases and particles, combined with a variety of patient genetic factors including hyperreactivity of the airways and less lung development during childhood.

Diagnostics: spirometry

The test with which COPD is discovered is spirometry – a simple diagnostic test that measures lung function and that highlights the presence and severity of irreversible bronchial obstruction typical of COPD.

Once the diagnosis of obstructive pulmonary disease has been made, it is necessary to evaluate its severity, its impact on the patient's health status and the risk of future exacerbations in order to set up an adequate treatment. When should the diagnostic investigation be done?

“Those with dyspnea (shortness of breath), chronic cough or expectoration and a history of exposure to risk factors for this disease should think about undergoing a medical examination to rule out the suspicion of COPD.”


A personalized assessment to reduce current symptoms and future risks of exacerbations is the treatment of choice:

“The drug therapy for COPD, almost exclusively by inhalation, is used for:

  • reduce symptoms;
  • reduce the frequency and severity of exacerbations;
  • improve exercise tolerance and health status.”

In addition to drugs, respiratory rehabilitation has proven to be a very effective therapeutic strategy for improving the sensation of air hunger, health and tolerance to physical exercise. To this must be added the degree to which the patient follows the doctor's recommendations regarding the doses, timing and frequency of taking the drug for the entire duration of therapy.

Furthermore, defeating the habit of smoking can positively influence the course of the disease with a consequent improvement in the results obtainable both from drug therapy and from respiratory rehabilitation.

Periodic monitoring and checks

In patients with obstructive pulmonary disease, periodic monitoring is essential. Explains Dr. Ranieri:

“Pulmonary function can get worse over time, even during an adequately calibrated therapy. Symptoms and exacerbations of bronchial obstruction should be monitored periodically to determine when the treatment needs to be changed and to identify any complications (such as respiratory failure) and / or the coexistence of other pathologies.”

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