Diagnosing COPD. How to identify patients with irreversible obstruction of the airways

Chronic obstructive pulmonary disease (COPD) is seen often in primary care offices. Its hallmark is dyspnea with obstruction. Smoking is the leading risk factor. Smokers should be counseled at every encounter to quit smoking to prevent development of COPD and lower the rate of decline of pulmonary function. Office spirometry detects the early changes of small airways obstruction. All patients with symptoms should receive baseline spirometry and follow-up spirometry once they have received maximal medical therapy. If evidence of obstruction is found and spirometric abnormality persists after therapy, COPD is present. Treatment early in the clinical course can markedly improve COPD and avoid the severe disability of end-stage disease.