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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Is spirometry must for the diagnosis of chronic obstructive pulmonary disease (COPD)?

Answered by
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Dr. Kaushal Bhavsar

Pulmonologist

Practicing since :2008

Answered : 14243 Questions

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Posted on Fri, 28 Dec 2018 in Lung and Chest disorders
Question: I just recently had a chest x-ray done when I was having some throat surgery done. That all turned out to be two benign cysts. One was a tonsillar cyst, and the other was an eryepligottic one. Anyway, it said that my lungs were hyperinflated, and that I have mild biapical pleural thickening. It is that necessarily COPD or could it be from having my C-pap pressure at 6 because my stomach is full of air in the morning, plus I am burping up air most of the time as soon as I get up in the morning. I am scheduled now for a spirometry which I saw my doc about the other day. That will be done on March 22. I am quite worried as the results said it was suggestive of COPD. XXXXXXX
doctor
Answered by Dr. Kaushal Bhavsar 25 minutes later
Brief Answer:
Yes, get done spirometry.

Detailed Answer:

Spirometry is a must for the diagnosis of COPD (chronic obstructive Pulmonary disease).
So COPD diagnosis should not be made only on the basis of chest X-ray.
If spirometry is suggestive of obstructive airway defect then the possibility of COPD is more.
Spirometry will also tell you about the severity of the disease and treatment is based on severity only.
Please let me know
1. Do you have breathing difficulty?
2. Do you smoke currently or in the past?
Please reply me answers to above-asked questions, so that I can guide you better. I will be happy to help you further. Wish you good health. Thanks.

Dr. Kaushal Bhavsar,
Pulmonologist
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Kaushal Bhavsar 3 hours later
Hi Dr. Bhavsar,
Yes, I did smoke for about 15 yrs, but quit at 39 years of age. A package of cigarettes would last me a week or more, so I was not a heavy smoker.

I do not have any breathing symptoms, but as I had said, I do have sleep apnea, which I am being treated for by C-pap, but it is causing me problems. I usually burp up air in the morning, and my stomach gets full of air as well. I have an appointment which was made for me by a sleep apnea specialist to see about trying a dental appliance for sleep apnea. That will be end of April that I see them for that. I would be interested to see if you have any more comments regarding this, as it sounds like you do not think the air inflation of my lungs would be to do with C-pap. I will wait to hear back from you. Many thanks, XXXXXXX
doctor
Answered by Dr. Kaushal Bhavsar 17 hours later
Brief Answer:
Burping and stomach gas are due to Continuous positive airway pressure (CPAP) but not hyperinflation.

Detailed Answer:

CPAP use can cause burping and stomach gas.
But it can not cause hyperinflation and COPD changes in lungs.
To prevent burping, you need to regulate pressures on the CPAP machine.
By reducing inspiratory pressure, this burping and stomach gas problem can be solved.
Or you can think of other treatment for sleep apnea other than CPAP machine like dental implants, mandibular surgeries etc.
But again you should get done spirometry to confirm COPD.
If spirometry is normal then no need to worry for hyperinflated lungs.
Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.
Dr. Kaushal Bhavsar,
Pulmonologist
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Kaushal Bhavsar 4 hours later
Are there any other issues that can cause hyperinflated lungs? Other than COPD. Thanks, XXXXXXX
doctor
Answered by Dr. Kaushal Bhavsar 8 hours later
Brief Answer:
Asthma, voluntary deep inspiration can also cause hyperinflated lungs.

Detailed Answer:

Other than COPD, hyperinflated lungs are commonly seen with Asthma, early ILD (interstitial lung disease), voluntary deep inspiration and breath holding while taking X-ray, interobserver variation (radiologist error).
Hyperinflated lungs on chest X-ray are significant only when PFT is showing abnormal values.
Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.

Dr. Kaushal Bhavsar, Pulmonologist
Above answer was peer-reviewed by : Dr. Kampana
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