Does inflammation continue in copd even years after stopping smoking?

[Lemon7]

I know that stopping smoking makes the deline of fev1 return to normal age related decline. However, does the inflammatory process that starts with this illness continue?

[hypercat54]

Hi no it doesn't necessarily. The damage to your lungs is unfortunately permanent and stopping smoking can only slow down the progression. If you are very mild then you might return to just age related progression, but not if you are at the more severe stages.

I am not sure what you mean about inflammatory processes? You are more likely to get chest infections and exacerbations or they are worse with copd. Also these can further compromise your lungs so it is very important to look after them well. x

[Lemon7 in reply to hypercat54]

No I didn't mean chest infections or exacerbation. When copd starts it causes lung damage and one of the ways is by inflammation. I wanted to know if this inflammation continues even after stopping smoking.

[hypercat54 in reply to Lemon7]

Inflammation occurs when you have an exacerbation. If you have copd then you are more likely to get an exacerbation. x

[2greys]

Short answer is yes, you are still susceptible to inflammation with or without an infection. Allergic reactions and triggers can cause inflammation.

10 mins of exposure to the smoke from wood burners or bonfires causes a 24 hour inflammatory response in me. Not a pleasant experience.

[Lemon7 in reply to 2greys]

Thanks

[stone-UK]

Hi

As you are aware COPD, is a umbrella term for Chronic Bronchitis inflammation of the airways. Noticeable by excess mucus production.

Emphysema damage to the Aveoli. Noticeable by poor gas exchange and air trapping.

Both conditions can be inflamed by toxic smoke or foreign matter.

Inflammation of the airways are also more susceptible to infection.

Emphysema is susceptible to triggers.

Both can lead to full blown exacerbation.

These no correct definition, of normal FEV1 decline.

There are several factors that can hasten FEV1 decline. Not just smoking.

[hypercat54 in reply to stone-UK]

Thank you stone, you put that very well and in bullet points which is easier to understand. x

[Lemon7 in reply to stone-UK]

Thanks

[Hidden]

A study I was reading about showed that inflammation continues for at least five years after smoking cessation, that was the length of the study so it probably continues for longer.

I believe the FEV1 returning to a normal rate of ageing is only relevant for a small portion of people and is mainly used as a tool for smoking cessation.It has also been proven that lung function decline is quicker in the earlier stages of the disease.

Most people with COPD decline at a quicker rate as shown by the reduction in FEV1 % over time. If we all returned to the normal rate then it wouldn't be a progressive disease IF we stopped smoking and our FEV1 % would still be the same 20/30 years after diagnosis.

The question about who has remained mild for a long period of time has cropped up alot and not many answer the question, which speaks volumes.

I would imagine that continuing inflammation plays a very big part in lung function decline.

[Lemon7 in reply to Hidden]

I have just read a bmj report that also suggests inflammation continues in non smokers with copd. They don't know all the reasons but some suggest it could be because it becomes like an auto immune disease where body attacks itself. I asked if anyone has remained mild for long and didn't get many responses. I have just been newly diagnosed with mild copd and also saw somewhere that it progresses quicker in early stages of disease. This is very scary and worrying to me because people say you won't die from it but with it, my fears are not how many years I have but quality of life in those years. Thanks for your honesty.

[Lemon7 in reply to Hidden]

Hi again, can you remember which report you read that said inflammation continued for 5 years, the length of the report etc.? I would like to read it.

[Hidden]

I don't unfortunately, I've read hundreds of things regarding COPD. Most say inflammation continues but this was a study over five years, that's all I remember I'm afraid.

[Lemon7 in reply to Hidden]

Do you mind me asking if you have copd, stage, when diagnosed, how many years, any changes etc? Your reply was so honest and reflects what I have read. Not just referring to exacerbations and infections.

[Hidden]

I was diagnosed via a spirometry test at work with a FEV1 of 79% two years ago. I then went to my GP and had another test a few months later which showed a FEV1 of 75% before inhaler and 82% afterwards.

The surgery didn't seem concerned so I paid privately to see a specialist who arranged a CT scan and full PFT at the hospital.

The CT scan showed ''minimal Emphysema'' and lung function test was 80% after inhaler.

I was told that as I had stopped smoking that it wouldn't get worse, I am not on any inhalers and was told to just carry on with work spirometry. Last years FEV1 was 79% , obviously without inhaler, same as the first one.

[Lemon7 in reply to Hidden]

I quit smoking 19 years ago. I am 63 newly diagnosed with copd mild. My fev1 was good so therefore mild but fev/FVC ratio was below the 70 threshold. Mine was 65 so it is obstructive. No improvement after bronchodilator on test meant not asthma but copd. My gp said I can't have CT scan to see if it's emphysema. However I don't have cough or mucus and only had bronchspasm in cold air and hurrying on level ground. Previously had shortness of breath on exertion, but mild. My mum has emphysema so I assume I have same, lack of chronic bronchitis symptoms at moment. However I am worried that the reports of persistent inflammation even in ex smokers and the fact that I quit so long ago and still went on to suddenly have symptoms and be diagnosed means it will continue to worsen regardless.

[Hidden in reply to Lemon7]

I had a random ct scan and got told i have emphysema changes on my lungs almost 3 years ago. And i was told most people don't find out until there about 63

[Gulgaio in reply to Lemon7]

I stopped smoking at 28 yo. Stopped due to cough. Now at 48 after some be years with mucus and stuff in realize I have Chronic Bronchitis. Fev1 around 70, which means 83% of expected so mild COPD.

If you do not have Chronic Bronchitis symptoms it is not too bad. Research I reviewed gives an average decline per year of;

5-20 ml per year for normal people

40-60ml for emphysema sufferers

And around 100 ml for Chronic Bronchitis sufferers.

Upsides:

I am still mild and will likely be in my 70' before it gets to bad.

A few therapies for ablating the lungs seems to be on the way (early stage) for ablating the lungs and throw without mucus producing goblet cells - for CB sufferers (CSA medical and Gala therapy)

But naturally we should be doing all we can to be in best shape in 20 years when they have been the real cure ready ... Or to just be able to enjoy the ride....

[Lemon7 in reply to Gulgaio]

Thank you for replying. Good wishes to you

[Lemon7 in reply to Hidden]

Also meant to ask if it was your private dr who said you wouldn't worsen or was it your GP?

[Hidden in reply to Hidden]

Yours sounds the same as mine about 80 but when i have a lung function test they don't use an inhaler just do the test.

[lKeith]

Lemon7

Hi Unfortunately COPD tends to be a progressive ailment, it therefore follows that the disease worsens with age and does not get any better with time. If you no longer smoke it will help to slow down the process.

IKeith

[Lemon7 in reply to lKeith]

I stopped smoking 19 years ago. I had mild shortness of breath on exertion over for a few years but I am petite female, 63 years old heavy gardening etc brought it on. Just recently had bronchspasm running for bus on level and on hill in cold air. Went to Dr and because my mum and her sister had emphysema was sent for spirometry. I have mild copd with good fev1. Won't give me CT scan so because I have no cough or mucus at moment believe it is likely emphysema more than chronic bronchitis. I had read accredited medical reports that even after stopping smoking inflammation persists in copd. This is making me fearful that I will still decline a lot especially as I have obviously got symptoms now all these years after quitting.

[lKeith in reply to Lemon7]

Lemon7

Hi again, At least you seem to be doing the right things, exercise, diet and working at a slower pace. There re many on this site that have worked around the disease and have lasted quite a while so your worries can be shared and your load lightened. You are not alone, this site will hopefully support you. For many their situation is already far worse and for many of us there is nothing left to treat, you on the other hand can take treatments especially as you seem to live a fit life.

Good luck, but do please start to search around for treatments while it's easier to be selective.

IKeith

[Comley1964 in reply to lKeith]

If you stop smoking slows down 48% nearly the same as none smoker .8% double a none smoker I found this report on the net

[Lemon7 in reply to Comley1964]

Thanks. Can you direct me to it? I take it you mean inflammation reduces and not lung function loss?

[soulsaver]

In simple terms:

Bronchitis is inflammation of the bronchial tubes.

Symptoms would be cough & excess mucous production.

You don't have those symptoms.

You've done the hard bit stopping smoking; try to stop worrying and follow the standard advice, get fitter, get a good bmi, eat healthily, avoid crowds in the colds season.

You'll be fine for decades to come.

Best wishes

[Lemon7 in reply to soulsaver]

I hope you are right soulsaver. Thanks again for replying. As mentioned before I don't have cough or mucus so assume I have mostly emphysema (my mum and her sister had emphysema). The GP said I will not be given CT scan to prove emphysema. I was ok only noticed shortness of breath on heavy gardening, exertion for few years. As now 63, petite female thought nothung of it. Recently running for bus and cold air on hill brought on bronchspasm. Saw dr, spirometry ruled out asthma, copd mild diagnosis because fev1 good. However recently read accredited medical reports saying that inflammation persists even in ex smokers with copd. Even theory that it could be auto immune response meaning body attacks itself. This has made me afraid that I will still worsen a lot even 19 years after quitting smoking because of developing my recent new symptoms.

[Schmicter]

If wheezing, coughing , and shallow breathing are symptoms of inflammation, then I can say they all went away after I quit smoking.

[Lemon7 in reply to Schmicter]

I gave up smoking 19 years ago. My mum and her sister had emphysema. I am 63 now. For a few years heavy gardening brought on shortness of breath. As I am old and petite female I didn't think anything of it. Few months ago running short distance on flat for a bus brought on bronchospasm. So did walking on hill in cold air. Then noticed mild wheeze lying in bed at night. Went to Dr sent for spirometry. Ruled out asthma. Copd obstruction but mild because fev1 level good. GP said won't get CT scan to show emphysema. As at moment I have no cough or mucus I assume I am most likely to be more emphysema copd. However I have read accredited medical reports saying that inflammation persists even in ex smokers with copd. That's made me fearful that I will still worsen a lot even though I quit smoking 19 years ago. I have recently got these new symptoms even though it's so long since I quit.