What’s the difference between emphysema and COPD?
Chronic obstructive pulmonary disease (COPD) is the name for a group of diseases that reduce airflow in and out of your airways, making it harder to breathe. COPD and emphysema have similar symptoms and treatments, but they are not the same thing. Emphysema is a type of COPD.
The National Heart, Lung, and Blood Institute classifies COPD into two conditions:
- Emphysema: Damage to the air sacs in the lungs makes it difficult for the lungs to inflate, which makes it harder to breathe.
- Chronic bronchitis: Inflammation in the airways leads to a chronic cough. Thick mucus forms in the airways, making it harder to breathe.
Emphysema tends to represent a later stage of COPD than chronic bronchitis, as emphysema involves lung damage.
COPD is common, affecting over 15 million adults in the United States. The American Lung Association reports that 3 million adults have emphysema. COPD is often preventable and, while there’s no cure, treatments can help you manage the condition. Recognizing the symptoms early improves how well your body can recover.
What are emphysema and COPD?
COPD is the name for a group of lung diseases. They are known as “chronic obstructive” diseases because they cause long-term blockages in the respiratory system.
Emphysema is a type of COPD. This means everyone with emphysema has COPD — but people can have COPD without having emphysema.
Emphysema arises when lung damage has already begun. Chronic bronchitis may develop at an earlier stage of COPD. Both conditions are progressive, meaning they get worse over time.
Medical professionals use the Global Initiative for Obstructive Lung Disease (GOLD) criteria to assess the stages of COPD:
- Stage 0: at risk
- Stage 1: mild COPD
- Stage 2: moderate COPD
- Stage 3: severe COPD
Symptoms of emphysema
Emphysema is a lung condition that develops gradually as lung tissue gets damaged over time.
The lungs contain many tiny air sacs (alveoli) that allow air to pass into the bloodstream. In emphysema, gradual damage causes these air sacs to burst. Air becomes trapped in the damaged tissue, preventing oxygen from entering the blood.
The symptoms of emphysema can take years to develop, and they become worse over time. Symptoms of emphysema include:
- shortness of breath
- chest tightness
- a wet cough
- weight loss
- barrel chest, where the lungs become overinflated
While there’s no cure for emphysema, effective treatments can help you manage your symptoms.
Symptoms of chronic bronchitis
Chronic bronchitis occurs when the tubes that connect your windpipe and lungs (the bronchi) become inflamed and produce excess mucus.
For a diagnosis of chronic bronchitis, you will have a cough with phlegm (mucus) that lasts at least 3 months and happens several times over a 2-year period.
Symptoms of chronic bronchitis include:
- excess mucus
- shortness of breath
- chest pain
Various treatments can help you manage bronchitis symptoms.
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Causes of COPD and emphysema
Smoking is the main cause of COPD, including emphysema. Quitting smoking is the most effective way to prevent COPD. That said, 30% of people with COPD have never smoked.
Other causes of COPD include:
- air pollution
- chemical fumes
- smoke from home cooking
- infections, including tuberculosis and HIV
- genetic factors
People who develop COPD are usually age 40 or older when they begin noticing symptoms. In addition, people with asthma are more likely to get COPD.
Treatments for emphysema and COPD
Many people are unaware they have COPD until the condition is advanced.
Medical professionals typically use similar treatments for people with COPD or emphysema. That said, emphysema represents lung damage seen in the later stages of COPD, so treatments may be more intensive than treatments for early stage COPD.
Bronchodilators are medications that relax the airways. Doctors may prescribe albuterol (Ventolin, ProAir) and other inhaled bronchodilators for any stage of COPD, including emphysema and bronchitis.
Oral corticosteroids, such as dexamethasone (Decadron) can help you manage acute symptoms.
Doctors may prescribe antibiotics when bacterial infections, like pneumonia, cause exacerbations. These can include:
Mucolytics make your mucus less sticky so that it’s easier to breathe. Guaifenesin is currently the only mucolytic approved by the Food and Drug Administration (FDA).
In addition to medications, oxygen therapy can help you with low oxygen levels (hypoxia) if needed. In severe cases, surgery to reduce the volume of the lungs can relieve pressure in the lungs.
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Is emphysema worse than COPD?
Emphysema is a type of COPD where lung damage has started to affect how well you can breathe.
People with other types of COPD may have fewer symptoms than people who have developed emphysema.
Emphysema is one type of COPD. It happens when the air sacs in the lungs become damaged.
Conditions that fall under the COPD umbrella are preventable, and while there are no cures, effective treatment options can help you manage your symptoms and improve your quality of life.
- Chronic bronchitis. (n.d.). https://www.lung.org/lung-health-diseases/lung-disease-lookup/chronic-bronchitis
- Chronic obstructive pulmonary disease (COPD). (2022). https://www.who.int/news-room/fact-sheets/detail/chronic-obstructive-pulmonary-disease-(copd)
- Emphysema. (n.d.). https://www.lung.org/lung-health-diseases/lung-disease-lookup/emphysema
- Fazleem A, et al. (2020). Early COPD: Current evidence for diagnosis and management. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7394029/
- Ferrera MC, et al. (2021), Advances in chronic obstructive pulmonary disease. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8011854/
- Higham A, et al. (2019). The pathology of small airways disease in COPD: historical aspects and future directions. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6399904/
- Learn about COPD. (2023). https://www.lung.org/lung-health-diseases/lung-disease-lookup/copd/learn-about-copd
- What is COPD? (2022). https://www.nhlbi.nih.gov/health/copd