COPD vs. Asthma

Asthma and COPD are both chronic lung diseases.

What is COPD?

COPD (chronic obstructive pulmonary disease) is a lung disease caused by chronic interference with lung airflow that impairs breathing and is not fully reversible. Usually, symptoms, for example, shortness of breath, recurrent coughing, clearing throat, and progressive exercise tolerance, worsen over time.

Many doctors and researchers (for example, the World Health Organization) consider terms such as chronic bronchitis and emphysema as forms of COPD. The major cause of COPD is smoking.

What is asthma?

Asthma is a respiratory condition marked by spasms of the bronchi, due to inflamed and narrowed airways in the lungs. Asthma causes difficulty in breathing that often results from an allergic reaction. Many substances may trigger asthma attacks.

• Asthma usually causes recurring periods of shortness of breath, wheezing, and/or chest tightness.
• Often, asthma can be fully reversible with medical treatment and breathing can return to normal.

COPD is caused by long-term exposure to lung irritants that damage lung cells. The main cause of COPD in the United States is cigarette smoke followed by other tobacco smoke (including secondhand smoke). Other possible causes of COPD include chemical or toxic fumes, and inherited (genetic) factors, like alpha-1 antitrypsin deficiency, but these causes are far less common than cigarette smoking.

Although cigarette smoke may trigger asthma in some patients, asthma triggers are different from person to person, and most commonly include airborne substances such as pollen, dust, mites, mold spores, pet dander, and/or many other substances. Inflammatory immune reactions to asthma triggers in the airways are the main cause of asthma.

Similar symptoms of asthma and COPD are coughing, shortness of breath, chest tightness, and wheezing.

There are some similarities in the symptoms and signs of COPD and asthma:

• Coughing
• Shortness of breath
• Chest tightness
• Exercise intolerance
• Wheezing (a whistling or squeaking sound in the chest)
• Anxiety with increased heart rate may occur in both diseases.

There are some differences in the symptoms and signs of COPD and asthma:

• In asthma, breathing can return to normal between attacks, while breathing with COPD usually does not return to normal.
• The symptoms of COPD gradually become more severe. (This also may occur if you have asthma.)
• COPD produces more mucus and phlegm compared to asthma.
• Chronic cough is common with COPD.
• People with COPD often have chronic blueness to fingernail beds and/or lips (cyanosis).
• Asthma can occur in a person of almost any age, while COPD usually occurs in those over the age of 40. (Although some individuals can develop COPD at a younger age.)

There are many treatment options and ways to manage COPD. The newest 2017 guidelines emphasize the use of combined bronchodilators as first-line therapy for COPD. Doctors recommend vaccinations for people with the condition to decrease the risk of lower respiratory tract infections. Alterations in health-related behaviors (for example, stopping smoking) are emphasized. Spirometry measurements can help determine the extent of obstructive lung disease. As COPD progresses, oxygen therapy, especially if you have obstructive sleep apnea, may help improve your survival.

Like COPD, there are many treatment options and ways to manage asthma. Your primary care doctor and/or an allergist will discuss and suggest the best choice of treatment and management drugs for you. Medications used include corticosteroids, short-acting beta-agonists (for example, albuterol, Proventil, and other brand names), and occasionally anticholinergic medications for severe exacerbations.

Occasionally, for long-term treatment and management of asthma, doctors will prescribe long-acting anticholinergic medications (for example, salmeterol [Serevent] and formoterol [Foradil]), corticosteroids, and/or other drug combinations of drugs. You and your allergist may need to try different drugs to find the most effective treatment for your condition. Your doctor may recommend allergy shots (immunotherapy) if you have become desensitized to certain asthma triggers.

Emergency treatment of life-threatening asthma or COPD may involve intravenous corticosteroids, intubation, mechanical ventilation, and oxygen treatment until the crisis is resolved.

The prognosis for COPD ranges from fair to poor and depends on how rapidly COPD advances over time. In general, individuals with COPD have a decrease in their lifespan according to research.

If you have asthma, the prognosis for most people ranges from fair to excellent, depending upon how well you can identify what triggers your attacks, and your response to medication.