Emphysema vs COPD: What’s the Difference?

Answering the most common questions patients have about emphysema and COPD

September 10, 2020
Emphysema vs COPD: Woman walking with dog and child

COPD (chronic obtrusive pulmonary disease) and Emphysema are two of the most common lung conditions in the world. An estimated 3.1 million Americans are affected by emphysema and 11.2 million have COPD. However, some estimates have suggested that as many as 24 million Americans are living with COPD due to undiagnosed cases. Regardless, chronic lung conditions are widespread and worth understanding better. In pursuit of that understanding, today’s blog centers around answering some of the most frequently asked questions by patients about emphysema and COPD.

The Difference Between COPD and Emphysema:

One of the most common questions people have about chronic lung conditions is the difference between COPD and emphysema. The answer is not as straightforward as saying that they are two entirely different conditions. Emphysema is a progressive lung disease that is caused by the overinflating of alveoli (tiny air sacs in the lungs responsible for taking in oxygen). Unlike emphysema, COPD is an overarching term describing a group of lung conditions. One of the lung conditions included under the COPD umbrella is emphysema. The other most common type of COPD is chronic bronchitis. For most people, the next question is naturally “then what’s the difference between emphysema and chronic bronchitis?” As they are both types of COPD, they do have a lot in common when it comes to symptoms and treatment. The main difference is that chronic bronchitis involves the destruction of cilia (tiny hairs in the airways of the lungs) rather than the alveoli.

Barrel Chest and Other Signs/Symptoms of Emphysema:

Emphysema has a wide range of symptoms and signs but one of the most recognizable is barrel chest. Although it typically only develops as the disease progresses, it is one of the most well-known and outwardly visible symptoms. If you have not heard of barrel chest, it refers to the barrel shape that the ribcage takes on due to chronic overinflation of the lungs. As barrel chest develops, breathing becomes less efficient and this results in shortness of breath. For this reason, it is often one of the most concerning and noticeable symptoms of emphysema or COPD.

Despite barrel chest being the most noticeable symptom of emphysema and its progression, there are lots of other symptoms. It’s especially important if you’re at risk of developing emphysema to keep an eye out for symptoms that show up earlier as many cases of emphysema aren’t diagnosed until at least fifty percent of the lung tissue has been destroyed. Some of the common symptoms to look for are shortness of breath, a feeling of not being able to get enough air, wheezing, a cough that won’t go away, and ongoing fatigue. If you’re experiencing any of these symptoms and you’re over the age of fifty or a smoker, you should speak to your doctor. However, it is possible to develop emphysema at a younger age if you are a heavy smoker or are frequently exposed to airborne irritants. For that reason, it’s best to report any symptoms to your doctor regardless of age, just in case.

The Different Types of Emphysema:

There are four primary forms of emphysema. Each of them is very similar, however they all affect different areas within the lungs.

  • Centriacinar – This form of the disease tends to be localized in the upper parts of the lung.
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  • Panacinar – Panacinar emphysema mostly affects the lower areas of the lung.
  • Paraseptal – This type of the disease can occur when airways and air sacs are damaged. It can also occur as a complication of other types of emphysema.
  • Bullous Emphysema – Bullous emphysema develops when an air pocket takes up space in the chest and disrupts the normal functioning of the lungs. It is also known as vanishing lung syndrome.

COPD Progression, Outlook, and Treatment:

Taking a step back from emphysema specifically, if you’ve been diagnosed with or are at risk of developing any type of COPD you should be aware of how it typically progresses and the outlook. There is no definite answer when it comes to life expectancy for COPD patients. That said, the further the disease progresses before diagnosis and implementation of treatment, the worse the results. That is part of why it is essential to try and catch it as early as possible and to take action immediately if it is diagnosed. The most important step to take if you’re diagnosed with or want to prevent any form of COPD is to quit smoking. Smokers are at the highest risk of developing the disease, and those who don’t quit once diagnosed have the greatest reduction in life expectancy. Aside from quitting smoking, maintaining a healthy weight, and increasing both lung and cardiovascular health are essential to reducing the risk of death.

Along with the lifestyle changes necessary to better COPD outlook, there is a wide range of medications commonly used in treating it. Below are the types of drugs typically used:

  • Bronchodilators – These work by relaxing the muscles around the airways. This relieves coughing and shortness of breath. These come in both quick action and long-term forms. Depending on the severity of the condition, it can be necessary to use both types.
  • Inhaled Steroids – Inhaled steroids reduce inflammation in the airways and can make breathing easier. They are most frequently prescribed for patients who often suffer from exacerbations because of COPD.
  • Combination Inhalers – These inhalers combine inhaled steroids and bronchodilators for patients that need both without having to deal with managing three or four inhalers.
  • Oral Steroids – Oral steroids are typically only used on a short-term basis during COPD flare-ups as long-term use can lead to serious side effects.
  • Phosphodiesterase-4 Inhibitors – These drugs relax the airway and reduce inflammation, making it easier for patients to breathe.
  • Theophylline– One of the cheaper medication options, theophylline can prevent worsening episodes of COPD and can help with easier breathing.
  • Antibiotics – Other respiratory infections can make COPD symptoms far worse. By taking antibiotics they can be prevented and they may even be able to reduce the severity of COPD episodes.

In some cases of severe COPD (usually emphysema), surgery may also be an option. The three types of surgeries typically used are lung volume reduction surgery, lung transplant, and bullectomy. A bullectomy involves doctors removing the air spaces formed in cases of bullous emphysema. Lung volume reduction surgeries remove damaged portions of the lung, leaving extra capacity in the chest for healthy lung tissue to expand. In only the most severe cases a lung transplant can be necessary. However, it is a complicated operation carrying great risks and is used only as a last resort.

Here are some other articles we think you might enjoy:
4 Smart Inhalers that Could Be Lifesaving for People Living with Asthma & COPD
Coronavirus: Advice for People Living with Respiratory Diseases

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