Asthma or COPD?

Asthma and chronic obstructive pulmonary disease (COPD) both are long-term lung diseases that make breathing difficult. And while similarities exist between the two, there are important differences. Getting a correct diagnosis is key to proper treatment.

Here are some distinctions between asthma and COPD:

• Physiology. Asthma involves inflammation of the tubes that carry air into and out of the lungs, as does chronic bronchitis, one type of COPD. With emphysema, another type of COPD, “the lung tissue itself is affected,” says Dr. Steven Weinberger, a Philadelphia-based lung disease specialist and senior vice president for medical education and publishing at the American College of Physicians.
• Risk factors. Asthma symptoms are triggered by allergens such as animal dander and pollen, irritants such as cold air and strong odors, and respiratory tract infections. Smoking is the most common cause of COPD, accounting for up to 90 percent of COPD-related deaths.
• Treatment. Both conditions are treated with inhaled bronchodilators, medicines that relax tight muscles around the airways, opening them up. “Inhaled anti-inflammatory drugs, which reduce airway swelling, are also frequently used in both conditions, but they have a much more important role in asthma than they do in COPD,” Weinberger says.
• Outlook. With treatment, most people with asthma have periods of few or no symptoms. And while the progression of lung and airway damage among COPD sufferers can be slowed, it can’t be reversed, says Houston pulmonologist Dr. Nicola Hanania.

To further complicate the issue, some people have asthmatic bronchitis, Weinberger notes. This condition combines features of both asthma and COPD. If the diagnosis isn’t clear after an initial breathing test, your doctor may order further testing or refer you to a specialist.

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