COPD vs. Emphysema: Understanding the Difference

COPD and emphysema are both progressive pulmonary diseases that can adversely impact your patient's overall quality of life. Often, people confuse COPD and emphysema because emphysema is one disease that falls under the category of chronic obstructive pulmonary diseases. When a person has more than one progressive lung disease, they are considered to have COPD.

Today, Carda is here to compare COPD and emphysema, including each obstructive lung disease’s causes, symptoms, severity, and treatment options. Read on to learn how you can support your overall lung function and pulmonary health with Carda.

What Is COPD?

COPD stands for chronic obstructive pulmonary disease and is a diagnosis for a group of progressive lung diseases. The name COPD can be misleading — while it implies only one disease, there are two different diseases (emphysema and chronic bronchitis) that comprise COPD. Usually, a COPD diagnosis involves a combination of both conditions.

In patients who have COPD, excess mucus buildup in the lungs causes inflammation and subsequent blockages in the smaller airway branches, such that the patient cannot effectively move air in or out.

The airflow obstructions cause permanent damage to the smaller airways and to the actual lung tissue, which can leave COPD patients with several different symptoms, including breathlessness, a chronic cough, and higher susceptibility to respiratory infections.

Symptoms of COPD can present as mild to moderate for decades before worsening, and some patients can even go years without experiencing any symptoms. However, each disease history is unique, and some patients may experience a quick transgression from mild to severe COPD symptoms.

What Causes COPD?

Cigarette smoking is the most common cause of COPD. Smoking destroys pulmonary cilia, depleting the lungs' ability to filter inhaled air and remove dirt, pollutants, or other irritant particles. With fewer cilia to sweep away the particles, the irritants remain trapped in the lungs and can gradually damage the tiny air sacs (alveoli).

Smoking also often causes inflammation, damaging the breathing tubes and bronchi and inhibiting enough oxygen from reaching the lungs.

Aside from cigarette smoking, there can be several other causes of COPD, including extended exposure to secondhand smoke, strong fumes, pollutants, or other lung irritants. A genetic cause, namely an alpha-1 antitrypsin deficiency, is another risk factor for COPD.

What Is Emphysema?

Emphysema is one disease that falls under the umbrella of COPD. If a patient has an emphysema diagnosis, they have COPD. However, not all COPD patients have emphysema — you can diagnose a patient with a COPD form that only involves chronic bronchitis.

The different types of COPD reflect different damage points to the lungs. Chronic bronchitis involves damage to the breathing tubes and bronchi, while emphysema damages the alveoli. Patients can experience damage to both areas, which is why a COPD diagnosis often involves both emphysema and chronic bronchitis.

With damaged alveoli and reduced oxygen transport, the lungs stretch, and airways can sag inwards, holding more air in the lungs. As such, emphysema may yield symptoms like breathlessness or wheezing.

What Causes Emphysema?

Cigarette smoking is the primary cause of emphysema — although secondhand smoke exposure, as well as long-term exposure to other lung irritants, pollutants, or fumes, are exacerbations that may also cause this chronic condition.

Inhaled smoke destroys cilia, trapping the irritant particles in the alveoli until these air sacs permanently stretch and rupture. Damaged cilia and alveoli make it harder for the lungs to filter air and exchange oxygen for carbon dioxide, leading to symptoms such as chronic coughing, fatigue, and breathlessness or wheezing.

Do COPD and Emphysema Share Symptoms?

Because emphysema is a form of COPD, the two share symptoms. However, while all emphysema symptoms are COPD symptoms, not all COPD symptoms mean that a patient has emphysema (they could only have the chronic bronchitis form of COPD).

Symptoms that both emphysema and COPD share include:

  • Shortness of breath
  • Frequent and persistent coughing (sometimes with clear, yellow, or green mucus)
  • Wheezing
  • Chest tightness
  • More frequent respiratory infections
  • Fatigue

Is COPD or Emphysema More Severe?

COPD and emphysema severity both depend on each unique patient’s set of conditions and symptoms. Sometimes, emphysema can be more severe than COPD with chronic bronchitis, but other times the chronic bronchitis form of the disease can cause worse symptoms than emphysema.

However, when a patient has a COPD diagnosis involving both emphysema and chronic bronchitis, this form of COPD is usually more severe than a diagnosis that only involves emphysema.

How Can COPD and Emphysema Be Treated?

Unfortunately, it is impossible to fully prevent COPD or emphysema from progressing because the pulmonary damage is not reversible.

However, while you cannot stop progression, you can take steps to treat the progression by slowing it down.

Treatment options, which include lifestyle changes, pulmonary rehab, and medication, can help a patient to utilize the oxygen they have available more efficiently and effectively.

Lifestyle Changes

A healthy lifestyle with a well-balanced diet and some physical activity plays a huge role in pulmonary strength and functioning. Proper nutrition and exercise may significantly slow the progression speed of COPD and emphysema.

While it may be hard for patients to exercise if they experience shortness of breath, even very low increments, such as 30 minutes a week, can help strengthen lung muscles and slow disease progression.

Additionally, smoking cessation supports lung health overall and can help ease COPD or emphysema symptoms. Even other lung irritants like air pollution, secondhand smoke, or strong fragrances can cause or exacerbate COPD and emphysema, so staying away from exposure to air that may cause a flare-up is a helpful treatment reminder for patients as well.

Pulmonary Rehab

If your COPD or emphysema symptoms progress to the more moderate side, your healthcare provider might suggest you attend a pulmonary rehabilitation program. This program is a way to foster awareness and management practices for your symptoms and disease progression.

In the past, the only option for pulmonary rehab was to refer patients to an outpatient clinic. However, as remote medicine and telemedicine continue to improve, virtual rehab options are increasingly prevalent and convenient.

Virtual rehab has tremendous potential for personalization, especially because a patient can choose where and when they do their rehab. Additionally, virtual rehab assigns each patient a clinical exercise physiologist assignment to consistently manage their case (which differs from a center-based approach to rehab where there may be a different provider each visit).

If you are looking to refer your patients to life-saving outpatient care and rehab that can help slow the progression of COPD or emphysema from the comfort of their homes, Carda is here to help.

Carda is cheaper and more effective than in-person rehab and is very convenient for patients. After filling out a simple questionnaire that collects information on their specific needs and goals for rehab, they'll be matched with a physician consult and will receive their first care package with all the supplies they need to start their personalized home-based program.

Medication

There are four stages of COPD, and each stage presents progressively worsening symptoms. While stage 1 often does not initially present with symptoms, if patients experience breathlessness, wheezing, or another breathing difficulty, medication can be a productive treatment option.

A bronchodilator medication, taken via nebulizer or inhaler, is an effective way to widen the patient’s airway passages and provide relief from labored breathing. In addition to bronchodilators and inhaled corticosteroids, you may also choose to prescribe antibiotics if the patient develops more frequent lung infections from COPD or emphysema.

Alongside medication, as COPD or emphysema progresses, the patient may need supplemental oxygen to help them breathe more easily in the later disease stages.

In severe cases, when the patient’s blood oxygen levels are so depleted that they are at risk for respiratory failure, oxygen therapy is not enough. In this case, pulmonary surgery (such as a lung transplant or a lung volume reduction surgery) is a treatment option.

The Bottom Line

COPD refers to a group of progressive lung conditions, and emphysema is one of the conditions in this group. All patients with emphysema have COPD, but not all COPD patients have emphysema — some might just have chronic bronchitis.

There is no cure for emphysema or COPD, as they inflict permanent damage to lung tissue and airways. However, there are several different treatment options that incorporate lifestyle changes, pulmonary rehab, and sometimes medication to help slow the disease progression.

With some healthy lifestyle changes and support from Carda Health’s virtual pulmonary rehab, it is possible to slow COPD or emphysema advancement, which can help enhance overall quality of life.

Sources:

Emphysema: definition, imaging, and quantification | American Journal of Roentgenology

Treating COPD | American Lung Association

The alpha 1-antitrypsin gene and emphysema | American Journal of Physiology | Lung Cellular and Molecular Physiology

Inhaled corticosteroids in COPD: the clinical evidence | European Respiratory Society

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