Emphysema vs. COPD: Similarities and Differences (2024)

Emphysema is a progressive health condition caused by persistent damage to the air sacs in the lungs, also known as alveoli.Along with chronic bronchitis, emphysema is one of the two most common types of chronic obstructive pulmonary disease (COPD). COPD is an umbrella term that refers to chronic lung disorders that cause problems with breathing.

In this article, we’ll go over how emphysema is related to COPD and how it differs from other types of COPD. We’ll also discuss common causes of emphysema and COPD, coping tips, treatment options, and more.

How Emphysema and COPD Differ

Many people aren’t sure of the relationship between emphysema and COPD and wonder which one is “worse.” Actually, emphysema is one of the two main types of chronic obstructive pulmonary disease. The other is chronic bronchitis. Most people with COPD have both conditions at the same time, but some people only have one or the other.

In many ways, chronic bronchitis and emphysema are more similar than they are different. Both are often, but not always, related to smoking. They have many overlapping symptoms. such as coughing and wheezing, and tend to progress (get worse) over time.

However, chronic bronchitis affects the airways in the lungs, while emphysema affects the air sacs. Also, chronic bronchitis is more likely to cause excess mucus production. The main symptom of emphysema is shortness of breath.

Symptom Onset and Progression

There are four stages of COPD, including emphysema. Each one is progressively more severe than the last. You will notice different symptoms in each stage, as follows:

• Stage 1: The symptoms of emphysema come on gradually and may go unnoticed for a long time. You may start to notice coughing, wheezing, pressure in your chest, or the occasional feeling that you can't take a full breath easily.
• Stage 2: During the second stage of COPD, breathing may become harder when you’re exerting yourself. Coughing may get worse and more “productive” (i.e., producing more sputum, phlegm, or mucus).
• Stage 3: In this stage, you could experience more symptoms like muscle weakness (especially in the lower half of your body), frequent flu and colds, and swelling in the ankles. You might have difficulty breathing on your own without oxygen therapy.
• Stage 4: In the final stage of emphysema, you could experience sudden, unintended weight loss and dangerously low blood oxygen levels. Some people experience heart failure; some may need surgical treatment.

COPD Without Emphysema

Chronic obstructive pulmonary disease refers to a group of similar lung disorders, the most common of which are emphysema and chronic bronchitis. Research suggests that most people with COPD have both conditions to some degree.

Still, there are some demographic differences between the two types of COPD. According to the American Lung Association, about 3.6% of adults in the U.S. have been diagnosed with chronic bronchitis. The condition is more common in women than in men.

Meanwhile, emphysema seems somewhat less common. Approximately 1.6% of American adults have been diagnosed with emphysema. The condition is more common among men than women.Both chronic bronchitis and emphysema are more common in older adults, especially people over 65 years old.

Is One Worse?

COPD is associated with high morbidity and mortality, representing one of the top 10 causes of death among American adults. Many people understandably wonder whether emphysema is associated with higher risks than other types of COPD.

Emphysema and chronic bronchitis have similar symptoms, treatment approaches, and prognoses. What’s more, you are more likely to develop chronic bronchitis if you already have severe emphysema and vice versa. People with symptoms of both emphysema and chronic bronchitis have significantly worse outcomes on average after receiving lung surgery than people who only have one type of COPD.

Causes of Emphysema vs. COPD

In up to 75% of cases, the cause of emphysema and COPD is smoking. However, nonsmokers can also develop emphysema. Some examples of other risk factors for emphysema include:

• Exposure to smoke, such as from secondhand smoke, wood-burning stoves, or coal
• Occupational exposure to other environmental irritants, such as dust or chemicals
• Air pollution
• A genetic alpha-1 antitrypsin deficiency

Emphysema and COPD on X-Ray

Because emphysema is a lung condition, you might think a chest X-ray can diagnose it. However, that’s not the case. A chest X-ray may show some signs of COPD, such as lung changes, and rule out other possible explanations for your symptoms.

To diagnose you with COPD, your healthcare provider will ask about your symptoms, lifestyle, and medical history, including risk factors such as your exposure to smoke and pollution. They may also perform a variety of tests, such as:

• Spirometry to measure how well you can breathe
• CT scans to assess the severity of your condition
• Oximetry to measure your oxygen blood levels
• Alpha-1 testing, to check for relevant genetic conditions

Treatment for Emphysema and COPD

COPD, including emphysema, can’t be cured. Treatment for emphysema and COPD typically involves quitting smoking and steering clear of secondhand smoke, as well as:

• Taking prescribed medications to help with breathing or respiratory infections, such as bronchodilators or antibiotics.
• Getting vaccinated for the flu, COVID-19, and pneumococcal pneumonia.
• Going through pulmonary rehabilitation, which may involve treatment from respiratory therapists, nutritionists, counselors, and/or exercise specialists.
• Oxygen therapy.
• Undergoing surgery to improve lung function in severe cases.

How to Cope With Emphysema and COPD

You can take steps to manage your symptoms of emphysema and COPD, such as:

• Creating a COPD action plan to identify and avoid triggers and signs of flare-ups
• Practicing deep breathing exercises and pursed lip breathing
• Pacing yourself and ensuring you get enough rest
• Exercising regularly to maintain your overall level of fitness
• Not reaching or bending too much to avoid fatigue
• Eating slowly and while upright
• Eating several small meals per day
• Prioritizing your mental health through relaxation exercises and counseling

Summary

Emphysema is a lifelong breathing condition caused by damage over time to the small air sacs in the lungs. It is one type of chronic obstructive pulmonary disease. It shares many similar symptoms and potential health outcomes with chronic bronchitis, the other primary kind of COPD. Many people with emphysema also have chronic bronchitis.

Warning symptoms of emphysema typically include tightness in the chest, chronic cough, whistling sounds while breathing, and difficulty taking a full, deep breath. Like other kinds of COPD, emphysema is progressive, meaning it usually gets worse with time.

If you think you may have emphysema or another kind of COPD, talk to your healthcare provider about treatment options. They can help you develop an action plan and prescribe medications and other forms of therapy as needed.