Asthma Or COPD? Similarities And Differences Between Asthma and COPD

Asthma and COPD are two distinct conditions affecting the lungs and share many similarities. However, the underlying cause is different and so is the treatment. For this reason, it is important to get a medical evaluation and receive the right diagnosis.  

Asthma vs COPD. Signs and symptoms

Signs and symptoms of asthma and COPD. The typical symptoms of asthma are cough, shortness of breath, wheezing, and chest tightness. The most common symptoms of COPD are also shortness of breath, wheezing, cough, chest tightness. How can you tell the difference? 

In asthma, cough is usually dry, mainly experienced at night, and often associated with allergies or with respiratory infections such as cold or flu. 

On the other hand, the cough associated with COPD may produce mucus and can be clear, white, yellowish, or greenish. In COPD, shortness of breath often develops during physical activities and even at rest in late stages, while in asthma it is often triggered by allergens (although there is exercise-induced asthma when symptoms worsen with exercise). Frequent respiratory infections, fatigue, weight loss, and swelling of the ankles or feet are other symptoms experienced by those with COPD.  Asthma can also lead to fatigue, sleeping problems and is often associated with allergies.

Asthma causes acute attacks, with long periods of no or little symptoms. COPD is often associated with acute exacerbations and symptoms tend to progress and worsen over time, especially if the person continues to smoke. Emphysema and chronic bronchitis are the two medical conditions that contribute to COPD, and these two diseases are seen together or one may be more severe than the other. 

Asthma vs COPD. Age of onset, underlying causes, and triggers

Asthma usually develops during childhood and some continue to have symptoms during adulthood. Adult-onset asthma is rare, but when it happens, it can be misdiagnosed with COPD. Asthma triggers include allergies, stress, cold air or sudden weather changes, certain food additives, acid reflux, exercise, and workplace chemicals or fumes (so-called occupational asthma). 

COPD is a disease that occurs later in life, mainly in smokers who smoked for many years. Less frequently, COPD is caused by air pollution, workplace exposure to dust, fumes, or smoke. Just like asthma, COPD symptoms may worsen due to a  respiratory infection, air pollution, or other triggers that cause inflammation. 

Genetics

Certain genetic variations predispose a person to develop both asthma and COPD. There are over 100 genetic mutations linked with asthma, but not one single genetic variation clearly correlates with asthma. About 1% of COPD cases are related to a genetic disorder that causes  alpha-1-antitrypsin deficiency. Some genetic factors may also contribute to the development of COPD in smokers, as not all smokers will have COPD. 

Asthma vs COPD. Diagnostic tests and treatments

A doctor performs a physical exam, listens to the lung sounds with a stethoscope, and recommends lung function tests like spirometry and peak flow. These tests are also needed to diagnose COPD, along with chest X-rays, arterial blood gas analysis, and certain blood tests.

There are two types of therapies for asthma- one is long-term, preventive therapy and involves the use of inhaled corticosteroids, leukotriene modifiers, or combination inhalers. The second therapy is used as needed, for example during acute attacks. Rescue medication includes quick-relief bronchodilators, anticholinergic agents, and corticosteroids in oral or iv form. 

COPD is also treated with inhaled corticosteroids, short-acting bronchodilators (used before activities), long-acting bronchodilators  (recommended to be used daily), inhaled corticosteroids, and combination inhalers. Oxygen therapy and lung pulmonary rehabilitations are recommended for moderate to severe cases of COPD. COPD exacerbations may require other medications like steroids, along with oxygen therapy and treatment in the hospital. Severe cases of COPD may benefit from special surgical procedures like lung volume reduction surgery, bullectomy, or lung transplant. 

Progression, possible complications, and overall  prognosis

Mild cases can be effectively controlled with medication, while severe cases of asthma tend to be harder to treat. However, many people live with asthma into old age. The life expectancy in individuals with COPD is significantly limited. 

Asthma complications include sleeping problems. Sick days from work or school, emergency visits, and hospitalizations during acute attacks. Asthma medications also have side effects, especially when taken long-term, in high doses. 

COPD can complicate respiratory infections, heart diseases, lung cancer, pulmonary hypertension (which is high blood pressure in the lungs), and depression. 

Can a person have both COPD and asthma? Yes, asthma is one of the risk factors for the development of COPD. The risk is even higher if a person has asthma and also smokes. Talk to your doctor if you are concerned about any of these two conditions.  Early diagnosis and treatment are essential to better manage both of them. According to experts from Mayo Clinic, COPD is commonly misdiagnosed and many people with COPD do not receive the diagnosis and get treated until this condition is at an advanced stage.  

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