Can you imagine how it would be if you found it difficult to breathe? Or if you had to put in immense effort to simply cough? How would it feel to be unable to bring out the phlegm accumulated in your lungs? This is how people with COPD or Chronic Obstructive Pulmonary Disease feel, day in and day out. In the year 2019, COPD resulted in 3.23 million deaths worldwide according to the WHO and this is the third leading cause of morbidity across the globe. However, COPD is a preventable and treatable disease.

COPD is often confused with emphysema, which also manifests with similar symptoms of shortness of breath. Emphysema is a disease that falls under the umbrella of COPD diseases. This confusion between the two can lead to delayed treatment or incorrect treatment in some cases, which prevents you from getting relief quickly and effectively. While the two are connected, it is important to know the differences too so that the right treatment regimen can be initiated in time.

Let’s start with the most common confusion:

Is emphysema and COPD the same thing?

No. COPD is a common disease across the world that is preventable. COPD affected people can be treated successfully too. COPD is a term used to categorize a range of diseases that affect the lungs. In general, this name is given to any condition where the lung function is impaired owing to obstructed airflow from the organ.

Among COPD diseases, the most common ones found are emphysema and chronic bronchitis. These two may also be seen together in the same patient. In such cases, the symptoms are even more severe as can be expected.

However, it is usually the terms COPD and emphysema that are confused and used interchangeably. Keep in mind, while emphysema is a form of COPD, COPD does not necessarily mean the person suffers from emphysema. While emphysema and COPD do share many similar symptoms, they are not one and the same.

What is the difference between COPD and emphysema?

Understanding the difference between COPD and emphysema helps make the distinction between the two easier.

Emphysema

This condition is caused by damage to the air sacs of the lungs known as alveoli that have very thin walls. These alveoli or air sacs are all clustered towards the end of the lung’s bronchial tubes. These air sacs stretch to take in the oxygen you breathe in and then move it to the blood stream. When you exhale, the air sacs shrink and push out the carbon dioxide. In a healthy person the lung has about 300 million such alveoli.

When emphysema affects the person, the fragile walls of the air sacs or alveoli are damaged. They are unable to help the bronchial tubes function in air transfer and the tubes collapse. This leaves the air that you breathed in trapped inside the lungs with no way to move into the blood stream or be exhaled.

COPD

Patients with COPD may have airflow obstruction caused by emphysema, meaning, from the damage to the alveoli. The obstruction may also occur because of inflammation in the airways. The main difference between emphysema and COPD is that, unlike emphysema, COPD may also be an obstruction caused by airway inflammation caused by bronchitis or a condition called refractory asthma.

Symptoms of COPD and emphysema

While the COPD and emphysema difference is clear from the above, you can also see why some of the symptoms may overlap even when the COPD is not caused by emphysema.

Emphysema symptoms:

• Shortness of breath with light activity
• Sensation of being out of breath all the time
• Wheezing
• Persistent cough, which is often described as smoker’s cough
• Persistent mucous production
• Fatigue

COPD symptoms:

• Breathlessness
• Difficulty in breathing
• Tightness in the chest region
• Increased accumulation of phlegm
• Chronic tiredness

As you can see signs of COPD and emphysema are often very similar. This is why the diagnosis of either is not done solely on the basis of typical COPD and emphysema symptoms. For example, to diagnose emphysema, the physician may carry out a battery of tests including X-Rays, pulse oximetry, ECG, pulmonary function test etc.

Causes of COPD and emphysema

Just like the signs of COPD and emphysema often overlap, so do the causative factors.

• Emphysema: The leading cause is smoking and this is good news in a way because this makes it one of the easiest to prevent respiratory diseases. Other causative factors are pollutants in the environment where we spent most of our time and hereditary factors like deficiency of alpha- 1 antitrypsin. In some cases, neglected respiratory infections also lead to emphysema.
• COPD: Any factors that cause airway obstruction can lead to COPD and these do include continuous exposure to pollutants either by smoking or from inhaling second hand smoke. COPD is caused by conditions like emphysema, chronic bronchitis and refractory asthma.

Treatment for emphysema and COPD

Emphysema COPD damage cannot be reversed but it can be treated and the symptoms managed quite effectively especially when the condition is diagnosed early. When the doctor has confirmed that the COPD is a result of emphysema, any or all of the following treatments may be adopted:

• Quit smoking: For smokers, the first step is to quit the habit. This prevents the lung from being subjected to more strain and damage when it is already weakened.
• Medications: A category of medications called bronchodilators is used to relax the airway muscles. These are taken through hand held devices and they give immediate relief.
• Inflammation reduction: Next, the inflammation in the airways is targeted with medications. Since these drugs can result in side effects if used long term, the doctor generally prescribes these with great caution.
• Oxygen: When the lungs are so badly damaged that the blood stream is not getting enough oxygen, it means the lungs cannot absorb adequate air from the environment. For such people, oxygen therapy, that is giving oxygen via mask or nasal prongs, is recommended.

In some cases, a more invasive and treatment method is also recommended based on the patient’s condition and profile. This is lung volume reduction surgery where the damaged lung tissue is removed and the remaining health lung tissue is joined together.

Emphysema and COPD life expectancy

Let’s make this clear at the outset: COPD is NOT a terminal illness. However, it can progressively worsen over time especially if not detected in time and if left untreated. It is preventable in most cases and also treatable. Early detection plus treatment is very important because this slows down the rate at which the lung function in the patient deteriorates. Healthy lifestyle changes too can slow down disease progression.

The life expectancy of an emphysema and COPD patient depends on their age, overall health and symptom severity. The severity of COPD is assessed using the Global Initiative on Obstructive Lung Disease (GOLD) system. Based on how much air you can blow out in a second after blowing into a spirometer, doctors calculate your GOLD score. The lower the GOLD score, the higher the life expectancy. Your doctor is the best person to answer the life expectancy question more accurately after factoring in your medical profile.

Conclusion

If you have been confused with the question ‘Is COPD and emphysema the same?’, the answer is No. Emphysema is ONE form of COPD so while COPD and emphysema may occur in the same person, it is typically because the latter is a result of the former.  While the emphysema and COPD difference is undeniable, since they can be interrelated, the symptoms may be the same and also the treatment. What is most important is to understand the value of quick and timely detection, diagnosis and treatment to slow down the disease progress.

Any persistent symptoms from the list you have seen above should prompt a visit to your doctor immediately. If they advise tests, get them done at a reputed lab that can give you accurate, reliable results quickly. If you are unsure about a lab that can give you the perfect results, walk into NURA and avail the standard health package that includes COPD screening. NURA uses unique, ultra-low dose CT scan equipment to screen for COPD. We prioritize patient comfort above everything else and make your experience hassle-free and simple.