Emphysema vs. Chronic Bronchitis

Chronic obstructive pulmonary disease (COPD) is a disease that makes your lungs inflamed. That makes it harder to breathe and get the air you need.

There are two conditions that contribute to COPD: emphysema and chronic bronchitis. Both cause breathing problems, so it can be hard to tell them apart. But there are some key differences between the two.

Signs of Chronic Bronchitis

This is when the lining of your bronchial tubes (which carry air to and from your lungs) becomes inflamed or irritated. This brings a “wet” cough that lasts at least 3 months. You might cough up thick, discolored mucus, and feel tired and short of breath.

Bronchitis can be temporary (your doctor may call it “acute”). But if you’ve had the symptoms of bronchitis off and on for at least 2 years, your bronchitis is considered chronic. This can be a sign that you have COPD.

In some cases, chronic bronchitis causes your airways to narrow, too, making it especially hard to breathe. This is chronic obstructive bronchitis.

Signs of Emphysema

When the air sacs in your lungs (alveoli) are damaged, that’s emphysema. This can cause the walls of the air sacs to become weak, and maybe break. That makes more space for air in your lungs. While that may sound like a good thing, your lungs have less space to pull in oxygen. As a result, less of it goes to your bloodstream, which can make you tired and cause other problems.

Also, damaged alveoli don’t work well. They can trap old air, making it hard for you to take in new air with fresh oxygen.

The main sign of emphysema is shortness of breath. At first, you may have it only after you’ve been active. Over time though, emphysema can make it hard to breathe even when you’re at rest.

You can’t undo damage to your alveoli. That’s why emphysema usually becomes worse over time. It makes it difficult to breathe and cuts the amount of oxygen in your blood. It can lead to other side effects, too, like a barrel chest (which is caused by your lungs getting bigger because of trapped air).

Most people with emphysema have chronic bronchitis, too.

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Causes

Cigarette smoke is the biggest cause of both emphysema and chronic bronchitis. Since these conditions make up COPD, smoking is the leading cause of COPD, too.

Air pollution and other pollutants, like chemical fumes, can also raise your chances of emphysema and chronic bronchitis. Your odds of both go up after you turn 40, as well.

Some things only raise your chances of one of the two conditions linked to COPD. Chronic gastric reflux, which irritates your throat, can contribute to chronic bronchitis, but not emphysema.

In rare cases, emphysema can be caused by a genetic condition called alpha-1-antitrypsin deficiency. This is when your body doesn’t make enough of the protein that helps your lungs work.

Diagnosis

The same tests are used to spot chronic bronchitis and emphysema. If you have regular breathing problems, your doctor may recommend a:

  • Health history
  • Physical exam
  • Pulmonary function test (PFT), to help your doctor tell how much air your lungs can hold and how much air you can exhale
  • Sputum exam, where your doctor will send a mix of saliva and mucus to a lab to examine the cells in it
  • Chest X-ray
  • High-resolution computed tomography (HRCT), a special kind of imaging test

If your team thinks you have emphysema, they might order a blood test that can show them how well your lungs move oxygen and carbon dioxide in and out of your bloodstream.

Treatment

One big difference between chronic bronchitis and emphysema is that emphysema isn’t reversible. But you may be able to lower your odds of chronic bronchitis. To help do that:

  • Steer clear of smoke, including secondhand smoke.
  • Wash your hands regularly, and use hand sanitizer.
  • Avoid contact with people who are sick.
  • Get the flu vaccine. And ask your doctor about whether you’re a good candidate for a pneumococcal vaccine, which may lower your chances of getting pneumonia.
  • Stay away from pollutants like cleaning sprays and chemical fumes, or wear a surgical mask if you have to be near them.

To treat chronic bronchitis, your doctor may recommend:

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Emphysema can’t be cured. But there are treatments that can help you breathe easier. Some can help keep the condition from getting worse. Your doctor may recommend:

You may also get nutrition therapy. A dietitian can give you advice on getting to a healthy weight, which can make it easier to breathe. If you have advanced emphysema, you may have a hard time eating enough, so a dietitian may give you tips to help you gain weight.

WebMD Medical Reference Reviewed by Nayana Ambardekar, MD on September 12, 2018

Sources

SOURCES:

Merck Manual: “Chronic Obstructive Pulmonary Disease (Chronic Bronchitis; Emphysema).”

Mayo Clinic: “COPD,” Bronchitis,” “Emphysema.”

University of California, San Francisco: “Chronic Bronchitis Diagnosis,” “Chronic Bronchitis Treatment.”

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