Emphysema vs. chronic bronchitis

Emphysema and chronic bronchitis are lung conditions that fall under the term chronic obstructive pulmonary disease, or COPD. Some of the symptoms are similar, such as shortness of breath and wheezing, but they are different conditions.

Emphysema is a lung condition wherein the air sacs, or alveoli, become damaged. These air sacs supply oxygen to the blood, so with damaged air sacs, less oxygen can enter the blood.

Chronic bronchitis is a lung condition that destroys tiny hairs, called cilia, in the airways of the lungs. The airways then become inflamed and narrower, making breathing difficult.

Symptoms

A person with emphysema may experience coughing, shortness of breath, and fatigue.

The symptoms of emphysema may include:

being short of breath during everyday activities and exercise

coughing daily or almost every day

wheezing

rapid breathing and heartbeat

barrel-shaped chest

fatigue

difficulty sleeping

weight loss

heart issues

depression

anxiety

The symptoms of chronic bronchitis may include:

wheezing

chest pain or discomfort

blueness in the fingernails, lips, or skin due to a lack of oxygen in the blood

crackling breathing sounds

swollen feet

heart failure

shortness of breath or difficulty breathing

People may have chronic bronchitis if they have a cough that produces mucus for 3 months or longer per year over the course of 2 years.

Similarities

Some people can manage their symptoms by taking bronchodilators.

Chronic bronchitis and emphysema “often occur together” and make up COPD.

Smoking is a leading cause of both conditions. According to the American Lung Association, smoking cigarettes causes 85–90% of all COPD cases.

Certain risk factors also make people more likely to develop either condition, including a family history of lung disease and high exposure to toxic fumes or secondhand smoke.

Both conditions make breathing difficult and share the following symptoms:

shortness of breath

wheezing

frequent coughing

heart issues

There is no cure for either condition, but treatment can help a person manage the symptoms. Both conditions require similar treatment methods. These can include:

Bronchodilators: These are medicines that people can take orally or via an inhaler to expand the airways and make breathing easier, as well as to clear mucus.

Other medication: This can include steroids and medication to help relieve symptoms such as wheezing or coughing.

Oxygen supply: People may need extra oxygen to help them breathe and carry out their everyday activities. This can be through the nose or as an oxygen mask.

Antibiotics: If people have a bacterial lung infection, they may require antibiotics.

Pulmonary rehabilitation: A team of healthcare professionals will put together a program for a person to learn more about the conditions and how best to manage them. People can receive advice on exercise and nutrition, as well as counseling support.

Lifestyle changes: Stopping smoking and avoiding air pollutants and secondhand smoke can help prevent the conditions from getting worse.

Surgery: In some severe cases, lung surgery may be necessary. A procedure called a bullectomy can remove damaged air sacs to help make breathing easier.

Lung transplant: In some rare cases, when there is severe damage to the lungs, a person may need a lung transplant.

Chronic obstructive pulmonary disease (COPD)
COPD is a group of conditions with a range of different symptoms and causes. Learn more about them here.
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Differences

Doctors often use X-rays and spirometry to diagnose lung conditions.

The main difference between these conditions is that chronic bronchitis produces a frequent cough with mucus. The main symptom of emphysema is shortness of breath.

Emphysema can sometimes arise due to genetics. An inherited condition called alpha-1-antitrypsin deficiency can cause some cases of emphysema. People tend to notice the symptoms of lung disease linked to the condition when they are 20–50 years old.

Gastroesophageal reflux disease can lead to chronic bronchitis. Older adults and people who have respiratory problems when they are younger may also have a higher risk of chronic bronchitis.

Emphysema is irreversible, but it is possible to stop the condition from worsening. People may be able to reduce their risk of developing chronic bronchitis by quitting smoking or avoiding being around secondhand smoke, as well as getting yearly flu vaccines.

People with severe emphysema may require lung reduction surgery. This is a procedure that removes areas of the diseased lung to allow healthier parts to work better. This can enable people to stay active and improve their quality of life.

How to tell the difference

A doctor can carry out various tests to check if a person has emphysema, chronic bronchitis, both, or another lung condition.

Pulmonary function tests show the condition of the lungs by examining how air moves in and out of them. Doctors use these tests to diagnose both conditions.

Examples include:

Spirometry

During spirometry, a person will exhale into a tube that is attached to a machine called a spirometer, which then shows the volume of air they are inhaling and exhaling. Spirometry can show whether airflow is restricted or disrupted, as well as how serious a lung condition is.

Chest X-ray

A chest X-ray will show any damage to the lungs. People stand in front of the X-ray machine and hold their breath for the X-ray to produce images of their lungs.

Arterial blood gases

A doctor will take a blood from an artery to test for oxygen and carbon dioxide levels in the blood.

Peak flow monitoring

In peak flow monitoring, a machine measures how fast a person can blow air out from their lungs. This assesses how much the condition is blocking the airways.

Using these tests, as well as performing a detailed physical examination and taking a thorough medical history, a doctor will be able to determine whether the condition is emphysema or chronic bronchitis.

If a person has a persistent cough that produces mucus for at least 3 months of the year for 2 years in a row, it may signal chronic bronchitis.

If tests show stretched lungs or lungs that are larger in places than usual, a person may have emphysema.

Summary

Emphysema and chronic bronchitis are two different lung conditions that make up an overall condition called COPD.

Both conditions can cause breathing difficulty and shortness of breath. People with chronic bronchitis will have a long-term cough that produces mucus.

A doctor can use a variety of tests to diagnose these conditions. Emphysema and chronic bronchitis require similar treatment methods for people to manage the symptoms.

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