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Difference Between Asthma and COPD

Ask the Expert

I always thought I had asthma, but now my doctor thinks I have COPD. What is the difference?

Both asthma and COPD, or chronic obstructive pulmonary disease, involve blocked airways. The difference between the two is that the blocked airways of asthma typically open up completely with medication, while the airways with COPD may be partially opened with medication.

Another difference is that asthma is often diagnosed in childhood but COPD is usually diagnosed in late middle age, typically in smokers who have smoked at least one pack a day for 10 to 20 years. Although both are lifelong diseases, people with COPD are rarely symptom-free without daily maintenance treatment. On the other hand, people with asthma can be symptom-free for periods of time without treatment.

However, it is possible to have both conditions. Adults who had asthma or asthma-like symptoms as a child that eventually improved can develop COPD after smoking or after being exposed to smoke, environmental fumes or occupational work hazards. Some research suggests that asthma may be a risk factor for developing COPD.

Other differences between the two include:

  • Asthma attacks come and go. They typically involve wheezing, shortness of breath and chest tightness. Some people with asthma have a nagging, dry cough that tends to occur at night and in the early morning, often triggered by allergies, cold or humid air, perfumes and other odors or exercise. The symptoms of COPD, however, are often constant, although they may improve significantly with medication.
  • The COPD cough usually (but not always) results in mucus production and may or may not involve wheezing. Plus, if you have severe or very severe COPD, it can be hard to breathe during usual activities most of the day. Asthma coughs rarely involve mucus production and nearly always involve wheezing.
  • COPD flare-ups, called exacerbations, are a severe worsening of symptoms. They are often the result of respiratory infections caused by bacteria or viruses or other exposures. While respiratory infections can bring on an asthma attack, most asthma attacks are caused by "triggers," such as allergens or exercise, and often can be prevented by avoiding those triggers. However, it is difficult to avoid the infections that cause COPD flare-ups.

Talk to your doctor about the reasons for the COPD diagnosis and how your treatment will differ from that of asthma. Ask your doctor to test your lungs with a simple test called spirometry, which measures your airflow. And remember: the earlier you begin treatment for COPD, the more likely your medications and lifestyle changes can help you reduce symptoms, avoid flare-ups and lead a healthier, more active life.

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