Representative image of a condition in the lungs.
Credit: iStock Photo
Although COPD and asthma share similarities, recognising their differences is essential for accurate diagnosis and treatment. On World COPD Day today, Dr B R Ramesh suggests going in for spirometry tests to measure lung function and to help distinguish between these conditions
Chronic respiratory diseases (CRDs), such as chronic obstructive pulmonary disease (COPD) and asthma, are among the most common non-communicable diseases worldwide. Although COPD and asthma share similarities, recognising their differences is essential for accurate diagnosis and treatment.
What is Chronic Obstructive Pulmonary Disease (COPD)?
COPD is a common condition that primarily affects middle-aged or older adults who currently smoke or have a history of smoking. It is an umbrella term used for a group of chronic lung diseases that cause progressive and irreversible airflow obstruction, making it harder to breathe over time. It includes two main conditions:
Chronic bronchitis, where the airways that carry air from the windpipe to the lungs become inflamed and produce excess mucus, leading to persistent coughing.
Emphysema, in which the tiny air sacs at the end of the airways in the lungs responsible for oxygen exchange, get damaged.
What is asthma?
Asthma affects both children and adults and is the most common chronic condition among children. It occurs when the airways in the lungs become swollen, making them overly responsive to allergens and irritants like dust, pollen, fumes, and pollution. This inflammation causes the muscles around the airways to tighten, resulting in narrow passages that make it difficult to breathe.
How are COPD and asthma different?
COPD usually develops after the age of 40, typically in people who smoke or have had long-term exposure to harmful inhaled noxious particles, like air pollution. However, given the progressive nature of the disease, younger people in high-risk groups, who have had exposure to irritants, should still be mindful of the potential long-term risks. In contrast, asthma can start at any age, often in childhood or early adulthood. Asthma risk factors include family history, allergies, and exposure to environmental irritants ranging from house dust and mites to chemicals or fumes.
Furthermore, asthma symptoms often worsen on exposure to factors like irritants, allergies, or exercise, resulting in attacks (exacerbations) which can be mild to severe. In fact, symptoms can fluctuate at various times, with individuals
experiencing both good and bad days (or extended periods). Between attacks, breathing may return to normal with little to no difficulty. In COPD, symptoms are consistently present and tend to become more severe over time.
Unlike asthma, where airflow obstruction is usually reversible with early intervention and the right treatment, COPD is a progressive disease with irreversible lung damage.
Inhaled corticosteroids are the cornerstone treatment for managing asthma, and treatment plans are based on factors like age, symptoms, and triggers. It often includes a combination of long-term controller medications to reduce airway inflammation and quick-relief inhalers to open airways during attacks. Avoiding triggers, like pollution or pet dander, is also key to managing asthma. For COPD, treatment focuses on inhaled medications like bronchodilators to ease breathing by relaxing airway muscles. Pulmonary rehabilitation can improve lung health while lifestyle changes such as quitting smoking and regular monitoring can help slow the progression of the disease and improve the quality of life.
However, with COPD and asthma, adherence to doctor-prescribed medication is important, along with adopting lifestyle changes that can help patients manage the disease better.
Why does it matter to know the difference?
Understanding the difference between asthma and COPD is essential for proper diagnosis, treatment, and management. Misdiagnosis, especially in older adults, can lead to ineffective care and worsening symptoms.
Key factors like smoking history, exposure to pollutants, family history, and symptom patterns must be considered for an accurate diagnosis. Spirometry tests, which measure lung function, help distinguish between these conditions.
Furthermore, knowing the difference allows for tailored treatment plans that address each condition’s unique needs.
Asthma management focuses on controlling symptoms and preventing flare-ups to maintain normal daily life, while COPD treatment aims to slow disease progression and relieve symptoms to improve quality of life.
(The author is a consultant pulmonologist.)