Are Asthma and COPD the Same Thing? - Separating Fact From Fiction

Health Professional

It's a common question... are COPD and asthma the same thing? Or does one lead to another? As a nurse, I've fielded this question quite a lot. And it comes up on both the HealthCentral asthma site and this one too.

The simple answer to both questions is a resounding "No" There are many similarities between the two diseases. But there are also some definite differences between them. So, let's take a closer look at what leads to the confusion on this issue.

Who Gets Them?

Both asthma and COPD are seen in adults, including older adults. But asthma is more common in children, though it can occur at any age. And COPD is more common in adults over the age of 40, especially senior adults.

Both diseases have smoking as a risk factor. In asthma, both smoking and exposure to secondhand smoke are risk factors, but others include genetics and environmental factors. In contrast, with COPD, it is your own long-term smoking habits that place you at the highest risk.

What's Going on Inside the Lungs?

Both asthma and COPD are chronic respiratory conditions, characterized by decreased airflow, due to a narrowing of the airways. However, asthma also causes a temporary tightening of the airways known as bronchospasm, while COPD does not.

What Are the Symptoms Like?

They each have similar symptoms, including shortness of breath, coughing and wheezing. However, asthma symptoms tend to come and go, usually in direct relation to your contact with allergic triggers or other respiratory irritants (such as cold air or wood smoke), while COPD symptoms are more constant throughout the day, and are often worst first thing in the morning.

Also, asthma usually produces only a dry, hacking type of cough (often worse during the night while sleeping), while COPD frequently causes a "wet" cough that is productive of mucus, especially first thing in the morning.

Shortness of breath in asthma is usually related to trigger exposure, while in COPD, it is mostly in response to activity, and gets worse over time. Asthma sometimes causes shortness of breath with exercise, but this can usually be prevented with medications.

How Are They Treated?

Although similar medications are used for both conditions, how they are used varies significantly. Asthma should be treated first with inhaled steroids, adding a long-acting bronchodilator in severe cases, while COPD is best managed with long-acting bronchodilators first, adding in steroids only in limited cases.

What Is the Outlook?

Asthma lung changes are generally completely reversible and symptoms can be controlled with the right treatment plan, so people with asthma can expect to live a life without limitations. In contrast, COPD is a progressive disease that may not ever be completely controlled, because there has been permanent damage to the lungs that is only partly reversible. Treatment will help make the COPD sufferer more comfortable, but generally does not completely eliminate symptoms or limitations. In addition, supplemental oxygen will often become a necessity in the later stages of the disease.

In Summary

There can be overlap between the 2 diseases, but it happens less often than most experts realize. Studies have shown that only 10 to 20% of people with COPD also have asthma. So, how can you be sure you get the right diagnosis?

The best advice I can give you is to get an evaluation by a pulmonary specialist, called a pulmonologist. This type of doctor should be able to distinguish between the two conditions and tell you which one you have, or if you might have both.

It is important to get the right diagnosis, because treatment varies greatly between the two conditions. So, if you're not satisfied with your diagnosis, then exercise your right to a second opinion!