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What is the difference between Emphysema and COPD?

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Chronic obstructive pulmonary disease, or COPD, is a lung disease that restricts airways causing difficult or uncomfortable breathing. Emphysema is a type of COPD that damages or collapses air sacs (alveoli) in the lungs, causing breathlessness and shortened lifespan in many cases.

Since emphysema is a form of COPD, your loved one would not be diagnosed with emphysema without also having COPD. However, it is possible to have COPD and not have emphysema.

Understanding the difference between COPD and emphysema will help you care for your loved one better, and support them to seek proper treatment. This article will discuss how the two conditions are related, and where symptoms, treatment, and risk factors can overlap or differ


How common is Emphysema vs. COPD?



According to the American Lung Association, over 3 million people in the U.S. have been diagnosed with emphysema.

Most emphysema patients are 45 years of age or older and smokers. Historically, emphysema was diagnosed more often in men, but cases among women are nearly equal today.



According to the Centers for Disease Control and Prevention (CDC), more than 16 million Americans suffer from COPD.

According to the American Lung Association, COPD is the third leading cause of death in the U.S., behind cancer and heart disease, and other research puts it fourth.

More than half of all people who die of COPD are women. Most COPD patients are non-Hispanic whites.

Research indicates that 8 out of 10 cases of COPD were caused by smoking.


Symptoms of Emphysema vs. COPD Emphysema symptoms

Emphysema is a disease that develops in the late stages of COPD. It is important that you are able to recognize the symptoms of COPD in your loved one before they worsen so that they can be diagnosed and treated early.


Emphysema Symptoms

Some patients may have emphysema for many years without recognizing the symptoms. The primary symptom is breathlessness, which worsens slowly over time.

Other symptoms of emphysema may include:

    • Chronic cough or wheezing

    • Shortness of breath, especially during light exercise or walking steps

    • Excess mucus or sputum production

    • Fatigue

    • Tightness in the chest


COPD symptoms

There are several symptoms an individual may experience that occur with COPD. Like emphysema, these symptoms sometimes appear only after severe lung damage and restricted airflow is present. The most common symptom is shortness of breath, which can worsen over time.

Other symptoms of COPD may include:

    • Breathlessness, especially during light exercise or walking steps

    • Chronic cough with clear, white, yellow, or a greenish sputum

    • Frequent colds or respiratory infections

    • Ongoing feelings of fatigue

    • Swollen legs, feet, or ankles

    • Tightness in the chest

    • Weight loss without trying


What are the causes of Emphysema vs. COPD?

As a caregiver, it is important to understand what causes Emphysema and COPD so that you are equipped to help your loved one prevent these serious conditions. The most critical step they can take is to quit smoking, and there are many resources to support your loved one in that process.


Causes of Emphysema

The most common cause of emphysema is smoking, and it can also be caused by long-term exposure to other airborne lung irritants, such as high air pollution, chemical fumes, and dust.

Other causes of emphysema may include a genetic condition called alpha-1 deficiency, a compromised immune system related to HIV, and a history of childhood respiratory infections.

Emphysema is preventable, as the main cause of the disease is smoking. This includes cannabis.


Causes of COPD

Similar to emphysema, COPD is most often caused by tobacco smoke.

Other causes of COPD include exposure to secondhand smoke, high air pollution, dust particles, chemical fumes, and genetic alpha-1-antitrypsin deficiency.


How are Emphysema and COPD diagnosed?

When symptoms of Emphysema and COPD are present, your loved one’s doctor will begin tests and other screenings to diagnose the condition and its severity. This section will outline the various diagnostic tools your loved one’s healthcare provider may employ so that you can help prepare them and know what to expect.


Diagnosis of Emphysema

A healthcare provider will diagnose emphysema with a thorough physical exam and medical history and ask questions about symptoms. Other tests they may use to diagnose emphysema may be chest X-rays and pulmonary function tests (PFTs).

In some cases, a doctor may order a CT scan to determine the severity of the condition's progression. It can also measure the extent of emphysema that has developed.

An ABG, or arterial blood gas test, can measure oxygen and carbon dioxide levels in the blood. This, and the measurement of the blood's pH balance, shows the current status of lung function.


Diagnosis of COPD

A doctor will utilize your loved one’s medical examination, complete medical history, and a discussion of symptoms and smoking habits to diagnose COPD

A chest x-ray, CT scan, and PFT tests, such as spirometry, are also ways to diagnose COPD.


What are the risk factors for Emphysema vs. COPD?


By understanding the risk factors of Emphysema and COPD, you will be better equipped to assess whether your loved one’s symptoms may be related to Emphysema and COPD. Knowing the risk factors can help you express your concerns to your healthcare provider.


Emphysema risk factors

Smoking is the most common cause of emphysema, making it the greatest single risk factor. The risk includes smoking tobacco, cigarettes, cigars, pipe, or cannabis. The longer the individual smokes and the amount smoked, the greater the risk of developing emphysema.

Age is also considered a risk factor for emphysema, especially for patients who are smokers. The average age for onset of emphysema symptoms is around 40-60 years.

Other risk factors are prolonged exposure to lung irritants such as secondhand smoke, air pollution, industrial fumes, and dust.


COPD risk factors

Risk factors for COPD include being over the age of 40 and long-term smoking. The longer one is a smoker, the greater the risk.

As with emphysema, the risk factor for COPD includes people who smoke tobacco, cannabis, pipe, or cigars. Asthma sufferers also have an increased risk.

Other risk factors include prolonged exposure to industrial fumes, air pollution, dust, and alpha-1-antitrypsin deficiency, a genetic risk factor.


What are the treatments for Emphysema and COPD?

The treatment plan for both emphysema and COPD will preserve lung function, but these conditions cannot be reversed. While there are no cures for emphysema or COPD, a lifestyle change program can help to make symptoms less severe for your loved one.

Working closely with healthcare providers, and following all medical advice, is essential to managing emphysema and COPD.


Emphysema treatments

There are a few treatment options to help manage the symptoms of emphysema

Your loved one’s healthcare provider may prescribe inhaled steroids, or a bronchodilator, based on the severity of the disease and current lung function of the patient.

Other courses of treatment for emphysema include:

    • Oxygen therapy

    • Pulmonary rehabilitation 

    • Lung transplant surgery (In extreme cases)


COPD treatments

The first step in treating COPD in mild cases is smoking cessation. Many programs and even medications can help an individual stop smoking, which can greatly improve the quality of life for a COPD sufferer.

For patients where COPD has progressed, medications such as bronchodilators, inhaled corticosteroids, or combination inhalers may be prescribed by their doctor, based on the severity of the condition.

Phosphodiesterase-4 inhibitors, a medication used for chronic bronchitis to decrease airway inflammation, may be prescribed for patients with severe COPD.

Routine vaccinations to prevent pneumonia and influenza will likely be prescribed as well.

Your loved one’s healthcare provider may consider other treatment options for COPD, such as oxygen therapy, supplemental oxygen, pulmonary rehabilitation, or an in-home machine to help the patient breathe easier.

Surgery may be required in severe COPD cases. Surgery for COPD may be a lung transplant, lung volume reduction surgery, or a bullectomy.


How can Emphysema and COPD be prevented?

Taking action now to help your loved one prevent Emphysema and COPD will allow them to live a longer, healthier life. The first step in both cases is to quit smoking.


Emphysema prevention

The easiest way to prevent emphysema is to avoid smoking, as smoking is the primary cause of this serious lung disease. Avoiding lung irritants, such as secondhand smoke, high air pollution, chemical fumes, and dust, can be preventative.


COPD prevention

Much like emphysema, the best way to prevent COPD is to avoid, or stop, smoking. Avoiding other common lung irritants can also help prevent serious lung conditions such as COPD.


Can my loved one get Emphysema or COPD, even if they are a non-smoker?

While COPD is strongly associated with cigarette smoking, studies show that 1 out of every 6 patients diagnosed with COPD are non-smokers. In cases of developing COPD as a non-smoker, genetics or exposure to other lung irritants prove to be the cause.


Can vaping cause COPD or Emphysema?

Research by Johns Hopkins Medicine scientists showed an increased likelihood of developing asthma and COPD amongst those who inhale smoke from e-cigarettes.

University of North Carolina Health Care researchers determined that e-cigarette vaping can be considered a risk factor for emphysema, as much as smoking traditional cigarettes is.


When’s the right time to talk to my loved one’s doctor about Emphysema or COPD?

If you or a loved one are frequently experiencing shortness of breath or other common symptoms of emphysema or COPD, call and make an appointment to see a doctor.

Getting these diseases diagnosed early on can slow progression by adopting a treatment plan to help your lungs get enough oxygen for optimal function.

Robert C. Fisher

A Nurse Director at a large medical center in Boston, MA, who holds a Master’s in Nursing Leadership and Administration and an MBA in Healthcare Management.

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