Asthma and COPD: What's the difference?

By Dr. Angel Brown | Northside Hospital

November is COPD Awareness Month, spotlighting the differences between chronic obstructive pulmonary disease (COPD) and asthma. While both lung diseases share symptoms like coughing and shortness of breath, they differ in causes and treatments. Understanding these differences helps patients and caregivers recognize symptoms and seek appropriate care.?

What is the difference between asthma and COPD?

Airflow obstruction (narrowing) in asthma is considered reversible, while airflow obstruction (narrowing) in COPD is not.

How can you tell the difference between asthma and COPD?

Asthma and COPD are the most common obstructive lung diseases diagnosed. They have shared signs and symptoms — shortness of breath, wheezing, coughing — making it difficult to determine if someone has asthma or COPD. The difference is that asthma is typically triggered by something inhaled, and COPD usually is not. Lung function testing is readily available at most pulmonary (lung specialist) offices, to determine if someone has asthma, COPD or both.

Can asthma turn into COPD?

Asthma and COPD are two distinctively different lung diseases. Asthma cannot turn into COPD, and COPD cannot turn into asthma, but both diseases can exist together.

How does asthma differ from COPD?

The major problem of both diseases is chronic inflammation. In asthmatic airways, inflammation is caused by an immune response to inhaling something your lung does not like, drawing allergy-responsive cells into the walls of the airway. In contrast, cells responsible for fighting infections play an essential role in the inflammation of COPD.

Is there an asthma-COPD link?

There is not a link per se. However, both have common signs, symptoms and causes that can be environmental. For example, asthma is triggered by allergens like pollen and dust, while COPD is triggered by cigarette smoking. Asthma-COPD Overlap Syndrome is a chronic lung condition that occurs when someone has symptoms of both asthma and COPD.

How common is Asthma-COPD Overlap Syndrome (ACOS)?

ACOS is uncommon. Some research studies found that approximately 5% of individuals 65 to 84 years of age have ACOS.

What are the treatment options for asthma?

Treatment is based on the severity of the symptoms. Mild asthma can be treated with a once-a-day allergy pill called montelukast. Asthma with frequent symptoms throughout the day or every day is usually treated with an inhaled steroid. If that does not help symptoms, patients are given an inhaled steroid mixed with a long-acting bronchodilator. If that is ineffective, patients may be given triple therapy and tested for immunodeficiency. Patients with no symptoms are usually monitored and given just an as-needed or rescue inhaler called albuterol for COPD. Patients who have COPD with symptoms, especially daily symptoms, are generally started on what is called triple therapy. Triple therapy includes using an inhaler with a steroid (for inflammation), a bronchodilator (to open airways), and medication that reduces mucus in the airways. For ACOS, patients are treated similarly but may also carry an albuterol rescue inhaler.

Learn more about pulmonology services at Northside.

Dr. Angel Brown is a board-certified physician in pulmonology and internal medicine. Her clinical interests include interstitial lung disease, COPD, asthma and sarcoidosis.?