Both asthma and emphysema are lung disorders that narrow your airways and make it hard for you to breathe. While both these conditions may have similar symptoms, their causes, effects, and treatment vary. With asthma, the swelling and narrowing of your airways are due to inflammation, which is often triggered by physical activity or something you are allergic to, such as mold or pollen.

But in emphysema, the air sacs of your lungs (alveoli) are damaged. Gradually the inner walls of these sacs weaken and rupture, resulting in larger air spaces in place of smaller ones. As your lung’s surface area decreases, the amount of oxygen your body cells receive also reduces. This is because the damaged alveoli do not function properly and cannot exhale the air entirely from your lungs, leaving lesser or no room for fresh, oxygen-rich air to enter.

Besides, asthma may get better. Symptoms of asthma come and go, and there may be a symptom-free period for a significant duration. With emphysema, symptoms may get worse with time or be constant, despite treatment.

As both asthma and emphysema have similar presentations, they are often confused. Asthma is frequently mistaken as emphysema. Almost half of the individuals with emphysema are not aware of their condition. Understanding the difference between both the disorders help in early diagnosis and preserve lung function in people with emphysema.

So, let us have a closer look at the differences between these conditions.

Symptoms

Some symptoms that can be present in both the disorders are:

  • Shortness of breath
  • Exercise intolerance
  • Anxiety with increased heart rate
  • Coughing
  • Chest tightness
  • Wheezing

Here are some differences:

  • Breathing returns to normal between attacks in asthma, while it does not return to normal in emphysema.
  • Long-standing cough is more common with emphysema
  • Emphysema results in the production of more phlegm as compared to asthma
  • People with emphysema may have blue fingernail beds due to breathlessness

Asthma Causes

Common causes for asthma include:

  • Chemicals
  • Pollen
  • Dust mites, pet dander, mold spores
  • Pollution
  • Strong smell
  • Cigarette smoke (not so common)

Emphysema is mainly caused by:

  • Cigarette and tobacco smoke (commonest cause)
  • Toxic or chemical fumes
  • Pollution
  • Dust

Factors Increasing the risk of Asthma & Emphysema

While anyone can get asthma and emphysema, certain factors increase their risk.

Asthma

  • Family history of asthma
  • Viral respiratory infections
  • Obesity
  • Smoking
  • Allergic conditions such as allergic rhinitis or sinusitis

Emphysema

  • Almost 75% of emphysema patient smoke or used to smoke
  • People above 40 years of age
  • A family history of emphysema
  • Long-standing exposure to irritants such as air pollution, smoke, secondhand smoke, dust, or chemical fumes
  • Genetics including alpha-1 antitrypsin deficiency

Effects

If either of the conditions is left unattended, it may result in complications. Some of them are:

Asthma-Related Complications

Unattended asthma mainly causes repeated or severe asthmatic attacks.

Some other complications are:

  • Pneumonia: While asthma directly cannot increase the risk of pneumonia, certain asthma medications such as corticosteroids may make you vulnerable to pneumonia.
  • Depression and anxiety: Physiological stress and negative emotions related to asthma increase the risk of anxiety and depression.
  • Obstructive sleep apnea: It is a condition where airways in the throat narrow in sleep. Nasal obstruction and mucus secretion in asthma increase the risk of obstructive sleep apnea.
  • Gastroesophageal reflux disease (GERD): In this condition, the stomach acid travels up in the food pipe, causing heartburn. Asthma is seen to increase the risk of GERD and aggravates its symptoms.

Emphysema-Related Complications

  • Heart Disorders: Emphysema may increase pressure in blood vessels supplying your lungs and heart. This may cause a section of your heart to weaken and expand, a condition known as cor pulmonale.
  • Collapsed lung (Pneumothorax): It is a rare complication but needs emergency attention. A collapsed lung can be a critical condition in emphysema patients as their lung functioning is already compromised.
  • Holes in the lungs (Bullae): Some emphysema patients develop empty spaces in the lung. Some bullae can be as large as half your lung. These holes reduce the space available for your lungs to expand and also increase the risk of pneumothorax

Comorbidities

Comorbidities are conditions that you may have along with the primary disorder. Comorbidities for asthma and emphysema are similar. Some of them are:

Remedies

Asthma Treatment

Asthma is a chronic inflammatory condition that can be managed with the right treatment. The primary aim of the therapy is recognizing asthma triggers and limiting your exposure to them. Your doctor will also advise you to monitor your breathing to understand if medications are working effectively.

Some commonly used treatment options are:

  • Quick-acting medicines: Some examples include oral and intravenous corticosteroids and short-acting beta-agonists.
  • Long-acting medicines: Your doctor may prescribe long-acting beta-agonists, inhaled corticosteroids, leukotriene modifiers, or combination inhalers.
  • Allergy medications: Some examples include omalizumab and allergy shots.
  • Bronchial thermoplasty: It involves heating the inside of your airways and lungs with an electrode. Doing this shrinks the muscles of your airways, preventing their narrowing and making it easier for you to breathe.

Emphysema Treatment

Medications

Your doctor may prescribe either of the medications depending on your condition:

  • Inhaled steroids: They reduce inflammation and improve the flow of air in your airways.
  • Bronchodilators: These medicines relieve shortness of breath and cough by relaxing your airways.
  • Antibiotics: They are helpful when you have a bacterial infection such as pneumonia or acute bronchitis.

Therapies

  • Nutrition therapy: You will get help depending on the stage of emphysema. In earlier stages, you may be advised to lose weight, while in later stages, you will need nutrition to gain weight.
  • Pulmonary rehabilitation: Here, your healthcare professional will teach you breathing techniques and exercises to reduce breathlessness and improve your endurance.
  • Supplemental oxygen: If you have low blood oxygen levels, your doctor may advise using oxygen daily at home. It is usually given through a narrow tube that enters into the nostrils.

Surgery

Based on your condition, you may be advised one or more types of surgeries. Examples include:

  • Lung transplant: It is an option if other treatments have failed or you have severe lung damage.
  • Lung volume reduction surgery: Here, the surgeon resects a small part of damaged lung tissues. This helps the remaining lung tissue to function and expand more efficiently, improving your breathing.

Final Thoughts

Asthma and emphysema are long-standing conditions that narrow your airways and cause breathlessness. While there may be certain similarities, knowing differences between these conditions will help diagnose and manage them. Asthma can often be managed easily on a daily basis, but emphysema worsens over time. 

In both conditions, you can improve their symptoms and prevent complications by adhering to their treatment plans.

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