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Patients & Consumers Online Tools Find an Allergist / Immunologist Pollen Counts Diseases 101 Featured Resources » AAAAI Tips Brochures Topic of the Month Research for Patients Drug Guide Allergy & Asthma ADVOCATE Information Request Form Donate Now En Español Just for Kids Seniors Contact Us Search by Condition (A-Z) Request a Speaker Smoke Free Homes Referral Guidelines Other Resources En Español Just for Kids Seniors		Seniors and Asthma Asthma vs. COPD: Similarities and Differences Michael Schatz, MD, FAAAAI June 2007 You can't breathe when you exert yourself and you have coughing episodes every morning. There are two potential likely causes for this: you could have asthma or you could have COPD (emphysema or chronic bronchitis). Because asthma and COPD have a number of similarities, sometimes it can be difficult even for your doctor to distinguish between them. However, when your doctor takes into account all of the relevant information, including your symptoms and medical history as well as the results from medical tests, he or she can help you determine which of these two common illnesses you have. Symptoms Both asthma and COPD may cause shortness of breath on exertion and a cough. A daily morning cough that produces phlegm is particularly characteristic of the chronic bronchitis type of COPD. Episodic wheezing and chest tightness, especially at night, is more common with asthma. In addition, patients with asthma are more likely to have previously experienced other allergic symptoms, such as hay fever or an itchy skin rash called eczema. History of Smoking COPD is almost always associated with a long history of smoking, while asthma occurs in non-smokers as well as smokers. However, smoking can also make asthma worse, and smokers are particularly likely to suffer from a combination of both asthma and COPD. Medical Examination Your doctor is more likely to hear wheezing with a stethoscope when you are having symptoms of asthma than when your problem is COPD. A "barrel chest," due to too much air trapped in the lungs, is more characteristic of COPD. Medical Tests Chest X-Rays: Chest X-ray findings may be normal in patients with either asthma or COPD. However, too much air in the lungs, called hyperaeration, may be seen in the emphysema type of COPD. Increased lung markings may be seen on an x-ray when a person has chronic bronchitis. A CT scan of the chest may show features more characteristic of emphysema. Allergy Tests Many patients with asthma have allergies to environmental materials, such as house dust mite, cockroach, mold and animal dander (dry skin flakes). These allergies, which can be confirmed by an allergist through skin or blood tests, may trigger asthma in many patients. Allergies appear to have nothing to do with COPD. Pulmonary Function Tests: Pulmonary function tests (PFTs) in patients with both COPD and asthma may demonstrate airway obstruction. However, the obstruction is caused by lung damage in patients with COPD, while it is generally caused by inflammation in patients with asthma. The obstruction present with asthma improves substantially when the patient takes medications called bronchodilators, which open up the constricted airways in the lungs. The PFT scores taken after administration of bronchodilators reflect this improvement. With COPD, there is little change in PFT scores after the use of bronchodilators. Although it may take some time and effort, it is important to distinguish between asthma and COPD. The treatment for the two conditions is different, and you will greatly benefit from an accurate diagnosis and appropriate treatment plan. Whether you have asthma, COPD, or both, make sure you see your doctor regularly. Michael Schatz, MD, MS, FAAAAI, is a Fellow of the American Academy of Allergy, Asthma and Immunology (AAAAI) and a practicing allergist/immunologist in San Diego, CA. Copyright 2000, Asthma Magazine. Reprinted by permission. <back>
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