Chronic obstructive pulmonary disease (COPD) is a group of diseases that cause damage to the lungs, limiting their ability to obtain oxygen, which makes breathlessness worse.

Emphysema is one type of COPD disease. It damages the air sacs in the lungs, making it progressively harder for the body to get the oxygen it needs.

The term COPD also covers chronic bronchitis and asthma. A person with emphysema has COPD, but a person with COPD may not necessarily have emphysema.

In this article, we detail what COPD and emphysema are.

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COPD is an umbrella term for the progressive lung diseases emphysema, chronic bronchitis, and asthma. These conditions impair lung function and can lead to feelings of breathlessness.

Typically, when a person breathes, air travels into tubes in the lungs called bronchial tubes or airways. These tubes split into smaller pathways called bronchioles. The bronchioles end in alveoli or groups of tiny air sacs. Blood capillaries run through the walls of these air sacs.

Typically these bronchioles and alveoli are elastic. With every breath, each air sac inflates like a small balloon as the person breathes in, and it deflates as they breathe out. In COPD, this process does not happen as easily, and less air flows through the airways.

In bronchitis, tissue in the bronchial tubes can swell and thicken. Mucus may also build up and clog these airways.

Learn more about bronchitis here.

Emphysema is a type of COPD. In this condition, damage to the walls of the air sacs affects their working. The inner walls of the sacs can weaken and lose their shape. These walls may even split, creating one large space to hold air instead of many small ones.

This reduces the surface area of the lungs so that less oxygen can get into the bloodstream through the capillaries.

Because of the damage to the air sacs, the old air is unable to escape and stays in the lungs. This leaves less room in the air sacs for fresh air to enter, compounding the problem of getting new oxygen to the body.

COPD and emphysema share similar outward symptoms. These symptoms can take time to appear and may only occur after significant damage to the lungs.

Typically, a person will notice the first symptoms of COPD or emphysema during physical activity.

Someone with one, or both, of these conditions may experience:

Symptoms tend to worsen over time, especially if a person continues their exposure to smoke or other irritants.

Learn 11 tips for quitting smoking here.

The most common causes of all forms of COPD, including emphysema, are environmental.

Environmental factors

In the United States, the leading cause of COPD and emphysema is tobacco exposure through smoking. The National Heart, Lung, and Blood Institute estimates that up to 75% of people with COPD smoke or used to smoke.

Breathing in secondhand smoke from cigarettes, air pollution, or chemical fumes can also lead to COPD and emphysema.

Genetic factors

Some people may develop some forms of COPD and emphysema despite never smoking or experiencing long-term exposure to other irritants.

Alpha-1 antitrypsin deficiency (AATD) is a genetic type of emphysema in which a person does not have enough of a protein. This protein typically helps to protect the lungs.

Having asthma is a risk factor for developing COPD, and the two can also overlap. Medical professionals may refer to this as asthma-COPD overlap syndrome.

The presence of symptoms compatible with COPD should trigger the evaluation for an early diagnosis, which can help slow the progression of the disease. Unfortunately, many people do not receive a diagnosis until they already have severe damage in their lungs.

For diagnosis, a doctor will review the person’s symptoms, family and medical history, and ask about exposure to lung irritants, especially cigarette smoke. To confirm a diagnosis, they may order several tests.

Spirometry test

Medical professionals typically use a spirometry test to confirm a COPD diagnosis.

During a spirometry test, a person blows into a tube connected to a machine called a spirometer. The machine measures how much air the lungs can hold and how fast the person can blow the air from the lungs.

This test can detect lung disease before symptoms start, and it may track the progression of the disease. It can also monitor how well treatment is working.

Learn more about spirometry tests for COPD here.

Other lung function tests

Lung, or pulmonary, function tests, which include spirometry, measure the amount of air that a person inhales and exhales. They also examine the lungs’ ability to deliver enough oxygen to the blood.

Learn more about lung function tests here.

Chest X-ray or CT scans

Doctors may use X-ray and CT scans to diagnose COPD and emphysema. These imaging tests can also identify other issues such as cancer and pulmonary fibrosis.

Blood gas analysis

This blood test measures the amount of oxygen and carbon dioxide in the blood. These measures can show how well the lungs are performing.

Other blood tests

Blood tests do not diagnose COPD or emphysema but can help to confirm or rule out if other conditions may be causing lung function issues. Importantly, blood tests can diagnose genetic conditions such as AATD.

Knowing when to seek medical treatment for COPD and emphysema can be difficult, as initial symptoms may not be obvious. Anyone who experiences the symptoms listed above should speak to a doctor promptly.

If a person is already receiving treatment, they will need to seek medical care if any of the following occur:

  • shortness of breath that is worse or more frequent than usual
  • changes to color, amount, or thickness of mucus or sputum
  • mucus or sputum becomes bloody
  • increase in coughing or wheezing
  • swelling of the feet or ankles that does not go away after sleeping with the feet up
  • headaches or dizziness, most frequently in the morning
  • fever, especially when combined with flu-like symptoms
  • unexplained severe weakness
  • confusion or disorientation

A person who experiences any new shortness of breath or breathing difficulty that does not improve with medications should see a doctor.

There is no cure for any form of COPD, including emphysema, but treatment can help to slow the progression of the disease and manage symptoms.

Treatments include medical, surgical, and therapeutic interventions.

Medical treatments

Medical treatments for COPD and emphysema may include inhaled and oral medicines.

Options often include:

  • Bronchodilators: A person inhales these medications. They relax the muscles around the airways, relieving coughs and shortness of breath.
  • Steroids: Taking oral or inhaled steroids can help with lung inflammation.
  • Antibiotics: People with COPD and emphysema are susceptible to lung infections, and they may need antibiotics to treat bacterial causes of bronchitis or pneumonia.

Pulmonary therapy and rehabilitation

A doctor may also recommend pulmonary therapy and rehabilitation.

As part of a pulmonary rehabilitation program, individuals can learn new ways to improve their breathing and their ability to exercise. Therapy aims to improve a person’s quality of life and decrease the frequency and duration of hospital stays.

During this rehabilitation, people may learn:

  • breathing exercises
  • exercise training
  • nutrition counseling
  • education on managing lung conditions

Should a person experience severe lung damage and their oxygen levels remain low, doctors may recommend supplemental oxygen therapy.

This involves a person breathing from an oxygen tank via a mask or nasal prongs. Depending on a person’s oxygen levels, they may need to breathe from these devices continuously or only at certain times of the day.

Surgery

Some people may need surgery to improve their quality of life and to manage the symptoms of the disease.

Options include:

  • Lung transplant: A surgeon replaces the COPD-damaged lungs with healthy lungs from a donor. It is not suitable for everyone, and major risks include organ rejection.
  • Lung volume reduction: This decreases lung volume by removing damaged lung tissue, allowing better gas exchange of oxygen and carbon dioxide.
  • Bullectomy: This involves removing large air spaces called bullae that form in the lungs when the air sacs become damaged. Removing the bullae also helps with gas exchange of oxygen and carbon dioxide.

Managing COPD can improve a person’s quality of life and slow disease progression.

Tips for living with COPD and emphysema include:

  • Quitting smoking: Smoking causes and worsens COPD and emphysema, so it is crucial to stop smoking as soon as possible after a diagnosis.
  • Controlling breathing: A person can use the techniques they learn in pulmonary rehab to manage their shortness of breath.
  • Eating a healthy diet: This helps to maintain strength and boost the immune system.
  • Getting plenty of exercise: Activity improves endurance and increases lung function, which can lessen symptoms. Regular physical activity can also improve mood, strength, and balance.
  • Managing mucus: Clearing mucus from the airways through controlled coughing and hydration can help.
  • Avoiding pollutants: Keeping away from secondhand smoke and staying indoors on days with poor air quality can slow the progression of the disease.

A person with COPD should follow the physician’s instructions, take all prescribed medications, and see their doctor regularly.

COPD refers to a number of lung conditions, and emphysema is one of them.

COPD and emphysema can be life-threatening. It is important for people to recognize the signs and learn how to manage their symptoms.

Stopping smoking and asking others not to smoke nearby is one way of reducing the risk of developing COPD and emphysema.