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What is the difference between emphysema and COPD?

Medically reviewed by Carmen Pope, BPharm. Last updated on Aug 23, 2023.

Official answer


The main difference between emphysema and COPD is that emphysema is a progressive lung disease caused by over-inflation of the alveoli (air sacs in the lungs), and COPD (Chronic Obstructive Pulmonary Disease) is an umbrella term used to describe a group of lung conditions (emphysema is one of them) which are characterized by increasing breathlessness. A person with emphysema has COPD; however, not everybody with COPD has emphysema.

What is emphysema?

Emphysema is one of the lung conditions included in the term COPD. Normal lung tissue resembles a sponge; however, the lungs of people with emphysema look like an old used sponge, with large holes in them and a limited ability to “spring-back” into shape.

Emphysema is a progressive disease, that usually starts slowly with small holes between the alveoli, which eventually collapse to form larger air spaces. Old air gets trapped in these air spaces, which makes it difficult for people to inhale fresh air. Blood flow through the alveoli is also impaired meaning that people with emphysema not only struggle to breathe but have trouble receiving enough oxygen.

Cigarette smoking is by far the biggest cause of emphysema, but also the most preventable. Emphysema is more common with age and in males, and it tends to run in families. Other causes include air pollution, airway reactivity, and a deficiency of alpha-1-antitrypsin.

Treatment is with bronchodilator inhalers, which help to open up the airways, corticosteroids to relieve inflammation, and oxygen therapy. Antibiotics are usually also needed regularly as people with emphysema are prone to infections.

What is COPD?

COPD is an umbrella term for three lung conditions that damage the lungs, impair airflow, and make breathing progressively more difficult over time. The three conditions are emphysema, chronic bronchitis, and refractory (non-reversible) asthma. COPD is the third leading cause of death in the U.S. and rates appear to be increasing.

Emphysema is explained above. In chronic bronchitis, the lining of the airways is irritated and inflamed and thickens with mucus. Coughing is frequent and breathing becomes difficult.

In refractory asthma, a severe form of asthma, the airways swell, become narrow and produce extra mucus. Symptoms such as wheezing, coughing, shortness of breath and chest tightness are present most of the time and asthma attacks that do not respond to treatment are frequent. Aggressive treatment, including corticosteroids, is required.

Symptoms of COPD typically include breathlessness, difficulty breathing, increased phlegm, and chest tightness. COPD cannot be cured; however, treatments can improve symptoms and prevent further damage.

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