COPD or chronic obstructive pulmonary disease as the name suggests causes obstructed flow of the air to the lungs. In common language, the person with COPD faces difficulty while breathing.
In asthma, the patient’s airway narrows or swells in response to an external allergen. This too makes breathing difficult due to narrowing and mucous secretion.
Both diseases present with short shallow breaths. The patient’s lungs are super sensitive in both cases.
Both above conditions may seem alike due to the appearance of similar symptoms, but there is a huge difference.
Presentation –
COPD mainly consist of two respiratory disorders:
- Chronic bronchitis
- Emphysema
Both of which are demarcated by inflammation of the inner lining of the lungs and reduced airflow.
Asthma includes symptoms like wheezing, coughing, and rapid shallow breaths. Now when we are clear about what each condition is, let us look into how each differentiates from others.
Disease Prevalence –
According to a study published in lancet journals of India, the number of cases of COPD in India increased from 28 million in 1990 to 55 million in 2016. There is an increase in disease prevalence from 3.3% to 4.2%. The age-standardized COPD prevalence and DALY (disability-adjusted life year) numbers were reported to be highest in the world.
According to the Global Asthma Report 2018, around 6% of children and 2% of adults have asthma. India with a population of 1.3 billion both numbers are very significant, which is a hundred and four million.
Apart from these segregated numbers, around 40% of people with COPD also have asthma. Asthma is also a precipitating factor for COPD. The co-existence of both diseases is frequently found in elderly cases.
Age of onset –
Asthma usually onsets in childhood while the symptoms of COPD start to appear only by age 40. The prevalence of COPD has also been associated with smoking.
Cause of the Disease –
Asthma is known to be caused by a mix of environmental and hereditary factors. It is mostly an allergic reaction in response to:
- Pollens
- Mites
- Mould fungus
- Animal hair
- Respiratory infections
- Exercises or strenuous activity
- Moist air
- Smoke or fumes
- Certain medications such as beta-blockers and aspirin
- Tension
- Sulfites and other similar preservatives from food or liquid refreshment
- Gastro oesophagal reflux disease
On the other hand, COPD is known to be caused by smoking, getting exposed to smoke, and fumes from cooking or factories. Smoke and particles found in it cause the airway lining to get inflamed. Eventually, the elasticity of the tissue decreases leaving a large amount of air trapped inside the lungs even after a complete exhalation.
COPD is rarely caused by Alpha-1-antitrypsin deficiency. Alpha-1-antitrypsin is a protein formed in the liver and protects the lungs from neutrophil elastase. Neutrophil elastase digests damaged or ageing cells and microorganisms from the lungs and promotes healing.
Precipitating factors for both the diseases –
Factors worsening asthma include:
- Exercises or strenuous activity
- Moist air and
- Allergens
While symptoms of COPD exacerbates in the presence of factors like:
- Respiratory infections like pneumonia or influenza
- Smoking
- Fumes and pollutants
Co-existing illnesses –
Coexisting illnesses are common in COPD. Both diseases to a larger extent share the coexisting illnesses which include:
- high blood pressure
- difficulty walking
- sleeplessness
- depression
- sinusitis
- migraine
- stomach ulcers
- cancer
Treatment and Management –
Asthma:
First of all asthma management consist of identification of allergens and trigger factors. Once the factors are identified, care should be taken to avoid them as much as possible. Using seasonal masks around February and dusty places is highly recommended.
Medication management include:
- prophylactic allergy shots
- bronchodilators in the form of inhalers
- short-acting beta-agonists
- oral and intravenous corticosteroids
- leukotriene modifiers
- long-acting beta-agonists
Surgical Management
Bronchial thermoplasty with heating electrodes relaxes the lung muscles making breathing easy.
COPD:
Medication Management
- bronchodilators
- inhaled steroids
- antibiotics
Therapies like
- Oxygen therapy
- Breathing exercises
- Diet modification
- Yoga and Pranayama
Surgical Management
- Volume reduction surgery
- Lung transplant
- Bullectomy
Prognosis
Both are chronic disorders but asthma can easily be managed through medication and lifestyle while COPD usually gets worse with age.
The main difference that clears out, in conclusion, is that even though both conditions reduce breathing capacity but the changes in asthma are reversible once the attack subsides but COPD makes a part of your lung nonfunctional forever and is more likely to get worse.
Dr. Navneet Sood, Consultant – Pulmonology, Dharamshila Narayana Superspeciality Hospital, Delhi