Is it asthma or is it COPD?

Is it asthma or is it COPD?

People with COPD (chronic obstructive pulmonary disease) often don’t know they have it because some of the symptoms (a cough or breathlessness) so closely resemble those of asthma, bronchitis or emphysema. However, differentiating between the three and the early diagnosis and treatment of COPD is critical. Here’s why…


Asthma, the Greek word for “panting”, refers to a condition that causes inflammation and obstruction of the airways making it difficult to breathe (shortness of breath). During an attack the person may make a whistling or wheezing sound while panting for breath. Other symptoms may include either a chronic dry cough or a “productive” cough accompanied by lots of mucus/phlegm. Although it is a different, separate disease a lot of people with COPD also have asthma.


COPD, on the other hand, refers to not one but a combination of conditions that obstruct the airflow to the lungs. These include chronic (persistent) bronchitis or emphysema or both.

Chronic bronchitis, an inflammation and irritation of the bronchial tubes (the airways of the lungs). is usually caused by viruses, bacteria, cigarette smoke, air pollution or when a cold or upper respiratory infection does not heal properly. It is characterised by tightness in the chest and an overproduction of mucus that forms sputum (phlegm) in the lungs and thus triggers the typical “productive” cough.

Emphysema is a condition that occurs when the smaller airways and air sacs (alveoli) of the lungs are damaged causing an even greater and more serious narrowing of the airways and obstruction to the airflow to the lungs.

Although a small percentage of people with a rare protein deficiency that may lead to lung, liver and blood disorders are classified as having a genetic/hereditary risk of developing COPD, most COPD patients are or have been heavy smokers! Non-smokers rarely develop COPD except if they may have been exposed to secondary smoke from spouses or other smokers.

Symptoms of COPD

Symptoms of COPD include the following:

    • Smokers’ cough that later becomes a chronic cough
    • Overproduction of mucus. The damaged airways produce more and more mucus that forms sputum that has to be coughed up
    • Breathlessness and wheezing that become progressively worse and later quite distressing and may end in fatal, respiratory failure
    • Chest infections such as pneumonia, colds and flu become more frequent and cause flare-ups of the symptoms
    • Heart failure due to reduced levels of oxygen in the blood and changes in the lung tissue that may result in strain on the heart muscle. This may worsen the already existing breathlessness and cause fluid retention
    • Depression and anxiety
    • Deterioration of mobility and general quality of health.

Differences between asthma and COPD

Some of the symptoms are similar and can be confused during diagnosis, especially the shortness of breath and typical cough. There are also similarities between the co-morbidities, diseases and conditions that co-exist with asthma/COPD, such as cancer, high blood pressure, sinusitis, migraine, depression, stomach ulcers, insomnia and impaired mobility.

However, there are various, very clear differences between the two conditions and these are used to make the proper diagnosis and plan appropriate treatment regimes.

Differences include:

    • Age of onset. People with asthma are usually diagnosed with the disease as children/young adults while COPD symptoms usually surface in older adults (40+)who are current or former smokers. Tragically many are only formally diagnosed after 60 years of age
    • Lung function after treatment (except in rare cases) is often fully reversible in asthma patients who usually also respond well to treatment while COPD treatment may ease symptoms but will not cure the condition as the airways are often permanently damaged
    • Different triggers cause the flare-up of symptoms, e.g. asthma is worsened by allergens, exercise and cold air. The main cause of COPD is smoking and flare-ups are mostly caused by respiratory tract infections and sometimes by environmental pollutants
    • Night time awakenings with breathlessness is common in asthma patients but not in those with COPD
    • Atopy, a history of allergies, hayfever and eczema, is common in asthma patients only.

Breath of life

Managing but not reversing COPD is possible. Medication and inhalers mayhelp reduce inflammation and open up the airways to ease breathing. Viral and bacterial infections can be prevented by being immunised against the pneumococcus germ that causes serious chest infections and by having an annual flu shot. Regular mild exercise is recommended to help improve breathing and losing extra weight will help ease breathlessness.

The moral of the story is that it is critical for those with COPD to try and preserve lung functioning and prevent early respiratory failure. This is only possible if they are correctly diagnosed as early as possible when damage to the lungs is not too far gone. Current and past smokers are most at risk as COPD is usually caused by smoking and although symptoms are unlikely to become better if they stop smoking, it will definitely become much, much worse if they do not!

Chronic Obstructive Pulmonary Disease. Retrieved from:
Exercising safely with COPD. Retrieved from:
Jovinely, J. Asthma vs. COPD: how to tell the difference. Retrieved from: