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Can You Have Emphysema Without COPD?

What is emphysema vs. COPD?

If you have emphysema, you have COPD — but the two conditions aren't the same. If you have emphysema, you have COPD — but the two conditions aren’t the same.

Emphysema and chronic obstructive pulmonary disease (COPD) both refer to a group of long-standing lung conditions that can make breathing difficult. Both of these conditions usually develop in people over 40 years old. Neither COPD or emphysema have a cure, but early action and treatments can improve breathing and overall quality of life. 

To understand the relationship between emphysema and COPD, it’s helpful to know the parts of the lungs they affect. 

Your lungs are filled with a system of airway tubes. Larger tubes at the top, called bronchi, split into smaller tubes called bronchioles, which carry air inside and out. Tiny air sacs, called alveoli, sit at the ends of the bronchioles. When you inhale, alveoli expand to help transport oxygen into your blood, and when you exhale, they contract to let out carbon dioxide.

What is emphysema?

Emphysema is a subtype of COPD that has to do with the shape of the alveoli and bronchioles. With emphysema, your bronchioles and alveoli are damaged, and have trouble efficiently pushing out all the air you breathe in. The bronchioles expand as you inhale but contract too much when you exhale, so not enough air gets out. This makes breathing difficult. 

The alveoli also lose their shape and stretchiness — they can get larger and trap air inside your lungs so that you can’t breathe out fast enough. Damaged alveoli also lose their ability to transport oxygen into your body.

What is COPD?

COPD is an umbrella term for a group of lung conditions that involve breathing difficulty and decreased lung function over time. The two main types of COPD, emphysema and chronic bronchitis, can occur independently or together. Bronchitis refers to inflammation, swelling, and mucus blockage of the bronchi and bronchioles, while emphysema refers to the structural damage of alveoli and bronchioles themselves.

What are symptoms and signs of emphysema vs. COPD?

If you have emphysema, you have COPD — but the two conditions aren’t the same. COPD encompasses more lung conditions than just emphysema. 

Symptoms of emphysema

Emphysema can have a variety of symptoms related to breathing difficulty. These symptoms include:

Symptoms of COPD

Other symptoms of COPD come from chronic bronchitis. Chronic bronchitis shares some characteristics with emphysema, but has a few different symptoms:

  • Coughing up mucus more often
  • Long-lasting coughing bouts with mucus that happen often
  • More often occurs in obese patients

What are causes of emphysema vs. COPD?

Repeated, long-lasting exposure to cigarette smoke and other harmful chemicals causes both emphysema and COPD. 

Causes of emphysema

The most common cause of emphysema is smoking cigarettes. Over time, cigarette smoke destroys the smaller ridges and chambers inside the alveoli that manage oxygen and carbon dioxide exchange. Cigarette smoke also reduces the alveoli’s stretchiness, making it harder to breathe out fully.

Less common causes of emphysema include repeated exposure to secondhand smoke (being close to people who are smoking), breathing in polluted air, and breathing in toxic gases or dust — often in the workplace. 

Causes of COPD

Like emphysema, smoking cigarettes is the leading cause of other illnesses under the category of COPD. Chronic bronchitis can also stem from exposure to irritating chemicals and pollutants. If you had a lot of respiratory infections during childhood, you may also be at higher risk of developing COPD. 

A rare genetic condition that runs in families makes some people more likely to develop COPD.

How to diagnose emphysema vs. COPD

Diagnosing emphysema and COPD are similar processes. 

Diagnosing emphysema

A doctor can perform a few examinations specific to emphysema. This could include measuring the size and shape of your chest, a chest X-ray, or CT scan.

Diagnosing COPD

Most of the tests and processes that diagnose emphysema also diagnose COPD. A doctor will likely ask you about your symptoms, personal and family medical history, medications you take, and if you smoke.

Your doctor may also perform some physical tests. These could include:

  • Measuring how much air you breathe out with special machines, also known as spirometry
  • Examining your fingers and lips for blue discoloration, which indicates low oxygen levels
  • Listening to your heart and lungs with a stethoscope

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Treatments for emphysema vs. COPD

Emphysema and other COPD-related illnesses usually require similar treatments.

Treatments for emphysema

Lung reduction surgery can help address lung swelling and growth as a result of emphysema. Although rare, serious side effects from this type of surgery can include heart attack, infection, and death.

Treatments for COPD

Treatments for multiple types of COPD, including emphysema, can include:

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