The simple explanation is this:
- The term COPD covers a group of lung diseases. In particular, it’s an umbrella term that includes both emphysema and chronic bronchitis. So, all emphysema is COPD but not all COPD is emphysema.1
- Emphysema, which is usually a direct result of years of smoking, is a disease of the middle aged and elderly. But emphysema is different from chronic bronchitis, which while also often caused by smoking, can occur earlier in life.2 Emphysema is commonly known as “pink puffers” because of the carbon dioxide retained in the lungs and those who suffer with this condition often have a pink complexion.3 It destroys the lung tissue called alveoli.
- Chronic Bronchitis, on the other hand, is known as “blue bloaters” because oxygen is retained in lungs and people with bronchitis may have blue lips and complexions.4 Often first diagnosed as chronic coughing with sputum or mucus—occurring twice a year (or lasting for three or more months) for two consecutive years.
To find out whether you have COPD emphysema, contact your doctor to discuss your symptoms. Your doctor will order the appropriate tests and provide a diagnosis.
How COPD Emphysema Progresses
For most COPD patients with emphysema, the disease begins by destroying the cilia—tiny brushes in the lungs that work to remove the particles that irritate and harm the lungs.5 These particles are then expelled through coughing up mucus. As the cilia are destroyed, the lungs fail to work properly. The particles can’t get out, which leads to damage of the alveoli—tiny air sacs in lungs.
The alveoli look like clusters of grapes. In COPD emphysema, as the alveoli are damaged they lose elasticity and won’t contract and stretch normally. Eventually, the alveoli become permanently stretched and your lungs have trouble taking in oxygen and expelling carbon dioxide. At their worst, the inner walls of the alveoli sacs weaken and rupture, thus creating one large air space instead of many small ones. This effectively reduces the surface area of the lungs. Old air becomes trapped, which leaves less room for fresh, oxygen-rich air to enter the lungs and reach the bloodstream.
This is different from the progression of chronic bronchitis where inflammation caused by smoking will lead to a cough and increased mucus production. Not only are the symptoms different, but chronic bronchitis may not lead to permanent lung damage. There is one important caveat: Many COPD patients have both emphysema and chronic bronchitis.
Early Symptoms of COPD Emphysema
As with all COPD, you can have COPD emphysema for years without noticing signs or symptoms. Typically, the primary symptom is the shortness of breath. The development is usually gradual. At first, you may notice that you start avoiding certain activities because they make you short of breath. You may also feel increasingly fatigued.
If this describes you, don’t write these symptoms off as normal aging. That’s particularly true if you currently smoke or used to smoke tobacco or marijuana, if you live in an area with severe air pollution, or if you are exposed to chemical or manufacturing fumes. Breathing secondhand smoke can also lead to symptoms, which is why years of smoking a pipe or cigars may also lead to COPD emphysema.
As COPD emphysema develops, you’ll notice that:
- You are short of breath climbing stairs
- Your lips and fingernail beds turn blue or gray with exercise
- You don’t feel mentally alert
COPD emphysema is a permanent and progressive disease. It cannot be cured, but it can be treated. The earlier you seek medical help, the better your outcome. It may be possible to slow lung damage, maintain a better quality of life and increase lifespan.
Tests and Treatment for COPD Emphysema
When you consult your doctor, you’ll need to be tested. Common tests used for diagnosing COPD emphysema include:
- Chest X-ray
- Computerized tomography (CT) scan
- Arterial blood gas test—blood from the artery determines how well lungs transfer oxygen and remove carbon dioxide from the bloodstream
- Lung function test (spirometry)
Traditional treatments for COPD emphysema include:
- Inhaled corticosteroids
- Pulmonary rehabilitation (breathing exercises)
- Nutritional recommendations to help you lose or gain weight
- Supplemental oxygen therapy
- Surgery—either 1) lung volume reduction to remove small wedges of damaged lung or 2) lung transplant
Emphysema is a form of COPD. If you think you may have the early indicators, stop smoking and see your doctor immediately. Your doctor will probably also recommend flu and pneumonia vaccinations to help prevent respiratory infections.
3 The Daily Sign-Out. Pink puffer versus blue bloater. http://pathlabmed.typepad.com/surgical_pathology_and_la/2009/12/pink-puffer-versus-blue-bloater.html. Accessed 7.23.16.
4 The Daily Sign-Out. Pink puffer versus blue bloater. http://pathlabmed.typepad.com/surgical_pathology_and_la/2009/12/pink-puffer-versus-blue-bloater.html. Accessed 7.23.16.
5 Healthline. COPD vs. Emphysema: What’s the Difference? http://www.healthline.com/health-slideshow/copd-vs-emphysema#2. Accessed 7.23.16.