Understanding and Managing Asthma, Chronic Bronchitis, and Emphysema

Asthma, chronic bronchitis, and emphysema look alike but have major differences. Learn more about the differences in presentation and treatment of these conditions.

Highlights:

Asthma, chronic bronchitis, and emphysema are all chronic respiratory conditions that can cause shortness of breath and difficulty breathing
Treatment options for these conditions vary and may include bronchodilators, corticosteroids, oxygen therapy, and pulmonary rehabilitation
Preventive measures include, quitting smoking, lifestyle changes, a healthy diet, physical exercise, and breathing exercises

Asthma, chronic bronchitis, and emphysema are chronic obstructive pulmonary diseases (COPD) that affect the airways and lungs. While there are similarities between these diseases, they also have distinct differences in terms of etiology, age group affected, pathogenesis, clinical features, X-ray features, spirometry, treatment, diagnosis, and blood report picture ().

Diet for Obstructive Lung Disease
The right balance of energy boosting foods and protein foods along with adequate vitamin and mineral intake is the right diet for COPD.

‘Chronic bronchitis and emphysema have smoking as the major trigger. Asthma has cold weather, various allergens as triggering factors. Avoiding these may help prevent acute, life-threatening attacks. #Asthma, #COPD’

Understanding the Causes of these Respiratory Diseases

Asthma is primarily caused by genetic and environmental factors, such as exposure to allergens and irritants, respiratory infections, and air pollution. Chronic bronchitis is usually caused by smoking and exposure to irritants such as air pollution and industrial dust. Emphysema is commonly caused by smoking and exposure to air pollution, dust, and chemicals.

What are the Age Groups that are Commonly Affected?

Asthma can affect people of all ages, but it usually starts in childhood. Chronic bronchitis is most common in people over the age of 40 who have a history of smoking. Emphysema is also most common in people over 40 who have a history of smoking (), ().

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What do these Conditions do to the Lungs?

Asthma is characterized by inflammation of the airways and the production of excess mucus, which can lead to narrowing of the airways and difficulty breathing. Chronic bronchitis is characterized by chronic inflammation of the bronchial tubes, leading to excessive mucus production and narrowing of the airways. Emphysema is characterized by the destruction of the walls of the air sacs in the lungs, leading to a loss of elasticity and decreased ability to breathe.

Chronic Obstructive Pulmonary Disease
COPD includes respiratory tract disorders that cause obstruction to airflow. These are chronic bronchitis, emphysema and small airway disease.

What are the Common Symptoms?

Asthma is characterized by wheezing, coughing, chest tightness, and shortness of breath. Chronic bronchitis is characterized by a persistent cough, shortness of breath, and mucus production. Emphysema is characterized by shortness of breath, wheezing, and chest tightness (), ().

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Other Medical Parameters to Spot the Differences

X-rays for Asthma

: In asthma, X-rays may appear normal or show signs of hyperinflation, which is an increased amount of air trapped in the lungs. Chronic bronchitis may show signs of bronchial wall thickening and increased bronchovascular markings. Emphysema may show signs of decreased lung markings, increased air space, and flattening of the diaphragm.

Spirometry for Asthma

: Spirometry is a test that measures how much air a person can exhale in one second (FEV1) and how much air they can exhale in total (FVC). In the spirometry report, you may see the following changes :

Asthma may show a reversible obstruction in air flow
Chronic bronchitis may show a decrease in FEV1 and FVC with a mild obstruction
Emphysema may show a significant decrease in FEV1 and FVC with severe obstruction

Diagnosis for COPD

Diagnosis of asthma is based on clinical symptoms, a physical examination, history of exposure to allergens. Family history also plays a very important role in understanding and diagnosing asthma.

Chronic bronchitis is diagnosed based on a history of cough and sputum production for at least three months in two consecutive years, as well as spirometry.

Emphysema is diagnosed based on history of smoking, clinical symptoms, a physical examination, and pulmonary function tests ().

Treatment for COPD

Treatment for asthma usually involves using bronchodilators and anti-inflammatory medications to reduce inflammation and open up the airways. Sometimes low dose corticosteroids are also prescribed based on the severity of the condition. The treatment mainly depends on the acuteness of the condition.

Treatment for chronic bronchitis may involve bronchodilators, corticosteroids, and antibiotics to treat respiratory infections.

Treatment for emphysema may involve bronchodilators, oxygen therapy, and pulmonary rehabilitation.

In asthma, the blood eosinophil count may be elevated, indicating an allergic or immune response. In chronic bronchitis, the white blood cell count is slightly elevated. Though blood reports are considerably less.

Preventive Strategies for COPD

Avoid smoking and exposure to secondhand smoke:

Smoking is a significant risk factor for all three conditions. Avoiding smoking and staying away from secondhand smoke is essential in reducing the risk of developing these conditions.

Avoid exposure to environmental irritants:

Exposure to environmental irritants such as air pollution, dust, and chemicals can worsen symptoms of asthma, chronic bronchitis, and emphysema. It is essential to limit exposure to these irritants.

Practice Good Hygiene:

Respiratory infections can trigger exacerbations of asthma, chronic bronchitis, and emphysema. Practicing good hygiene, such as washing hands regularly and avoiding close contact with sick people, can reduce the risk of infections.

Get Vaccinated

: Getting vaccinated against influenza and pneumonia can reduce the risk of respiratory infections, which can trigger exacerbations of these conditions.

Lifestyle Modification

Lifestyle modifications and breathing exercises can be helpful in managing the symptoms and improving lung function in individuals with asthma, chronic bronchitis, and emphysema ().

Regular Exercise

: Regular exercise, such as walking, swimming, or cycling, can improve lung function and reduce the risk of exacerbations in individuals with asthma, chronic bronchitis, and emphysema. However, it is essential to consult a healthcare provider before starting an exercise program ().

Breathing Exercises

: Breathing exercises such as pursed-lip breathing, deep breathing, and diaphragmatic breathing can help improve lung function and reduce shortness of breath in individuals with these conditions ().

Avoiding Triggers

: Individuals with asthma and chronic bronchitis should identify and avoid triggers that can worsen their symptoms, such as pollen, dust, and cold air.

Dietary Modifications

: A healthy diet, including fruits, vegetables, and lean proteins, can improve overall health and reduce the risk of exacerbations in individuals with asthma, chronic bronchitis, and emphysema.

Maintaining a Healthy Weight

: Maintaining a healthy weight can reduce the burden on the lungs and improve overall health in individuals with these conditions.

Stress Management

: Stress can worsen symptoms of asthma, chronic bronchitis, and emphysema. Techniques such as deep breathing exercises, meditation, and yoga can help manage stress and improve symptoms.

It is essential to consult a healthcare provider before starting any lifestyle modifications or breathing exercises to ensure that they are safe and effective for the individual's specific condition.

References:

Asthma and Chronic Obstructive Pulmonary Disease (COPD) – Differences and Similarities - (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3633485/)
Emphysema: Overview - (https://www.mayoclinic.org/diseases-conditions/emphysema/symptoms-causes/syc-20355555)
Chronic Bronchitis - (https://www.ncbi.nlm.nih.gov/books/NBK482437/)
Study of the effect of yoga training on diffusion capacity in chronic obstructive pulmonary disease patients: A controlled trial - (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3410191/)

Source-Medindia