Given the fact that chronic obstructive pulmonary disease (COPD) and asthma are both respiratory conditions characterized by chronic inflammation and airflow obstruction, people usually mistakenly think they are the same. However, although the symptoms may overlap, the cause of these respiratory conditions is the main difference. What&rsquo's more, COPD and asthma may sometimes overlap which is known as ACOS (asthma-COPD overlap syndrome).
COPD and Asthma Symptoms
The most common symptoms of these conditions include:
- Chronic cough
- Chest tightness
- Shortness of breath
But, there’s a difference in the frequency and predominating symptoms. In fact, COPD patients usually have a morning cough, increased sputum, and experience the symptoms constantly, whereas, in asthma patients, the symptoms are episodic rather than persistent. And, asthma symptoms occur after being exposed to certain triggers while COPD symptoms occur with no reason at all.
Another difference is the comorbid conditions, for example, if you have eczema or allergic rhinitis you are at great risk of developing asthma. And, if you suffer from osteoporosis or coronary heart disease you are more likely to develop COPD. Also, people tend to get diagnosed with asthma early on, in childhood or adolescence. But, COPD is most frequently diagnosed in adulthood.
COPD and Asthma Causes
Even though both asthma and COPD are inflammatory diseases, the inflammation doesn’t come from the same white blood cell type.
When it comes to asthma, the inflammation is an acute result of eosinophil production, which is a white blood cell type that rises when there’s an allergen present. As a result, the airways get inflamed and irritable and impede the air to move in and out of the airway.
On the other hand, COPD development is the most common result of chronic cigarette smoking which damages the lungs and causes airway obstruction and hyperinflation. Over many years, the production of macrophages and neutrophils increases and results in inflammation.
COPD and Asthma Diagnosis
We&rsquo've previously mentioned the time when people usually get diagnosed with these conditions and even though the timing differs, they are both diagnosed via testing and physical exam, as well as the patient’s family history and lifestyle habits.
Regarding the physical exam, the doctor will search for symptoms like cough, wheezing, or shortness of breath, and even nasal inflammation signs. Spirometry is yet another breathing test that is noninvasive but helpful in diagnosing both asthma and COPD.
Once you get diagnosed with either of these conditions, your doctor will recommend further testing and examinations which may include pulse oximetry, arterial blood gases, X-ray, or computed tomography.
Asthma-COPD Overlap Syndrome (ACOS)
Finally, when asthma and COPD occur together, the condition is known as ACOS (asthma-COPD overlap syndrome).
According to several studies, 10% to 20% of people with COPD, also experience asthma symptoms, while 25% of asthma patients are smokers and are therefore at a higher risk of developing COPD.
To be diagnosed with ACOS, your physician will consider the following criteria:
- Asthma and COPD diagnosis
- 40+ years old
- Increased total IgE
- Smoking history
- FEV1/ FVC ratio lower than 70%
- FEV1 improvement and peak flow following bronchodilator
- Eosinophilia in the spetum
After being diagnosed with ACOS, further treatment depends on the predominant condition and may include short-acting bronchodilators (SABAs), long-acting bronchodilators (LABAs), anticholinergics, inhaled steroids, systemic steroids, and antibiotics.