Understanding Emphysema vs. Chronic Bronchitis

Did you know that COPD stands for Chronic Obstructive Pulmonary Disease and that it is an umbrella term for more than one chronic lung disorder? It's true. COPD is any condition where your internal lung tissues are chronically inflamed. That inflammation narrows and blocks the air passages, which makes it hard to breathe well. There are two main types of COPD:1

  • Chronic bronchitis
  • Emphysema

Because most people who have COPD suffer from both types, experts started preferring the use of the blanket term, rather than the individual conditions. However, you might be interested in understanding the differences and similarities better.

Defining chronic bronchitis & emphysema

Chronic bronchitis is an inflammation of the upper respiratory system and the passageways of the lungs.2 Typically, there is a chronic cough that produces sputum. Although bronchitis may start out as an acute condition, when it recurs repeatedly over 2 years, the diagnosis changes to chronic bronchitis.1

Emphysema is a condition that damages the tiny air sacs, called alveoli, in the lungs. These air sacs lose their elasticity, swell and some even burst.2 The destruction is widespread and irreversible.1

Similarities between chronic bronchitis & emphysema

Cigarette smoking is the main cause of both conditions, but air pollution may also play a role.6 Both are chronic and incurable, although stability and progression can vary from person to person and from month to month.

In addition, both bronchitis and emphysema can have some similar symptoms, although the exact nature of these symptoms can vary:

  • Breathlessness
  • Chronic cough
  • Fatigue

Both types of COPD involve changes in the lungs, but the changes in bronchitis come and go, while those in emphysema are permanent. However, both conditions are chronic and the symptoms will recur at regular intervals.

How chronic bronchitis & emphysema differ

The way the lungs are affected in each of the types of COPD accounts for the differences in symptoms. With bronchitis, there are glands that line your larger airways, called bronchi. These glands enlarge and produce large amounts of mucus. The next smaller airways, called bronchioles, also become inflamed. This causes them to spasm and swell. The result of all these changes is obstruction of the airflow through these airways into and out of your lungs.1 Over time, these changes cause permanent damage to your airways.

Bronchitis starts out as an acute illness. But when it lasts for 2 or 3 months and comes back off and on over 2 years, it's considered chronic. Bronchitis's main symptom is a "wet" cough, one that brings up thick, sticky mucus. A low-grade fever (less than 100.4 degrees Fahrenheit) may also occur. Also, as described earlier, bronchitis symptoms tend to come and go.6

Emphysema, on the other hand, causes a collapse of the walls of the small air sacs in the lungs called alveoli. These changes generally develop over many years and do not cause noticeable symptoms until the damage has been done. The result of these changes is permanent and irreversible airflow obstruction.6

Another difference with emphysema is that the condition is progressive. It doesn't come and go like bronchitis. It worsens over time. Although shortness of breath and fatigue are two of the most common symptoms, there can be a chronic cough. This cough is not usually as "wet" as that from chronic bronchitis, however.

Other symptoms of emphysema might include:

  • decreased mental acuity and trouble focusing
  • bluish or gray fingernails and/or lips, especially after activity

In summary

The bottom line is that both types of COPD cause difficulties with breathing. Plus, most people have both types of COPD. While the symptoms of chronic bronchitis might not be constant, they do recur regularly. And due to the damage each of these conditions causes to the lungs, your symptoms will get worse over time. This can take years though.

And here's the good news: Both conditions are treatable. The treatments available can greatly reduce your symptoms and even slow down the progression of your lung damage. If you still smoke, quitting smoking is the best thing you can do. It won't reverse any damage already done. But it will improve your chances of continuing to live the best quality of life possible for the longest time.

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