Chronic obstructive pulmonary disease (COPD) can result from chronic bronchitis or emphysema. Some people may also have COPD and asthma, which can worsen both conditions.

Chronic obstructive pulmonary disease (COPD) is a lung condition that you either develop from external factors or inherit, and it lasts throughout your life.

Two conditions cause COPD: chronic bronchitis and emphysema. Both affect your lungs in different ways.

Asthma is not considered a type of COPD, but it is a chronic respiratory condition. You can have asthma along with COPD. This is called asthma-COPD overlap syndrome (ACOS).

You may have COPD if you notice persistent, prolonged changes to your breathing. Symptoms can include:

  • tightness in your chest
  • difficulty taking deep breaths
  • wheezing
  • feeling out of breath
  • coughing
  • feeling tired
  • frequent colds and infections in your nose and throat

These symptoms usually worsen over time without treatment. You can also develop conditions like irregular heartbeats, heart failure, and high blood pressure, especially without treatment.

Keep reading to learn more about the types and causes of COPD and how doctors diagnose and treat them.

Bronchitis occurs when the larger airways, or bronchi, in your lungs become swollen and inflamed. This typically causes symptoms like:

  • coughing spells that bring up mucus or phlegm
  • wheezing
  • feeling out of breath
  • chest pain

This condition makes it difficult for your lungs to bring air in and let it out.

Bronchitis can be acute (sudden and short-lasting), usually relating to a lung infection like the common cold. Or it can be chronic (long-lasting) and worsen over time.

Chronic bronchitis is the type of bronchitis that causes COPD. It develops when hair-like fibers called cilia disappear from the bronchial tubes, making it difficult to cough mucus from the lungs. There isn’t a cure for chronic bronchitis.

Causes

Chronic bronchitis typically results from smoking cigarettes or contact with environmental factors that cause lung damage, like:

  • air pollution
  • fumes or chemicals
  • dust

Diagnosis

To receive a diagnosis of chronic bronchitis, you must have a cough that produces phlegm or mucus for at least 3 months over the course of 2 years.

A doctor usually diagnoses chronic bronchitis using a breathing test called spirometry. This test measures how much air you exhale. You take deep breaths into a tube that a computer monitors to determine if you have COPD or another condition like asthma.

Treatment

  • medications, such as inhaled bronchodilators that help open the airways and inhaled or oral corticosteroids to reduce inflammation
  • oxygen therapy
  • pulmonary rehabilitation
  • avoiding further lung damage by quitting smoking, if you smoke

Doctors may also recommend:

  • eating a balanced diet
  • doing specific kinds of physical activity
  • taking precautions to avoid respiratory illnesses
  • getting recommended vaccinations, especially to prevent viral and bacterial pneumonia

Emphysema causes damage to the lungs’ air sacs, called alveoli. A person usually has about 300 million alveoli in the lungs.

With emphysema, damage destroys the walls of the alveoli and causes them to increase in size. When these air sacs break, they form larger pockets that can trap air in the damaged tissue. This makes it harder for the lungs to transfer oxygen into the bloodstream.

This can result in difficulty breathing because the lungs lose their elasticity. This damage cannot be reversed.

Causes

Emphysema has many of the same causes as chronic bronchitis, which include:

  • cigarette smoking
  • air pollution
  • chemicals
  • dust

You can also inherit emphysema. Some people have an alpha-1 antitrypsin deficiency in their genes, which can cause emphysema.

Diagnosis

A doctor usually diagnoses emphysema by:

  • going over your medical history
  • performing a physical exam
  • using spirometry, a type of breathing test

They may also perform other tests to get a better understanding of the damage.

Learn more about diagnostic tests for COPD.

Treatment

Treatment for emphysema usually involves medications and lifestyle changes to help manage your symptoms. This can include:

  • medications for quick relief from symptoms
  • medications you take daily to reduce swelling and inflammation
  • oxygen therapy
  • pulmonary rehabilitation
  • nonsurgical procedures such as endobronchial valve (EBV) therapy
  • surgical procedures, such as lung volume reduction surgery and lung transplant
  • smoking cessation, if you smoke

The treatment a doctor recommends can depend on the severity of your symptoms and other factors.

They may also recommend:

  • doing physical activity appropriate for your condition
  • practicing strategies to support your overall health, including eating a nutritious diet
  • avoiding getting respiratory illnesses, to the extent that it’s possible

Asthma is not a condition that causes COPD, but you can have both conditions at the same time. This condition is called asthma-COPD overlap syndrome (ACOS).

It can lead to more problematic respiratory symptoms, affect your quality of life, and increase the chances of hospitalization.

Causes

People with ACOS have both COPD and asthma.

While researchers still do not know exactly what causes asthma, multiple factors may play a role. Some of the factors are similar to the causes of COPD. They can include:

  • a family history of asthma
  • a history of allergies, obesity, or both
  • a history of respiratory infections in childhood
  • cigarette smoking
  • air pollution
  • exposure to chemicals and fumes, such as in the workplace

Diagnosis

If a doctor thinks you might have asthma and COPD, they may perform an exam and order tests to determine that you have both conditions. They may also ask additional questions about your symptoms, including when they appeared and any recent changes.

Your doctor may order an imaging test to see your lungs. This could be a chest X-ray or a CT scan.

Additional diagnostic tests may include monitoring your breath as you sleep or exercise.

Treatment

Treating ACOS may involve:

  • low dose inhaled corticosteroids to reduce inflammation from asthma
  • medications to relax the muscles around your lungs
  • medications to prevent excess mucus due to COPD

You may also need other types of therapy, depending on the severity of your symptoms, including:

  • oxygen therapy
  • pulmonary rehabilitation
  • nonsurgical procedures
  • surgical procedures

There is no set age for a COPD screening. It’s best to discuss symptoms with your doctor if you suspect you have COPD.

Your doctor may also be aware of your breathing difficulties and diagnose the condition, but don’t be afraid to ask if you suspect you have this lung condition. Early treatment will prevent the condition from getting worse.

Keep in regular contact with your doctor following a diagnosis of COPD. Reach out if you experience side effects of medications, worsening symptoms, or new symptoms.

COPD is a serious and chronic lung condition. Two conditions can cause it: emphysema and chronic bronchitis. Your doctor usually diagnoses the condition with a breathing test.

You will likely need to make lifestyle changes, in addition to taking prescribed medications, to prevent the condition from worsening.

It’s best to talk with your doctor if you suspect COPD or if you have the condition and experience flaring symptoms.