Asthma and COPD
Both show up as cough, wheezing and breathlessness, but their causes, course and treatment differ. This page explains the difference, how the diagnosis is made and what inhalers do.
Why are these two together?
In both, air passes through the airways with more difficulty. They differ in how the disease behaves, and that difference changes the treatment.
Asthma tends to come in episodes. Symptoms come and go and are often worse at night or early in the morning. Exercise, cold air, air pollution, pollen, dust, mould, animals, smoke and infections can set it off. So can some medicines, such as aspirin and ibuprofen.
COPD is the name for a group of conditions, including emphysema and chronic bronchitis. It usually appears in middle or older age in people who smoke or used to. Breathlessness on effort, a lasting chesty cough and repeated chest infections are among its symptoms, and without treatment it usually gets worse.
How is the diagnosis made?
The examination and history come first. Then a breathing test, spirometry, shows how air comes out. In asthma a peak flow meter is sometimes used at home for a few weeks, and the doctor may try asthma medicine to see whether it helps. Many people do not know they have COPD. If you are over 35, smoke or used to, and your symptoms persist, do not put off being assessed.
How do inhalers differ?
- A reliever is for when you have symptoms.
- A preventer is used every day to reduce symptoms, even on days you feel well.
- Some inhalers do both jobs.
Which inhaler suits you is your doctor’s decision. Using it properly matters as much as the medicine itself, so read the inhaler guide and ask your doctor or pharmacist to watch you use it.
What else helps?
- Stopping smoking, the most important step in COPD.
- Pulmonary rehabilitation, which combines exercise and education.
- Regular exercise, to the point of being a little breathless but not beyond it.
- Flu and pneumococcal vaccines, as your doctor advises.
- Avoiding triggers such as smoke, fumes, air fresheners and strong cleaning products.
When should you act urgently?
In an asthma attack, sit up straight, stay calm and use your reliever as your doctor’s plan says. If you do not improve, get worse at any point, or have no inhaler, call 115 and do not drive yourself. After any attack, speak to your doctor soon so your treatment can be reviewed.
Frequently asked questions
Can asthma start in adulthood?
An asthma diagnosis is not limited by age, and symptoms that come and go should be checked at any age. Because they vary, reaching a diagnosis can take time.
Can COPD be cured?
The lung damage in COPD is permanent and the disease has no cure, but treatment can slow it and keep symptoms under control. Stopping smoking is the most important step.
Does a water pipe cause COPD too?
Smoking is the main cause of COPD, and long-term contact with harmful smoke and fumes can also cause it. Do not assume water-pipe smoke is safe, and tell your doctor honestly how much you use.
The first step, a calm conversation.
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