How the Two Main Types of COPD Differ

Comparing Emphysema and Chronic Bronchitis

Chronic obstructive pulmonary disease (COPD) kills more than 120,000 Americans each year and is predominantly associated with cigarette smoking. COPD affects around 5% of the U.S. population and can take one of two common forms of the disease: emphysema or chronic bronchitis.

Emphysema and chronic bronchitis can be difficult to tell apart since each causes the restriction of breathing as well as symptoms of fatigue, wheezing, and excessive mucus production. Some people can experience both conditions at once, particularly in later-stage COPD.

The main difference between emphysema and chronic bronchitis are the structures of the lungs they affect. For emphysema, the damage would occur in the air sacs of the lungs, called the alveoli, while the bronchial tubes would be the structures affected by chronic bronchitis.

Senior woman holding chest in pain
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Features of Emphysema

Emphysema is a form of COPD in which the alveoli are progressively damaged, causing them to weaken and burst. This reduces the surface area of the lungs and restricts the amount of oxygen that can reach the bloodstream.

Emphysema also causes the lungs to gradually lose their elasticity. The lack of oxygen combined with the build-up of carbon dioxide can lead to a myriad of symptoms, including:

  • Shortness of breath
  • Wheezing
  • Persistent cough
  • Excessive mucus production
  • Chronic fatigue
  • Rapid heartbeat (tachycardia)

More than four million Americans are diagnosed with emphysema each year. Cigarette smoking is the main cause, the risk of which is associated with the duration of smoking and the number of cigarettes smoked each day. Non-smokers can also develop emphysema if regularly exposed to secondhand smoke.

Features of Chronic Bronchitis

Chronic bronchitis is a form of COPD that causes inflammation of the bronchial tubes. When exposed to persistent inflammation, these passages will secrete mucus as a form of self-protection. The problem with this, of course, is that the excessive production can clog some of the smaller passageways, making it difficult for air to enter or leave.

Chronic bronchitis is characterized by a persistent cough occurring on most days for at least three months and for at least two consecutive years. Other symptoms include:

  • Coughing up clear or white mucus
  • Shortness of breath
  • Wheezing
  • Chest tightness or discomfort
  • Chronic fatigue

In the later stages of chronic bronchitis, the skin and lips may develop a bluish tinge. This is caused by the lack of oxygen in the bloodstream, a condition known as cyanosis. Over the long term, decreased oxygen can lead to the development of high blood pressure in the lung blood vessels, which may result in swelling of the legs and ankle (peripheral edema).

The number of adults living with chronic bronchitis continues to grow in the U.S. with numbers now exceeding 11 million.

Improving Your Symptoms

There is no cure for emphysema or chronic bronchitis. Treatment of these conditions is focused on the reduction of symptoms and slowing the progression of the disease. Treatment may involve oral drugs, inhaled medications, and surgery.

Lifestyle changes are also central to treatment. Chief among these is the cessation of smoking, either by going cold turkey or using smoking aids. Without the complete termination of cigarettes, there is little way to either slow the disease or reduce the severity of illness.

By kicking the habit, exercising regularly, losing weight, and using the appropriate medications, you can significantly reduce COPD symptoms and increase both your lifespan and quality of life.

5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. Voelkel NF, Gomez-arroyo J, Mizuno S. COPD/emphysema: The vascular story. Pulm Circ. 2011;1(3):320-6. doi:10.4103/2045-8932.87295

  3. CDC - Data and Statistics - Chronic Obstructive Pulmonary Disease (COPD)

  4. Kim V, Criner GJ. Chronic bronchitis and chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2013;187(3):228-37. doi:10.1164/rccm.201210-1843CI

  5. Lahousse L, Seys LJM, Joos GF, Franco OH, Stricker BH, Brusselle GG. Epidemiology and impact of chronic bronchitis in chronic obstructive pulmonary disease. Eur Respir J. 2017;50(2) doi:10.1183/13993003.02470-2016

Additional Reading
  • U.S. National Library of Medicine: National Institutes of Health. COPD. MedlinePlus. Bethesda, Maryland.

By Deborah Leader, RN
 Deborah Leader RN, PHN, is a registered nurse and medical writer who focuses on COPD.