Difference Between Chronic Bronchitis and Emphysema

Chronic bronchitis and emphysema are two conditions that fall under the umbrella term of chronic obstructive pulmonary disease (COPD). Both chronic bronchitis and emphysema are caused by damage to the lungs and airways, which can lead to breathing difficulties and other symptoms. Despite some similarities, there are distinct differences between the two conditions.

What is Chronic Bronchitis?

Chronic bronchitis is a chronic inflammatory disease of the bronchi. It is characterized by prolonged cough and mucus formation in the respiratory tract. Bronchitis is considered chronic if the symptoms occur most days of the month, three months a year for two consecutive years, and in the absence of secondary causes of a cough.

Patients with chronic bronchitis have varying degrees of breathing difficulty. Symptoms can be aggravated or relieved at different times of the year. The main cause of chronic bronchitis is smoking. Risk factors include continuous attacks of acute bronchitis, air pollution, industrial fumes, etc.

People with an increased risk of developing chronic bronchitis include −

• Smokers;

• Passive smokers;

• People with a weakened immune system;

• People exposed to irritants at work;

• People who live in a polluted air.

The signs and symptoms of chronic bronchitis include −

• Inflammation and swelling of the bronchi;

• Cough;

• Production of clear, white, yellow or greenish sputum;

• Lack of air;

• Rales;

• Fatigue;

• Chest pain and discomfort.

Diagnosis is based on a medical examination. If wheezing or abnormal sounds are heard on auscultation, chest radiography, spirometry, sputum analysis, and blood tests are done. Differential diagnosis includes chronic obstructive pulmonary disease (COPD), bronchial asthma, left ventricular heart disease.

The treatment of chronic bronchitis includes bronchodilators, cough medicines, anti-asthma drugs, anti-inflammatory drugs, corticosteroids. Antibiotics are effective in bacterial infections.

The prognosis is determined by the degree of bronchial obstruction and its dynamics.

What is Emphysema?

Emphysema is a chronic progressive lung disease where tissues supporting the function of the lungs are destroyed. Due to the destruction of the surrounding pulmonary tissue, the alveoli become enlarged and incapable of carrying out a normal gas exchange.

The main symptoms of emphysema are −

• Severe dyspnea, especially in physical exercise;

• An effort to exhale;

• A distinctly enlarged chest.

• Typically, the dyspnea gradually deteriorates over many years. It is also possible to have a cough or a whirling breath.

The main cause of emphysema is smoking. Secondary risk factors include air pollution, hereditary predisposition, male gender, allergies and/or asthma and age.

Sometimes emphysema occurs as a result of the normal aging process, which leads to gradual degenerative changes of the lung tissue. The respiratory muscles, like all others, are weakening. In rare cases, emphysema occurs as a result of congenital alpha-1-antitrypsin deficiency.

The diagnosis of emphysema is made by examining pulmonary function, most often by spirometry, measurement of exhaled carbon monoxide levels, chest X-ray. Emphysema is an irreversible, progressive disease. If the diagnosis is confirmed, urgent action is necessary – an immediate cessation of smoking and irritant exposure.

Pulmonary tissue damage is persistent and irreversible, but inflammation (and disease progression, respectively) can be delayed by corticosteroids (inhaled or oral). Breathing can be alleviated with the help of bronchodilators, cholinolytics, proper body positioning, and eventually oxygen.

Surgery to reduce the lung volume in which the most damaged tissue is removed allows functional lung tissue to work better. It has shown some benefit to a relatively limited group of patients. The only definitive solution for emphysema is lung transplantation.

Differences: Chronic Bronchitis and Emphysema

The main difference between chronic bronchitis and emphysema is the location of the damage in the lungs. In chronic bronchitis, the damage is focused on the bronchial tubes, while in emphysema, the damage is focused on the air sacs. Another difference between the two conditions is the type of mucus that is produced. In chronic bronchitis, the mucus is thick and sticky, while in emphysema, the mucus is thin and watery.

Chronic bronchitis and emphysema also have different risk factors. The most common risk factor for chronic bronchitis is smoking. Exposure to air pollution, dust, and chemicals can also increase the risk of developing chronic bronchitis. In contrast, emphysema is primarily caused by smoking. Other risk factors for emphysema include exposure to air pollution, genetics, and age.

Treatment options for chronic bronchitis and emphysema are similar, but may differ in some cases. The main goal of treatment is to manage symptoms and improve quality of life. This may involve medications, such as bronchodilators and corticosteroids, which help to open the airways and reduce inflammation. Oxygen therapy may also be used to help with breathing. In some cases, surgery may be recommended to remove damaged tissue or to transplant healthy lung tissue.

The following table highlights the major differences between Chronic Bronchitis and Emphysema −

Characteristics	Chronic Bronchitis	Emphysema
Definition	Chronic bronchitis is a chronic inflammatory disease of the bronchi, characterized by prolonged cough and mucus formation in the respiratory tract.	Emphysema is a chronic progressive lung disease where tissues supporting the function of the lungs are destroyed.
Causative agents	The main cause of chronic bronchitis is smoking. Risk factors include continuous attacks of acute bronchitis, weak immune system, irritants, and polluted air.	The main cause of emphysema is smoking. Risk factors include air pollution, hereditary factors, male gender, allergies and/or asthma, age, and congenital alpha-1-antitrypsin deficiency.
Symptoms	The symptoms of chronic bronchitis include inflammation and swelling of the bronchi, cough, production of clear, white, yellow or greenish sputum, lack of air, rales, fatigue, and chest pain.	The main symptoms of emphysema are severe dyspnea, an effort to exhale, and a distinctly enlarged chest.
Diagnosis	Diagnosis of chronic bronchitis is based on a medical examination. If wheezing or abnormal sounds are heard on auscultation, chest radiography, spirometry, sputum analysis, and blood tests are done.	Diagnosis of emphysema is made by examining the pulmonary function, most often by spirometry, measurement of exhaled carbon monoxide levels, chest X-ray.
Treatment	The treatment of chronic bronchitis includes bronchodilators, cough medicines, anti-asthma drugs, anti- inflammatory drugs, corticosteroids. Antibiotics are effective in bacterial infections.	Inflammation can be delayed by corticosteroids. Breathing can be alleviated with the help of bronchodilators, cholinolytics, proper body positioning, and eventually oxygen. Surgery allows functional lung tissue to work better. The only definitive solution for emphysema is lung transplantation.

Conclusion

In summary, chronic bronchitis and emphysema are two different types of COPD that share some similarities, but have distinct differences. Chronic bronchitis is characterized by inflammation and irritation of the bronchial tubes, while emphysema is characterized by damage to the air sacs in the lungs. The type of mucus produced, risk factors, and treatment options also differ between the two conditions.

If you are experiencing symptoms of COPD, it is important to speak with your healthcare provider to determine the underlying cause and develop a treatment plan. Quitting smoking and avoiding exposure to air pollution and other environmental toxins can also help to reduce the risk of developing chronic bronchitis or emphysema.