Emphysema and Chronic Bronchitis: How Do They Differ and How Do They Relate to COPD?

Many People Confuse Emphysema and Chronic Bronchitis Because Both are Serious Lung Conditions That Make Breathing More Difficult

Today in America, more than 3 million people have emphysema and 9 million have chronic bronchitis. Yet even though both conditions are fairly widespread and many people understand that they are lung conditions that make breathing difficult, some people still confuse the two.

Lesley Williams, Registered Respiratory Therapist and Apria’s Market Clinical Trainer, states, “Our customers often ask us questions about emphysema and chronic bronchitis: what they are, how they’re different, how they are related to COPD. And we make it a priority to answer these questions. Because the first step to effectively managing these conditions is to understand them.”

Emphysema and chronic bronchitis can occur together. And although they have some similarities, there are also important differences.

What Is Emphysema?

Emphysema is a progressive disease that gets worse over time.

Your lungs have tiny air sacs called alveoli, which supply oxygen to the blood. When you have emphysema, these air sacs become damaged or are destroyed. As a result, your lungs lose their elasticity, less oxygen enters your blood, and breathing becomes harder.


The main symptom of emphysema is shortness of breath. Other symptoms include:

  • Fatigue
  • Difficulty performing tasks
  • Chest pain or discomfort
  • Coughing or wheezing daily or almost every day
  • Rapid breathing and heartbeat
  • Heart issues
  • Difficulty sleeping
  • Anxiety or depression
  • Decreased mental alertness
  • Weight loss
  • Barrel-shaped chest (due to trapped air, which causes your lungs to get larger)
  • Swollen feet
  • Blue or gray lips or fingernails because of a lack of blood oxygen

What Is Chronic Bronchitis?

Chronic bronchitis is the irritation and inflammation of your bronchial tubes, which carry oxygen to and from your lungs. This irritation damages the tiny hairs, called cilia, that help remove phlegm from your lungs. The result: mucus builds up, causing a “wet” cough that lasts more than three months. In some cases, chronic bronchitis causes your airways to narrow, making breathing especially hard.


The main symptom of chronic bronchitis is a frequent cough with mucus. Other symptoms include:

  • Fatigue
  • Excess mucus production
  • Fever
  • Chest pain or discomfort
  • Wheezing
  • Shortness of breath or difficulty breathing
  • Fluctuating symptoms: symptoms may get worse for a time, then better
  • Crackling breathing sounds
  • Blue or gray lips or fingernails because of a lack of blood oxygen
  • Swollen feet
  • Heart failure

What Are the Causes of Emphysema and Chronic Bronchitis?

Smoking cigarettes is the biggest cause of both emphysema and chronic bronchitis.

Air pollution and other pollutants increase your risk.

Emphysema can be also caused by a genetic condition called AAT (alpha-1 antitrypsin) deficiency. AAT is a protein that protects your lungs from damage. AAT deficiency is an inherited condition. People who have it may also develop liver problems.

GERD (gastroesophageal reflux disease) is a condition that can contribute to chronic bronchitis. When you have GERD, stomach acid flows back up into your mouth through your esophagus, irritating your throat.

How Are Emphysema and Chronic Bronchitis Diagnosed?

Many of the same tests help doctors diagnose both emphysema and chronic bronchitis:

  • Medical history and physical exam
  • Imaging tests, such as chest X-ray and CT (computed tomography) scan
  • Pulmonary function tests, which measure how well your lungs are working. A spirometer is often used to perform this test
  • Arterial blood gas test, which measures the pH as well as oxygen and carbon dioxide levels in your blood
  • Peak flow monitoring, in which a machine measures how fast you can blow air out of your lungs. This helps your doctor determine if your airways are blocked
  • Sputum exam, where a lab analyzes samples of your saliva and mucus

Apria’s Lesley Williams adds, “If your doctor suspects your emphysema is caused by AAT deficiency, you may also undergo an AAT test.”

How Are Emphysema and Chronic Bronchitis Treated?

There’s no cure for emphysema or chronic bronchitis. But there are effective treatments to help manage both conditions. These include:

  • Stop smoking. This is not strictly a treatment—but it is the most important thing you can do to stop your condition from getting worse
  • Bronchodilators: You can take these either orally or with an inhaler. They expand your airways to relieve coughing and make breathing easier
  • Inhaled steroids. These aerosol sprays reduce inflammation and relieve shortness of breath
  • Antibiotics help treat bacterial infections such as pneumonia
  • Supplemental oxygen delivered through your nose or mouth with an oxygen mask provides you with the oxygen you need to perform daily tasks
  • Pulmonary rehabilitation. Your healthcare team will design a program to help improve your breathing, including advice on proper nutrition and exercise as well as counseling support
  • Surgery. Lung surgery or a lung transplant may be needed if lungs are severely damaged

How Are Emphysema and Chronic Bronchitis Related to COPD?

COPD (chronic obstructive pulmonary disease) is a leading cause of death in the United States and affects more than 16 million Americans.

Lesley Williams adds, “Emphysema and chronic bronchitis are the most common conditions that contribute to COPD.”

As with emphysema and chronic bronchitis, smoking cigarettes is the major cause of COPD, accounting for more than 90% of COPD cases.

COPD presents many of the same symptoms as the other conditions, such as shortness of breath and frequent coughing.

It is also diagnosed with many of the same tests: imaging tests, pulmonary function tests, and arterial blood gas analysis. And many of the same methods are used to treat it: medications, oxygen therapy, pulmonary rehabilitation programs, and surgery.

Short of Breath? Coughing Frequently? Call Your Doctor!

If you are experiencing any of the symptoms discussed here, contact your doctor. With proper, timely treatment, emphysema, chronic bronchitis, and COPD can be effectively managed!

Apria is a leader in COPD management

We offer custom treatment plans, work closely with your physician’s office care team to manage your COPD through its many stages, deliver a wide range of treatment options, and provide ongoing monitoring to optimize your treatment. Learn more.

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3. Emphysema vs. chronic bronchitis: Understanding the differences. National Emphysema Foundation. http://www.emphysemafoundation.org/index.php/about-uss/privacy/83-copd-emphysema-articles/428-emphysema-vs-chronic-bronchitis-understanding-the-differences.
4. Holland, K. (2018, November 12). Emphysema vs. Chronic Bronchitis: Is There a Difference? Healthline. https://www.healthline.com/health/copd/emphysema-vs-chronic-bronchitis.
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6. Leader, D. (2020, May 12). Differences Between Chronic Bronchitis and Emphysema. VeryWell Health. https://www.verywellhealth.com/the-difference-between-emphysema-and-chronic-bronchitis-914876.

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About the AuthorApria

Apria is a leading provider of home healthcare equipment and related services across the USA, offering a comprehensive range of products and services for in-home care and delivery of respiratory therapy, obstructive sleep apnea treatment, and negative pressure wound therapy, along with additional equipment and services.