COPD VS Asthma: Is It Asthma Or COPD?

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Updated June 21, 2014.

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Question: COPD VS Asthma: Is It Asthma Or COPD?

Answer:

When you ask yourself "Do I have COPD or asthma?" there are actually a number of questions that may help you answer the question.

Did I have symptoms of allergy or asthma as a child?- While some patients are diagnosed with asthma in adulthood, most asthmatics are diagnosed in childhood or adolescence. In fact, a number of studies have shown that primary care doctors will often label older patients with asthma when in fact they have COPD.

What makes my symptoms worse? Asthmatics can often identify what it is that worsens their symptoms. Things such as:

COPD, on the other hand, is often made worse by respiratory tract infections and not any of the previously mentioned asthma triggers.

Do I smoke? While COPD and asthma may occur together, COPD is more common in current or former smokers and those exposed to environmental tobacco smoke.

Am I ever symptom free? Patients with asthma experience symptoms intermittently and may be relatively symptom free between asthma exacerbations. COPD patients, on the other hand, experience progressive symptoms and rarely go a day without symptoms.
Does my lung function return to normal between exacerbations? In both asthma and COPD your doctor will measure certain aspects of your lung function with spirometry such as FEV1. With asthma, treatment returns your lung function to normal or near normal and you should not have many asthma symptoms between asthma exacerbations.

On the other hand, a COPD patient's lung function will generally not return to normal and only partially improves even with smoking cessation and bronchodilator treatment. Additionally, once a COPD patient develops symptoms, symptoms are generally chronic.
Sources:

Tinkelman DG, Price DB, Nordyke RJ, Halbert RJ. Misdiagnosis of COPD and asthma in primary care patients 40 years of age and over. J Asthma. 2006 Jan-Feb;43(1):75-80.

Kuebler KK, Buchsel PC, Balkstra CR. Differentiating chronic obstructive pulmonary disease from asthma. J Am Acad Nurse Pract. 2008 Sep;20(9):445-54.
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