Asthma vs. COPD: Why early differentiation matters, according to pulmonologist

Asthma and COPD may look similar but differ in causes, symptoms, and treatment. Learn how to tell them apart and protect your lung health early. (Image: Pexels)

Asthma is predominantly an allergic or immune-mediated disease and often starts in childhood or early adult life. It's often brought on by allergens, dust or cold air, and symptoms can vary or ease with medication. By contrast, COPD — comprising chronic bronchitis and emphysema — occurs slowly over time, usually because of long-term exposure to cigarette smoke or other environmental pollutants. Long-term airway narrowing and lung damage Unlike asthma, with COPD, the narrowing of your airways is not fully reversible.

Prevention is better than cure and the earlier you can differentiate between asthma and COPD, the sooner you can take steps to mitigate its impact with suitable intervention that benefits from personalized therapy leading to a better quality of life,” says Dr Vikas Mittal, Director and Pulmonologist at CK Birla Hospital, Delhi. Understanding what makes them different can help patients find the correct diagnosis and protect their lungs from irreversible damage with lifestyle interventions, medications and preventive care.

Also Read: World Asthma Day 2025: 6 tips to manage asthma symptoms effectively, avoid triggers

1. Age of onset

One difference between asthma and COPD is when they tend to begin.

• Asthma usually sets in at an early age of childhood or early adulthood, but it can be established later in life, too.
• COPD usually manifests in individuals over 40 years of age after prolonged exposure to injurious irritants.

Asthma is mostly caused by a genetic predisposition and by allergic irritants like pollen, dust, smoke, or cat dander. Asthma will likely occur in people with a family history of asthma or allergies.
Conversely, COPD is usually the outcome of long-term exposure to an irritant, primarily tobacco smoke, air pollution, biomass fuel, or occupational chemicals and dust. Present smokers and individuals residing in environmentally polluted areas are quite likely to be at higher risk.
3. Nature of airway obstruction

Both asthma and COPD are marked by airway obstruction, with reversibility being the differentiating feature.

- In asthma, airway narrowing is typically reversible, spontaneous, or with treatment, resolution of symptoms.

- In COPD, obstruction is irreversible and progressive, i.e., worsening with time regardless of therapy.
4. Symptom pattern and course of disease

Asthma symptoms such as wheezing, cough, chest tightness, and shortness of breath are typically episodic and unpredictable; they may appear and disappear with seasons or exposure and get along fine with other periods.

COPD symptoms do persist. Patients experience year-round chronic shortness of breath, chronic cough, and weakness, with exacerbations that markedly affect quality of life.5. Disease progression

While the two diseases are chronic, asthma will not become worse with time if adequately controlled. COPD, however, is a chronic disease with progressively worsening lung function progressively worsening year after year.

Also Read: Pulmonologist flags rise in childhood asthma as smog worsens; suggests prevention tips

Asthma and COPD are presented with similar overlapping signs and symptoms, but their etiology, reversibility, and course of disease are different. Early recognition of the differences is essential in employing the appropriate management techniques and preventing irreversible impairment of the lungs.

Disclaimer: This article, including health and fitness advice, only provides generic information. Don’t treat it as a substitute for qualified medical opinion. Always consult a specialist for specific health diagnosis.