Q: What are the differences between asthma and COPD? Can you have both conditions at the same time?

William Berger, MD: For many patients, the difference between asthma and COPD is not very clear. It’s important to talk with a board-certified allergist so you can get an accurate diagnosis.

Asthma is usually diagnosed early in a person’s life. Symptoms include coughing, wheezing, chest tightness and shortness of breath. Asthma patients often have allergies that can lead to allergic rhinitis, sinus problems or eczema. They may also have a family history of asthma and allergies.

COPD tends to occur in people after the age of 40. It involves lung diseases that develop over time, including emphysema and chronic bronchitis. Symptoms are like asthma but also involve increased mucus or phlegm and more respiratory tract infections. COPD is often the result of long-term, heavy cigarette smoking. The disease tends to get worse over time.

There are not perfect lines separating these medical conditions. A person can have both asthma and COPD at the same time. This is Asthma-COPD Overlap (ACO).

People with asthma often use an albuterol inhaler for quick relief. They also take a daily inhaled corticosteroid to reduce inflammation and control symptoms.

People with COPD are usually prescribed a combination inhaled corticosteroid and long-acting beta-agonist. This helps prevent and reduce airway swelling. Other COPD patients take a muscarinic antagonist (anticholinergic) to help with chronic bronchitis.

ACO treatment may involve treatment with three drugs instead of two. These medications include an inhaled corticosteroid, a long-acting bronchodilator inhaler and an anticholinergic. Annual pneumonia and flu vaccinations and pulmonary rehabilitation are also recommended.

If you smoke and you have asthma, COPD or both, it’s critical that you stop. Find out about smoking cessation programs in your area.

If you are experiencing symptoms of coughing, wheezing and shortness of breath, don’t diagnose yourself. Go see an allergist who can make a proper diagnosis and set you on the right treatment course.


William E. Berger, MD, FACAAI, is a board-certified allergist with Allergy & Asthma Associates of Southern California in Mission Viejo, California. He is a Distinguished Fellow and Past President (2002-03) of the American College of Allergy, Asthma & Immunology (ACAAI).


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