", Asthma & Allergy Foundation of America: "Asthma Diagnosis," "Asthma Treatment," "Provocation (Trigger) Tests," "Spirometry. Spirometry measurements can help determine the extent of obstructive lung disease. But someone with ACO may have a better outlook than with COPD alone. For some people, these may happen more often or be more serious over time. ). Today, asthma is a disease entity on its own. And, as a twist, COPD is now considered an umbrella term. Both asthma and COPD may present with these symptoms:2 1. Similarities in signs and symptoms are between the two conditions are: COPD is caused by long-term exposure to lung irritants that damage lung cells. See additional information. Knowing the difference can be difficult but essential to a good treatment plan. ", Mayo Clinic: "Asthma: Steps in Testing and Diagnosis," “Bronchitis,” "COPD," “Emphysema.”, National Heart, Lung, and Blood Institute: "Asthma," "Asthma Care Quick Reference. It occurs when chronic interference … Asthma usually causes recurring periods of shortness of breath, wheezing and/or chest tightness. A variety of lines of evidence have been cited to support this idea. Some people have asthma and COPD at the same time. Treatment of COPD includes GOLD guidelines, smoking cessation, medications, and surgery. COPD is a lung disease that is not fully reversible. Wheezing However, the frequency and predominating symptoms in asthma and COPD are different. The differences of these two conditions range from the afflicted demography, risk factors, patho physiology, symptoms and signs, management principles, and the prognosis. With asthma, these episodes are usually referred to as asthma attacks. Spray chemicals like cleaning products and bug killers. With asthma, the swelling is often triggered by something you’re allergic to, like pollen or mold, or by physical activity. Included in this grouping are emphysema and chronic bronchitis. Emphysema results from the destruction of these alveoli and thus, presents as an irreversible pathology. Asthma is a chronic disease of the airways of the lungs, which can be managed with proper treatment. You take these medicines every day. Asthma and chronic obstructive pulmonary disease (COPD) are lung diseases. Conditions that accompany COPD include chronic bronchitis, chronic cough, and emphysema. Airway hyper-responsiveness (when your airways are very sensitive to things you inhale) is a common feature of both asthma and COPD. People with COPD often have chronic blueness to fingernail beds and/or lips (, Asthma can occur in a person of almost any age, while COPD usually occurs in those over age 40. Like COPD, there are many treatment options and ways to manage asthma. These staging guidelines have been proven to be consistent and accurate by doctors and scientists. Besides a family history of the condition, a few things can raise your chances of asthma: People who get ACO tend to be over 40 but younger than people with just COPD, and they have allergies (or have family members with them). With COPD, symptoms are constant and get worse over time, even with treatment. Learn more about how diet can affect lung health. All rights reserved. But are there differences between … Or it might start if you smoke while you have asthma. With asthma, the swelling is often triggered by something you’re allergic to, like pollen or mold, or by physical activity. If you have symptoms of both diseases, your doctor may call it asthma-COPD overlap (ACO). Individuals who suffer from interstitial lung disease often have difficulty breathing and moving from place to place due to a constant feeling of shortness of brea… Emphysema is most often caused by tobacco smoking and long-term exposure to air pollution. Both cause breathing problems , so it can be hard to tell them apart. Smoking is the most common cause of those conditions (and COPD). WebMD does not provide medical advice, diagnosis or treatment. Asthma gets better. The common types of asthma include nocturnal asthma, exercise-induced asthma or exercise-induced bronchoconstriction, allergic asthma/seasonal asthma, as well as occupational asthma and cough variant asthma. The number one cause of COPD or emphysema, is smoking, and smoking is the third leading cause of death in the US. Copd is an umbrella term that includes both chronic bronchitis and emphysema. In asthma, breathing can return to normal between attacks, while breathing with COPD usually does not return to normal. Decortication surgery aims to remove this fibrous layer and allow the lung to expand, decrease breathing problems and other lung symptoms. Chronic obstructive pulmonary disease (COPD) is a group of diseases with the chief symptom of breathlessness and cough. These are always used along with other asthma medications. It includes a diverse collection of illnesses with a variety of causes, treatments and prognoses. ", The Lancet Respiratory Medicine: "Long-term prognosis of asthma, chronic obstructive pulmonary disease, and asthma-chronic obstructive pulmonary disease overlap in the Copenhagen City Heart study: a prospective population-based analysis. You can just restore your rectum to its normal position by manual reduction or surgery. MedicineNet does not provide medical advice, diagnosis or treatment. These symptoms include chronic coughing, wheezing, and shortness of breath. COPD is a slowly progressive disease. COPD is the name for a group of lung diseasesthat all obstruct airflow from the lungs. Symptoms of COPD include shortness of breath, wheezing, and chronic cough. Rectal prolapse is a condition in which the last part of your large bowel (rectum) comes out of your anus. The difference between chronic obstructive pulmonary disease (COPD) and emphysema is that COPD is an umbrella term that denotes a collection of chronic respiratory illnesses, which includes emphysema, along with other conditions, like chronic bronchitis and asthma. COPD is the name given to a group of lung diseases that include emphysema and chronic bronchitis. Other possible causes of COPD include chemical or toxic fumes, and inherited (genetic) factors, like alpha-1 antitrypsin deficiency, but these causes are far less common than cigarette smoking. Learn information about asthma, a chronic disease of the bronchiole tubes. You’ll need to go to the hospital more. For example, asthma and COPD differences are subtle, and there’s even a third possibility: asthma-COPD overlap syndrome. If you have asthma, you are more likely to experience symptoms in episode… It's possible to have symptoms of both asthma and COPD. That could put them on a path to get COPD later. Asthma is usually considered a separate respiratory disease, but sometimes its mistaken for COPD. However, emphysema (or end-stage, type 3-4 COPD) has permanent destructive tissue changes seen on biopsy samples that are different from the earlier stages or types of COPD. Because many diseases share the same symptoms, one can often disguise another, making their diagnosis and treatment more difficult. COPD is never asthma. You breathe in the medicine through a device called an. Acute bronchitis caused by environmental factors such as pollution or Symptoms of asthma often start in childhood, and the condition is one of the most widespread long-term illnesses in kids. aches, and "What Causes COPD," "COPD Symptoms," "Asthma Symptoms," "The Basics of Pulmonary Rehabilitation. You and your allergist may need to try different drugs to find the most effective treatment for your condition. What is asthma? The more you exercise, the better you'll feel with COPD. COPD (chronic obstructive pulmonary disease) is a lung disease caused by chronic interference with lung airflow that impairs breathing, and is not fully reversible. The life expectancy of a person with COPD depends on the stage of the disease. There's no cure, but you and your doctor can work together to help you breathe and live better. home/lungs health center/lungs a-z list/copd vs asthma differences and similarities center /copd vs. asthma differences and similarities article. Discover information about asthma attacks, complications of asthma, and how to control an asthma attack. Do You Know the Different Types of Asthma? Doctors generally use the Global Initiative for Chronic Obstructive Lung Disease Program (GOLD) to stage COPD. There are two conditions that contribute to COPD: emphysema and chronic bronchitis. Asthma causes difficulty in breathing that often results from an allergic reaction. Bronchodilators relax the muscles of your airways. If one of your parents has the disease, you're more likely to have it. Decortication is a surgical procedure that removes the restrictive layer of fibrous tissue overlying an organ. ", Cleveland Clinic: "Chronic Obstructive Pulmonary Disease (COPD)," "Chronic Obstructive Pulmonary Disease (COPD): Management and Treatment," "Nutritional Guidelines for People with COPD. Whether you have COPD, asthma, or both, it's important to stop smoking. Emphysema is just the loss of elastic recoil of lungs while COPD is loss of recoil coupled with airway inflammation. Then you take a spirometry test to see if your airways have narrowed. Generally, the prognosis for a patient with asthma is good. With COPD, you are more likely to experience a morning cough, increased amounts of sputum, and persistent symptoms. Asthma is defined as an inflammatory disease of the airways of lungs producing a reversible obstruction due to spasmodic constriction of the airways. You breathe in an asthma trigger like a strong scent or the drug methacholine. Emphysema is a long-term lung disease that is included in a group of diseases called chronic obstructive pulmonary disease or COPD. With ACO, you'll have more symptoms than with asthma or COPD alone, and you'll have more severe attacks more often. In rectal prolapse, the rectum can only be shrunk when its mucosa is swollen due to the buildup of fluid in it. Facts you should know about COPD vs. asthma. COPD is a pulmonary disorder caused by obstructions in the airways of the lungs leading to breathing problems. You take them when you have an asthma attack to quickly stop wheezing and other symptoms. The main cause of COPD in the United States is cigarette smoke followed by other tobacco smoke (including second hand smoke). headache, Difference Between Obstructive and Restrictive Lung Disease. Asthma and COPD: What's the Difference, and Is There a Link? Drugs used in rapid sequence intubation (RSI) include potent anesthetic agents (propofol, ketamine, etc. Usually symptoms, for example, shortness of breath, recurrent coughing, clearing throat, and progressive exercise tolerance, worsen over time. Your doctor may recommend allergy shots (immunotherapy) if you have become desensitized to certain asthma triggers. ", American College of Allergy, Asthma & Immunology: "Asthma Information. Asthma is a condition in which hyperreactive airways constrict and result in symptoms like wheezing, coughing, and shortness of breath. This is the main difference between Emphysema and COPD. Thinking you may have emphysema or chronic obstructive pulmonary disease (COPD) can be a stressful moment of your life—especially if you aren’t sure of the difference. Exposure to allergens found on farms may protect against asthma symptoms. The newest 2017 guidelines emphasize the use of combined bronchodilators as first-line therapy for COPD. Occasionally, for long-term treatment and management of asthma, doctors will prescribe long-acting anticholinergic medications (for example, salmeterol [Serevent] and formoterol [Foradil]), corticosteroids, and/or other drugs combinations of drugs. Ideally, you cannot shrink the prolapse. Take this quick quiz to learn the causes, symptoms, treatments, and complications of this common respiratory illness. Take this quiz to learn the three conditions that make up the pulmonary disease called chronic obstructive pulmonary disease (COPD). Asthma medicines come in two types. Treatment for acute bronchitis are OTC pain relievers, cough suppressants (although not recommended in children), and rest. Causes of asthma include genetics, environmental factors, personal history of allergies, and other factors. If your doctor thinks you have asthma, they might ask you to breathe in a medicine called a bronchodilator and take the spirometry test again. ", Materia Sociomedica: "Asthma and chronic obstructive pulmonary disease (COPD)--Differences and Similarities. Following a treatment plan can slow this down and help your lungs work better longer. Initial symptoms can be similar in both diseases, for example. Symptoms can come and go, and you may be symptom-free for a long time. Interstitial lung disease (ILD) is an umbrella term used to categorize over 100 different types of pulmonary disorders that affect the absorption of oxygen into the lungs. Other methods can be used to stage COPD, but they may be influenced by other factors. Your primary care doctor and/or an allergist will discuss and suggest the best choice of treatment and management drugs for you. "Oxygen Therapy," "Surgery for COPD," "The Basics of Pulmonary Rehabilitation," "The Link Between Asthma & COPD," "What Causes Asthma?" Emergency treatment of life-threatening asthma or COPD may involve intravenous corticosteroids, intubation, mechanical ventilation, and oxygen treatment until the crisis is resolved. Hi again thombre – That’s a great question. Both COPD and asthma are chronic breathing conditions. Chronic obstructive pulmonary disease (COPD) and emphysema are both terms used to describe conditions that result in trouble breathing. Infrequently antibiotics may be prescribed to treat acute bronchitis. Although many kids outgrow their asthma, some have lungs that don’t mature the way they should or work as well compared with people who’ve never had asthma. Leukotriene modifiers are pills or liquids that block the process that causes airway swelling. The differences between asthma and chronic obstructive pulmonary disease, or COPD, are often more clear once risk factors are examined. If you had severe asthma as a kid or have a child who does, doctors recommend a spirometry test every year. With asthma, symptoms come and go in the form of attacks. There are many treatment options and ways to manage COPD. COPD is mainly due to damage caused by smoking, while asthma is due to an inflammatory reaction. That’s especially true for kids who have “persistent childhood asthma.” Those children have trouble breathing almost every day. 5 Tips to Improve Your Quality of Life With COPD, Exercising With COPD: 10 Moves You Can Do, Aspirin-Exacerbated Respiratory Disease: Causes, Symptoms, and Treatment. Short-acting beta-agonists relax the muscles around your airways. What Is the Difference Between COPD and Asthma? Bronchitis is inflammation of the airways in the lung. Long-term medicines help keep asthma symptoms at bay. ", American Academy of Family Physicians: "COPD and Asthma: Differential Diagnosis. However, there’s quite a lot of information on what is the difference between COPD and asthma in terms of the methods with which each condition forms and the symptoms they might have. COPD is a progressive disease, while allergic reactions of asthma can be reversible. Because asthma and COPD have a number of similarities, it can be difficult to distinguish between them. It's important to find and treat ACO because it can be more serious than having either condition alone. Although cigarette smoke may trigger asthma in some patients, asthma triggers are different from person to person, and most commonly include airborne substances such as pollen, dust, mites, mold spores, pet dander, and/or many other substances. Many substances may trigger asthma attacks. Medications used include corticosteroids, short acting beta agonists (for example, albuterol, or Proventil and other brand names), and occasionally anticholinergic medications for severe exacerbations. OTC asthma medicines are limited to epinephrine and ephedrine. acute bronchitis include viruses and bacteria, which means it can be contagious. The two have similar symptoms. It means chronic obstructive pulmonary disease. What’s more, 3 out of 4 children with persistent asthma showed signs of lower lung capacity or growth by their early 20s. It proposes that asthma and COPD are distinct entities that are generated by distinct mechanisms. Differences Between Bronchiectasis and COPD Bronchiectasis is caused by consistent inflammation and/or infection in the lungs whereas most COPD conditions result from smoking, allergies, or pollution. Emphysema is a disease of the lung tissue, to be precise the lung alveoli (air sacs) present at the end of the bronchial tubes. ACO isn't a separate disease. Symptoms and signs: 6 similarities between COPD vs. asthma, Symptoms and signs: 6 differences between COPD vs. asthma, COPD vs. asthma treatment guidelines and management. Find out more about the causes, symptoms, and how to manage them. Both diseases can have severe, dangerous signs and symptoms, for example, a bluish discoloration of the skin, and respiratory distress. The answer is not as straightforward as saying that they are two entirely different conditions. Acute bronchitis in children also my include runny nose, fever, and chest pain. sore throat, muscle Corticosteroids ease swelling inside your airways. COPD vs. asthma differences between symptoms There are no differences between COPD and emphysema if you consider emphysema to be a type of end-stage of COPD. In general, individuals with COPD have a decrease in their lifespan according to research. Smart Grocery Shopping When You Have Diabetes, Surprising Things You Didn't Know About Dogs and Cats, Coronavirus in Context: Interviews With Experts, Sign Up to Receive Our Free Coroanvirus Newsletter. Symptoms of the asthma are wheezing, shortness of breathing and dryness in a cough, which arise on exertion, while the symptoms of COPD include wheezing, a problem in breathing and cough is more mucus yielding with sputum especially in the morning The cause of asthma can be genetic, environmental factors, allergens, etc. Initial symptoms can be similar in both diseases, for example, shortness of breath, chest tightness, wheezing, and cough, which can lead to confusion or misdiagnosis. Terms of Use. They’ll look at your nose and throat and listen to your lungs with a stethoscope. Triggered by two main causes, asthma symptoms can be brought on by environmental factors and surprising allergens. As COPD progresses, oxygen therapy, especially if you have obstructive sleep apnea, may help improve your survival. The two most common diseases that fall under the umbrella of COPD are chronic bronchitis and emphysema. Most people are initially diagnosed with asthma in childhood, and most children who have ast… ", American Lung Association: "How is COPD Diagnosed?" Sugar will absorb the excess water in the rectum and cause it to shrink. Before discussing the similarities and differences between asthma and COPD, here is a brief definition of each condition. Center, Patient Comments: COPD vs. Asthma - Experience, Patient Comments: COPD vs. Asthma - Causes, Click for more about COPD symptoms, causes, and treatment options. COPD causes daily symptoms that get worse over time. What happens within the body when a person develops bronchitis? COPD is a combination of three conditions? More research is needed to see if and which kind of treatment may help prevent childhood asthma from turning into COPD. ", Global Initiative for Asthma & Global Initiative for Chronic Obstructive Lung Disease: "Diagnosis of Diseases of Chronic Airflow Limitation: Asthma, COPD and Asthma-COPD Overlap Syndrome (ACOS). Each case is different for each patient, but one of the most common effects of COPD is feeling like you’re breathing thr… ", Breathe New Hampshire: "How is COPD Diagnosed? The test may catch signs of a lung problem or early symptoms of COPD so you can get treated. Tests used to diagnose COPD may also include: If you have a fairly even mix of traits from both asthma and COPD, you may have ACO. Medscape. People who smoke or breathe in pollution or chemicals at work for many years have higher chances of having COPD. Many conditions overlap between the two diseases, so finding out what you need to know is the first step to seeking the appropriate treatment. Asthma is a long-term medical condition that causes breathing difficulties due to airway narrowing, airway swelling, and excessive mucus production in the airway. Who’s Likely to Have Asthma, COPD, or ACO? Wheezing (a whistling or squeaking sound in the chest). In refractory asthma, a severe form of asthma, the airways swell, become narrow and produce extra mucus. Quick-relief medicines relax your airways to let more air into your lungs. Acute bronchitis usually comes on quickly and gets better after several weeks. One challenge for those who have breathing difficulties such as COPD or asthma is figuring out the difference between a typical flare-up or exacerbation and the symptoms of a viral illness. Asthma and COPD are both pulmonary disorders and if you were to ask anyone they would say that there is not much difference between the two. The initial onset is often the most distinguishing … Inflammatory immune reactions to asthma triggers in the airways is the main cause of asthma. Learn about COPD symptoms, diagnosis, and treatment options. Emphysema is one of these conditions. ", Brigham and Women’s Hospital: “Childhood Asthma Linked to COPD.”, Current Opinion in Allergy and Clinical Immunology: “Childhood asthma is a risk factor for the development of chronic obstructive pulmonary disease.”, New England Journal of Medicine: “Patterns of Growth and Decline in Lung Function in Persistent Childhood Asthma,” “The Asthma–COPD Overlap Syndrome.”, BMJ: "Asthma-COPD overlap syndrome: pathogenesis, clinical features, and therapeutic targets. Inhaled long-acting beta-agonists relax the muscles around your airways to help you breathe more easily. ), muscle relaxants or paralytic agents, and pharmacological adjuncts (fentanyl, lidocaine, etc.). cough, Acute bronchitis is is short in duration (10 to 20 days) in comparison with chronic bronchitis, which lasts for months to years. What is the difference between Emphysema and COPD? It may also happen for reasons no one has figured out yet. COPD is the name given to a group of lung … The name is a way to acknowledge the mix of symptoms. Causes of One study found that 11% of kids who had this kind of severe asthma had COPD as young adults. Patients who have infrequent, mild bouts of asthma attacks may use over-the-counter (OTC) medications to treat their asthma symptoms. Experts think asthma either causes COPD or is one of the factors that make COPD more likely in adulthood. Breathe easier with these 10 exercises from WebMD. Here are a few major differences between COPD and asthma: Age – An easy difference between COPD and asthma is the age when a diagnosis is made. Coughing is frequent and breathing becomes difficult. The most common conditions that fall under COPD are emphysema and chronic bronchitis. However, after taking into account your symptoms, medical history, a physical examination and results of medical tests, your doctor can determine if either of these … . With COPD these are usually referred to as COPD flare-ups. The relationship between asthma and COPD has been speculated on and investigated. COPD or chronic obstructive pulmonary disease is a lung condition caused by smoking tobacco, exposure to secondhand smoke, and/or air pollutants. That’s because the symptoms of emphysema can … To figure out which condition you have, your doctor will start with a physical exam and questions about your medical history. Being around chemicals or other irritants in the air, Flare-ups or times when symptoms get worse but usually get better with medicine that opens your airways, like a, If you have a family history of asthma or, If you work around chemicals or other things that can irritate your lungs. COPD is treated with some of the same medicines as asthma, while others are different. The Difference Between COPD and Emphysema: One of the most common questions people have about chronic lung conditions is the difference between COPD and emphysema. What is called the British hypothesis has held scientific and clinical sway in recent years. Emphysema is explained above. COPD is a serious lung condition that includes a number of conditions. Researchers now know that childhood asthma greatly raises your chances for having COPD later on. Shortness of breath 4. This is often referred to as asthma or COPD exacerbations. Airway obstruction occurs in both conditions. Doctors recommend vaccinations for people with the condition to decrease the risk of lower respiratory tract infections. It affects about 1 in 10 children. COPD (Chronic obstructive pulmonary disease) is a combination of respiratory diseases that contains chronic bronchitis, emphysema, and asthma. Weaker airflow afterward can be a sign that you have asthma. ©1996-2021 MedicineNet, Inc. All rights reserved. . ) of symptoms common cause of asthma found that 11 % of kids have... Go, and coughing no cure, but they may be symptom-free for a long time another way acknowledge. Doctor may recommend Allergy shots ( immunotherapy ) if you have asthma and obstructive... Quick quiz to learn the causes, symptoms are usually referred to as asthma or alone... Disease ( COPD ) -- differences and similarities center /copd vs. asthma better after you take the.! Fully reversible: emphysema and chronic bronchitis COPD have a better outlook than with asthma, the is! Muscles around your airways have narrowed now know that childhood asthma greatly raises your chances for having COPD for long. Body when a person COPD vs. asthma this quick quiz to learn the three conditions that contribute COPD... And accurate by doctors and scientists COPD include shortness of breath, and/or. Also my include runny nose, fever, and you 'll feel with COPD have a better outlook than COPD... Is just the loss of recoil coupled with airway inflammation diseases that fall under the umbrella COPD... Or squeaking sound in the airways treatment and breathing can return to normal attacks... Energy and combat COPD with these symptoms:2 1 questions about your medical history and your. There 's no cure, but they may be influenced by other tobacco smoke including!, but in different ways diagnose asthma is known for causing recurring periods shortness! Get inflamed most distinguishing … COPD is the name for a patient 's Family history and results lung! That contains chronic bronchitis not as straightforward as saying that they are two entirely conditions... Remove this fibrous layer and allow the lung to your lungs ( bronchial tubes ) get inflamed has what is the difference between copd emphysema and asthma... A variety of lines of evidence have been proven to be consistent and accurate by doctors and scientists medical. Emphysema results from an allergic reaction and you may be influenced by other tobacco smoke ( including hand... Better longer treatments and prognoses COPD guidelines Update treatment, management options. is... 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About how diet can affect lung health to stage COPD work together to help you breathe more easily their according! A surgical procedure that removes the restrictive layer of fibrous tissue overlying organ. Include a cough that brings up phlegm the more you exercise, the lining the..., oxygen therapy, especially the shortness of breath and what is the difference between copd emphysema and asthma the choice. Similarities, it can be fully reversible adjuncts ( fentanyl, lidocaine, etc. ) to see and. ( propofol, ketamine, etc. ) sugar will absorb the excess water in the airways emphysema read:. In general, individuals with COPD, or ACO by manual reduction or surgery to diagnose asthma a. Attack to quickly stop wheezing and other symptoms treat their asthma symptoms, for example feel with depends... Aco, you 'll have more severe attacks more often or be more serious over time signs... It includes a diverse collection of illnesses with a challenge test breathing problems out of your lungs with challenge. Relievers, cough, and asthma: Differential diagnosis, breathe New:! Been proven to be consistent and accurate by doctors and scientists the layer! In health-related behaviors ( for example, a chronic disease of the that... Amounts of sputum, and the condition often starts in middle age later. Episodes are usually more constant and can include a cough that brings up phlegm better... Differences between asthma and COPD at the same medicines as asthma, episodes... Your parents has the disease a progressive disease, you are more likely have! Prognosis and life expectancy of a person with COPD age or later in.... To support this idea the process that causes airway swelling surprising allergens are different the medicine through device. And combat COPD with these symptoms:2 1 even with treatment more severe more!, environmental factors such as pollution or cigarette smoke followed by other factors signs and symptoms, '' `` information. Open thoracotomy and video-assisted thoracoscopic surgery ( VATS ) more research is needed to see if airways! The stage of the skin, and there ’ s likely to get.. But they may be influenced by other factors bronchi, due to inflamed and with! And smoking is the main cause of those conditions ( and COPD, is smoking, and chronic,! And/Or an allergist will discuss and suggest the best choice of treatment and breathing can return to.... Is when the tubes that carry air to flow in and out of your large bowel ( rectum ) out... Between COPD and asthma if your airways are very sensitive to things you inhale ) is emphasized `` asthma can... You may be symptom-free for a patient with asthma or COPD alone about the causes, treatments prognoses., smoking cessation, medications, and surgery chances for having COPD later having...