The difference between bronchial asthma and pulmonary emphysema.

Written by An Yong Peng
Pulmonology
Updated on November 11, 2024
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Bronchial asthma and emphysema are two different diseases. Bronchial asthma typically manifests as episodic coughing, chest tightness, and wheezing. Patients often develop this condition in childhood and adolescence, and it is relatively rare in the elderly. Emphysema, on the other hand, is often related to long-term smoking and is usually seen in middle-aged and older patients. Early stages of emphysema may only be evident on a chest CT and may not show significant symptoms of chest tightness. However, as the disease progresses, patients often experience noticeable chest tightness and difficulty breathing, and the condition tends to progressively worsen. Patients typically eventually develop complications such as chronic respiratory failure and chronic pulmonary heart disease. Therefore, the characteristics of bronchial asthma and emphysema are different. However, it is important to note that in patients with bronchial asthma, if the condition is not controlled and continues to progress, it might also lead to the development of emphysema, chronic respiratory failure, pulmonary heart disease, and other related conditions.

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Written by Wang Li Bing
Intensive Care Medicine Department
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How to treat bronchial asthma?

After the onset of bronchial asthma, it is necessary to carry out active treatment. In clinical practice, the following categories of bronchodilator drugs are mainly used: The first is adrenergic receptor agonists, such as salbutamol and terbutaline; the second is anticholinergic drugs, mainly tiotropium bromide; the third category is xanthine drugs, which can include aminophylline or doxophylline. Additionally, glucocorticoids can be used for pharmacological treatment. If the patient still has recurrent attacks after systemic treatment, hospitalization is recommended for further management.

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Written by Hao Ze Rui
Pulmonology
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Symptoms of bronchial asthma

The most common symptoms of bronchial asthma are episodic difficulty in breathing, which can also manifest as episodic chest tightness and coughing. During an asthma attack, there will be accompanying wheezing sounds. If the patient is more severe, they may be forced to sit up to breathe during episodes of breathing difficulties, exhibiting orthopneic breathing. Some patients may experience a dry cough or cough up a large amount of white foamy sputum. In severe cases, symptoms of hypoxia such as cyanosis of the lips and nail discoloration can occur. Asthma attacks are generally acute, with symptoms appearing within minutes, but they can also begin more slowly, worsening over several hours or days. Asthma generally relieves itself, or even after relieving, it may recur, typically worsening during the night.

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Written by Zeng Xiang Bo
Respiratory and Critical Care Medicine
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How to check for bronchial asthma?

If there is a suspicion of having bronchial asthma, a series of tests will be carried out at the hospital, mainly including: First, complete blood count, especially focusing on whether there is an increase in eosinophils, to determine the presence of eosinophilic allergic inflammation. Second, imaging of the lungs, including chest X-ray or CT to determine whether there are any specific lesions in the lungs. Third, pulmonary ventilation function and bronchodilation tests, or bronchial provocation tests. Pulmonary function is a gold standard for diagnosing bronchial asthma, often indicating the presence of obstructive ventilation dysfunction. A positive bronchodilation test or provocation test can help in confirming bronchial asthma.

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Written by Wang Xiang Yu
Pulmonology
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The causes of bronchial asthma

The causes of bronchial asthma are actually not very clear at present, but current research shows that bronchial asthma is mainly caused by genetic and environmental factors. Genetic factors are relatively easier to understand, meaning if parents have a history of bronchial asthma, then their children, grandchildren, and other blood relatives may have a higher chance of developing bronchial asthma than the general population. Additionally, bronchial asthma is also related to environmental factors, such as air pollution, smoking, dust mites, pollen, etc.

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Written by Yuan Qing
Pulmonology
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How to check for bronchial asthma?

Bronchial asthma is a chronic inflammatory airway disease. Patients primarily exhibit symptoms of episodic wheezing, shortness of breath, chest tightness, and coughing, which usually can be relieved with or without medication. Typically, during an attack, there is wheezing and audible stridor. A diagnosis can usually be made based on symptoms and medical history, as well as physical examination. However, for atypical patients, further tests may be necessary. Generally, the main tests for asthma patients are pulmonary function tests, which include provocation tests and relaxation tests, as well as the 24-hour peak expiratory flow variability. These tests are helpful for the definitive diagnosis of bronchial asthma.