You may experience symptoms such as cough, sleepiness, breathlessness, chest condition, and slow walking with emphysema or bronchitis. A spirometry test is one way to distinguish the type of lung disease.

Emphysema and chronic bronchitis are both long-term lung conditions.

They’re part of a disorder known as chronic obstructive pulmonary disease (COPD). Because many people have both emphysema and chronic bronchitis, the umbrella term COPD is often used during diagnosis.

Both conditions have similar symptoms and are typically caused by smoking. Up to 90% of COPD cases are related to smoking. Less common causes include genetic conditions, air pollution, exposure to toxic gases or fumes, and dust.

Both emphysema and chronic bronchitis affect your lungs. That means they can cause similar symptoms.

Emphysema is a progressive disease. This means that symptoms of the condition get worse over time. Even if you quit smoking, you can’t stop your symptoms from worsening. You can, however, slow them.

Chronic bronchitis symptoms may get worse for a period of time and then get better. People with chronic bronchitis may pick up a virus or bacteria that makes the condition worse for a short period of time.

Chronic bronchitis has several more notable symptoms than emphysema.

Here are their common symptoms and how you can tell the difference.

SymptomEmphysemaChronic bronchitis
Shortness of breath✓✓
Fatigue✓✓
Difficulty concentrating✓
Feeling less alert✓
Blue/gray fingernails✓
Fever✓
Cough✓
More mucus✓
Symptoms fluctuate✓

Emphysema’s primary symptom is shortness of breath.

It may start small: For example, you might have difficulty breathing after a long walk. But over time, the shortness of breath worsens.

Before long, you may have difficulty breathing even when you’re sitting and haven’t been active.

This symptom isn’t as common in people with bronchitis, but it’s possible.

Catching your breath may be more difficult as your chronic cough and airway swelling from chronic inflammation worsens.

As breathing becomes more labored, people with emphysema may find that they tire more easily and have less energy. The same is true for people with chronic bronchitis.

If your lungs can’t properly inflate and supply oxygen to your blood, your body will have less energy. Likewise, if your lungs can’t properly expel oxygen-depleted air from your lungs, you have less space for the oxygen-rich air. This can lead you to feel fatigued or weak overall.

Learn about how to address fatigue if you live with COPD or one of the lung diseases that may include emphysema or chronic bronchitis.

There isn’t a single test to diagnose emphysema. Your doctor will perform a physical exam after assessing your symptoms and reviewing your medical history.

From there, they may perform one or more diagnostic tests.

Chronic bronchitis is diagnosed after you experience several episodes of acute bronchitis in a short period of time. Acute bronchitis refers to short-term lung inflammation that can affect anyone and is usually the result of a viral or bacterial infection.

Typically, doctors don’t diagnose chronic bronchitis unless you’ve had three or more bronchitis episodes in a year.

If you’ve had recurrent bronchitis, your doctor may still perform a few tests to determine if you have COPD.

The tests for diagnosing these lung diseases may be the same and may include:

  • Spirometry test: This test is often the first test used to detect emphysema, and it measures how strong airflow is and estimates the size of your lungs.
  • Imaging tests: Both a chest X-ray and CT scan of your lungs can help your doctor detect possible causes for your symptoms.
  • Alpha-1 antitrypsin (AAT) test: AAT is a protein that protects your lung’s elasticity. You can inherit a gene that will make you AAT deficient. People with this deficiency may be more likely to develop emphysema, even without a history of smoking.
  • Pulmonary function tests: This series of tests can help your doctor understand how well your lungs work. They can measure how much air your lungs can hold, how well you’re emptying them, and how well air is flowing into and out of your lungs.
  • Arterial blood gas test: This blood test helps your doctor get a very precise reading of your pH and oxygen and carbon dioxide levels in your blood. These numbers provide a good indication of how well your lungs are working.

You can learn more about the different diagnostic tests used for COPD, including emphysema and chronic bronchitis.

Several conditions can cause difficulty breathing, chest pain, and shortness of breath. Depending on your symptoms, you may not be experiencing emphysema or chronic bronchitis.

Your symptoms may point to asthma in some cases.

Asthma develops when your airways become inflamed, narrow, and swollen. This can make breathing difficult, especially when combined with excess mucus production.

These symptoms may be similar to those you might experience with other conditions. That can include:

  • heart problems
  • collapsed lung
  • lung cancer
  • pulmonary embolism

You can experience emphysema and chronic bronchitis at the same time. People with chronic bronchitis may still experience certain acute bronchitis flare-ups on top of their long-term bronchitis issues.

Your doctor can determine if your symptoms are caused by emphysema, bronchitis, or another condition. Without treatment, these conditions may worsen and cause additional symptoms and complications.

Emphysema and bronchitis are both lifelong conditions. If you receive a diagnosis of either condition, your doctor will work with you to develop a treatment plan focused on symptom management.