Idiopathic pulmonary fibrosis (IPF) and chronic obstructive pulmonary disease (COPD) are both chronic and disabling lung diseases that cause shortness of breath. However, IPF and COPD cause different forms of physical damage to your lungs.
IPF is a lung disease that makes it hard to breathe. It damages the air sacs in your lungs, which send oxygen to the blood. This damage causes the lungs to stiffen. It also makes it hard for oxygen to reach the blood. This makes people with IPF cough and get short of breath. In IPF, your lungs become scarred, stiff, and thick, and the progressive damage is not reversible.
In COPD, the airways, which are branching tubes that carry air within the lungs, become narrow and damaged. This makes people feel out of breath and tired. The two most common forms of COPD are emphysema and chronic bronchitis. COPD can be a serious illness. It cannot be cured and can get worse over time. But there are treatments that can help.
Both IPF and COPD benefit from early diagnosis. People with IPF typically survive for 3 to 5 years after diagnosis, but some people live longer. Early treatment can help improve your quality of life. COPD is treatable, with usually better results if you catch it early.
Survival times vary for both IPF and COPD, depending on:
- the severity of the disease
- your general health
- your history of smoking
The epidemiology of IPF has been challenging to study as it is a relatively uncommon disease with evolving diagnostic criteria. Reported prevalence and incidence for IPF vary and depend on reporting methods.
IPF is diagnosed more in men than women and is associated with advancing age, with presentation commonly occurring in the 60s and 70s; rarely is IPF seen in patients under 50 years old.
According to the Pulmonary Fibrosis Foundation, there are over 200,000 U.S. cases overall (with 50,000 new cases a year).
COPD is much more prevalent and is seen as a major U.S. medical concern.
The Centers for Disease Control and Prevention (CDC) states that
However, COPD is often underdiagnosed, and the actual totals may be higher.
According to the
The cause of IPF is unknown, and the disease course is not predictable. In contrast, smoking causes around 85 to 90 percent of COPD cases, and the course of the disease is well studied.
IPF is often not diagnosed until permanent lung scarring is present. Many people with COPD have only mild symptoms and are not diagnosed until their disease has progressed further.
Although the cause of IPF is unknown, several risk factors for the disease have been established:
- Smoking. Similar to COPD, IPF is often associated with smoking.
- Age. Most people affected by the condition are between 50 and 70 years old.
- Environmental exposures. Exposure to pollution and toxins increases your risk of IPF. Higher rates of IPF may be found in people with occupations that involve working around dust, chemicals, or fumes. Farmers are one example, according to a
2016 study . - Sex. More men than women are diagnosed with IPF.
- Genetics. Having family members with pulmonary fibrosis increases your risk of this condition.
The risk factors for COPD are similar to those for IPF:
- Smoking. Long-term smoking is responsible for the vast majority of COPD cases. This includes use of pipes, cigarettes, and cannabis. Long-term exposure to secondhand smoke is also a risk factor for COPD. People with asthma who smoke have an even higher risk.
- Age. Most people are at least 40 years old when they first notice COPD symptoms.
- Environmental exposures. A 2019 report from the United Kingdom found that gardening, agriculture, painting, and working in a warehouse were some of the occupations associated with a significantly increased COPD risk. These occupations increase your exposure to substances such as dust, chemicals, or fumes.
- Sex. In most geographic regions, men are more likely than women to develop COPD. However, a 2010 study suggests that women are more susceptible to physical damage from smoking.
- Genetics. A rare genetic disorder called alpha-1-antitrypsin deficiency is the cause of about 4 to 5 percent of COPD cases, according to a 2012 study. Other genetic factors may also be involved.
IPF and COPD share many symptoms:
- Shortness of breath. A primary symptom of both diseases is shortness of breath, which gets progressively worse.
- Cough. Both diseases involve a chronic cough. In IPF, the cough is a dry and hacking one. In COPD, there’s mucus production and wheezing.
- Fatigue. Both diseases are marked by fatigue. This is because getting oxygen into the blood and carbon dioxide out of the blood is more difficult.
- Changes to your hands. Both diseases can affect your fingertips. In IPF, your fingertips and nails may be enlarged, which is called clubbing. In COPD, your lips or fingernail beds may turn blue. This is called cyanosis.
- Weight loss. When severe, both diseases can lead to unintended weight loss. This is because eating becomes difficult.
- Chest pain. IPF and COPD can also involve chest tightness and swelling in your ankles, feet, or legs due to the strain on the right side of the heart.
There’s currently no cure for IPF or COPD. Treatment aims to relieve symptoms.
If you smoke and you have IPF or COPD, considering quitting is an important first step. Another recommended early step is removing air pollutants from the home or workplace immediately. Also, work with your doctor to ensure you’re always up to date with your vaccinations to help avoid flare-ups and complications from infection.
The lung scarring in IPF cannot be reversed, but it may be reduced with the help of the prescription medications nintedanib (Ofev) or pirfenidone (Esbriet). Both slow down the declining lung function associated with fibrosis.
Most prescription medications for COPD dilate the airways, which makes breathing easier and less strenuous.
Bronchodilators can help relax the muscles around your airways. These drugs are used with an inhaler device and can be short-acting or longer-acting, depending on your needs.
They can also be combined with inhaled steroids, depending on the severity of your COPD symptoms and number of COPD flares. Oral corticosteroids are prescribed for short-term use only and are used mainly for COPD and not IPF.
Supplemental oxygen from a small portable oxygen tank is used as a treatment for both IPF and COPD.
The oxygen is supplied through a tube or a face mask and helps you breathe more comfortably while you sleep or carry out normal daily activities. It can also be used during exercise depending on your oxygen requirements.
Pulmonary rehabilitation is a group of programs designed to help you cope with IPF or COPD. It involves breathing and stress reduction exercises. It may also include nutritional and psychological counseling and disease management.
The goal is helping you stay active and keep up with daily activities. If you have severe disease, you may need help at home with your daily routine.
For those with either IPF or COPD a lung transplant is a possibility. It can extend your lifespan, but it also has risks.
Other surgeries can be used to help relieve COPD symptoms, depending on the type of lung damage that’s taken place. In a bullectomy, enlarged air spaces in the air sacs, called bullae, can be removed to help you breathe. In lung volume reduction surgery, damaged lung tissue can be removed to help improve breathing.
Both IPF and COPD are life threatening diseases, so early detection is key. If you have any of the known symptoms, get evaluated immediately. Once you’re diagnosed, sticking to your treatment plan can help extend your life. This includes exercising as prescribed.
There is ongoing research into finding new medications and possible ways of preventing both diseases.
There are also other supporting resources available.
For example, joining a support group can provide you with a space to discuss the challenges of IPF or COPD and find resources to help you cope. Support groups can also alert you to any new developments in treatment.