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A to Z of Health

Not all that wheezes is bronchial asthma!

/ 12:20 AM November 14, 2015

Are you more than 40 years of age? Do you have a history of exposure to tobacco, home cooking or heating fuels as well as occupational dust or chemicals? Are you experiencing persistent and progressive shortness of breath, prolonged coughing with or without productive phlegm as well as wheezing sounds? If your answer is yes to those questions then you have the key indicators to suspect chronic obstructive pulmonary disease or COPD.

According to the Global Initiative for Chronic Obstructive Lung Disease (GOLD), COPD is a common preventable and treatable disease, which is usually characterized by persistent airway narrowing that is usually progressive and accompanied by significant inflammation. As such, individuals with COPD will usually have nonremitting cough as its first symptom and later a sense of increased effort to breathe, chest heaviness, air hunger or even gasping. Indeed, these symptoms really cause anxiety and disability among those inflicted.

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Cases of COPD are steadily increasing worldwide; it is projected to be the fourth leading cause of death globally by 2030. In the Philippines, it is underrecognized. You may initially think that wheezing and cough is just limited to your reversible childhood asthma. However, with the increasing trend of metabolic diseases and cigarette smoking, we need to determine other potential medical explanation for such abnormal sounds, which may include heart failure and, definitely, COPD. COPD is also underdiagnosed. Although spirometry, the gold standard in the diagnosis of obstructive lung diseases, is increasingly being made available among local hospitals and clinics, the test is still underutilized. In fact, a 2011 Philippine study showed a dismal 2 percent of COPD cases were doctor-diagnosed.

Should you experience any of the COPD symptoms mentioned or already have its risk factors, it is always prudent to have yourself checked by your family physician or lung specialist at the soonest possible time. Bear in mind that COPD may not present early symptoms and with the lungs functioning worse before an individual experience shortness of breath or persistent cough.

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Stop smoking. Smoking cessation is at the forefront of managing COPD cases. Stop exposing yourself from the cigarette’s deadly chemicals and substances. Stopping late will delay disability and death, while stopping very soon enough may probably leave you without lung impairment. However, for those already diagnosed with COPD, regular follow-up with their physician is a must to assess your symptoms, evaluate response to treatment or subsequent need to modify medications. Currently available medications for COPD in the country include medications delivered via compressor units like the nebulizers, aerosols and dry powder inhalers. Nonpharmacologic management also plays a role in COPD through the individualized Pulmonary Rehabilitation program available in at least eight tertiary institutions in the country.

Dr. Roland Panaligan is a consultant and head of the Education and Community Services Unit of the Center for Respiratory Medicine, University of Santo Tomas Hospital. The A to Z of Health information advocacy is a joint initiative of a group of medical specialists and supported by AstraZeneca Philippines aimed at raising public awareness on various diseases and providing health information and updates to the healthcare community.

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TAGS: bronchial asthma, health and science, wheezing
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