Asthma vs COPD: What's the link & overlap?

Do you have a cough that you can't seem to get rid of? Do you have a habit of cleaning your throat a lot? That after two flights of stairs, you need to take a break and collect your breath? These typical signs and symptoms could be completely innocuous. However, they could also be signs of a significant underlying issue called chronic obstructive pulmonary disease (COPD) or asthma.

Asthma and Chronic Obstructive Pulmonary Disease (COPD) are lung diseases, causing swelling in the airways and making it difficult to breathe. Asthma can be triggered by allergens such as pollen, mold, dust mites etc or physical activity, causing swelling. COPD is an umbrella term for progressive, inflammatory lung illnesses such as chronic bronchitis and emphysema. It is a severe worldwide health hazard that is often underestimated. COPD includes emphysema and chronic bronchitis. Some people suffer from asthma and COPD simultaneously, causing an overlap called asthma COPD overlap (ACO), changing the way one's lungs work, making bronchial constriction more likely. About 40% of people with COPD also contract asthma.

What's the overlap?

Because ACO can be more serious than either condition alone, it's critical to diagnose and treat it. Although there is no cure, breathing and quality of life can be improved.

Who is at risk of asthma, COPD, or ACO?

COPD is more likely in people who smoke, breathe in pollution/chemicals at work for a long time or inhale firewood smoke while cooking. As a result, the disease frequently manifests itself in middle age or later in life.

Gene changes that are passed down through families can sometimes cause asthma.

Symptoms:

Asthma and COPD can both lead to breathing problems, cough and wheezing. Asthma, on the other hand, is characterized by attacks of wheezing and chest tightness. It improves with time, whereas COPD symptoms are more persistent, with a cough producing phlegm.

ACO might also have the following symptoms: Flare-ups or harsh symptoms are usually relieved by taking an inhaled bronchodilator (medications that open the airways), neutrophils or eosinophils may be found in one's spit (white blood cells linked to inflammation).

Diagnosis:

The doctors perform physical examinations and inquire about things like: Signs and symptoms, family history of asthma or allergies. If one smokes or inhales second-hand smoke, If one works in an environment containing chemicals or other substances that can irritate the lungs. A spirometry test is performed to see how well the lungs are working. A challenge test might also be used to diagnose Asthma.

Treatment options:

Asthma is a long-term medical condition that can be managed with proper treatment. Recognizing the triggers and taking precautions to avoid them is an integral part of treatment, while also monitoring the breathing to ensure that daily asthma medications are working correctly. Taking medications basis the prescription by the doctor is an essential step to better lung health.

Treatment options include: Short-acting beta-agonists, salbutamol, levo-salbutamol are examples of bronchodilators that are usually used for symptom control. Good treatment of Asthma will reduce the need to use these medications.

Long-term asthma control medications include inhaled corticosteroids (most important), Inhaled long-acting beta-agonists-bronchodilators, combination inhalers, leukotriene modifiers (Montuleukast).

Allergy Medications (immunotherapy) injection and under the tongue can help in controlling Asthma. Omalizumab, Mepolizumab, Benarlizumab are medications that can help control difficult asthma.

Bronchial thermoplasty - causes the smooth muscle in the airways to shrink and reduces the airway's ability to tighten, making breathing easier and reducing asthma attacks. Again an option for difficult to treat Asthma.

COPD, like asthma, is a chronic illness. The goal of treatment is to prevent it from getting any worse. Quit smoking and avoid second-hand smoke to prevent exacerbation.

Other common COPD treatments include:

Medications - Bronchodilators, inhaled steroids, combination inhalers. phosphodiesterase-4 inhibitors and theophyllines are some medicines. Lung therapies - pulmonary rehabilitation and oxygen therapy programs involving education, exercise training, nutritional advice, and counselling to improve life quality.

Surgeries - lung volume reduction surgery, lung transplant, or bullectomy.

(The author is, Director, Pulmonary Disease, Fortis Hospital, Bangalore)