Focus on Asthma-COPD Overlap Syndrome (ACOS)


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Maria Patricia S. Abes, MD; Maria Remedios D. Ignacio, MD; Nanneth T. Tiu, MD – a group of expert Filipino ALLERGISTS bond together as the H & L Allergy Team, whose aim is to give advice, to help readers understand and find relief in dealing with common allergic disorders.

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Asthma is characterized by airway hyper responsiveness and inflammation, and is considered severe when it is difficult to treat and manage the symptoms. Chronic Obstructive Pulmonary Disease (COPD) is a collection of lung diseases that cause breathing problems and have reduced lung function. This group of diseases can include severe asthma, emphysema and chronic bronchitis. Most people with asthma will not develop COPD, and many people with COPD don’t have asthma. However, it’s possible to have both. Asthma-COPD overlap syndrome (ACOS) is diagnosed when you have symptoms of both asthma and COPD. It is a chronic respiratory condition which features clinical features of both asthma and COPD.

Signs and Symptoms of Asthma-COPD Overlap Syndrome

• Difficulty breathing
• Wheezing
• Frequent coughing
• Chest tightness
• Excessive phlegm
• Feeling tired
• Low physical tolerance for exercise
• Shortness of breath during routine activities

An Allergist or Pulmonary Specialist will do the following:

• Complete history and physical examination – to determine the pattern of respiratory problems
• Spirometry
• Chest X-ray
• Chest CT scan

Treatment of ACOS

There are three types of medications that can help improve symptoms of ACOS

• Inhaled Corticosteroids – a long term anti-inflammatory medication for asthma
• Long Acting Bronchodilator – medication which helps keep airways open for a longer period of time
• Long Acting Muscarinic Agonist – medication for COPD which helps keep airways from tightening

Supplemental oxygen and pulmonary rehabilitation will help decrease the symptoms.

Lifestyle changes – exercise, breathing techniques, avoidance of irritants, and for smokers, it is advisable to stop smoking.

References
• ACAAI Asthma-COPD Overlap
• American Lung Association Asthma-COPD Overlap Syndrome
• Global Initiative for Asthma
• AAAAI Epidemiology and risk factors of Asthma-COPD Overlap

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