Studies show that Black Americans are more prone to developing asthma and chronic obstructive pulmonary disease (COPD). While some of this increased risk can be linked to environmental factors, there is a genetic predisposition that doctors highlight as well. One subset of these people with respiratory conditions that aren’t studied as often is Black people who have both conditions at the same time. According to one recent study, Black Americans have a higher likelihood of having asthma-COPD overlap syndrome (ACOS) but may not know it. Here’s what you need to know about ACOS.
What is Asthma-COPD Overlap Syndrome (ACOS)?
Generally, doctors don’t regard ACOS as a separate illness. Giving it a name is simply a way to acknowledge that you are dealing with the symptoms of two different chronic conditions at the same time. While the symptoms of asthma and COPD are similar, having them together can often result in more severe respiratory issues that have to be managed with a more intricate medical regimen.
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8 Signs You Have It
1. Constant Wheezing
Many people with asthma only wheeze when they’re having a flare-up or have been exposed to a trigger. When you have COPD, the wheezing is a little more constant so if you’re always wheezing you may have both.
2. Difficulty Breathing
When you have asthma, you can expect to have difficulty breathing if you have a flare, you’ve been exposed to an irritant, or you’re doing strenuous exercise when you have the type of asthma that’s triggered by physical activity. On the other hand, difficulty breathing is a characteristic symptom of COPD.
3. Excess Mucus When Coughing
It’s typical for asthmatic coughs to be dryer than the coughs you get from respiratory infections. However, people with COPD have an accumulation of mucus in their lungs that can result in wet, mucus-filled coughs.
4. Frequent Coughing
Depending on how severe your asthma is, you may go without coughing for a long time. When you’re dealing with COPD, however, the cough is almost chronic.
5. Chronic Fatigue
This symptom is usually only experienced by people who have COPD. If you’re dealing with asthma alone, you shouldn’t have chronic fatigue.
6. Frequent Shortness of Breath
It’s typical for shortness of breath to accompany an asthma flare or when you’ve done strenuous physical activity. You should be able to breathe normally if none of that is happening. If you have COPD, though, shortness of breath is something you have to deal with every day.
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7. Tightness in the Chest
Again, this is a symptom that usually only happens when having an asthma flare. Once your body isn’t responding to a trigger, you shouldn’t have tightness in your chest. With COPD, this is an almost constant symptom.
8. Worsening Symptoms
One of the main things you’ll notice if you have ACOS is that your symptoms tend to worsen regardless of what you do. That’s because while asthma may stay the same as long as you manage it, COPD is a progressive condition. COPD is known to get worse over time so symptoms that used to be intermittent will become constant. At this point, your doctor will have to adjust your treatment.
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How The Condition is Treated
Your treatment for ACOS begins with getting a diagnosis. Given that the two conditions have similar symptoms, it’s not always easy to diagnose. Your doctor will need detailed descriptions of your symptoms as well as the results of several tests. Some of the tests that you may undergo include X-rays, CT scans, or MRIs. You may also need a pulmonary function test that measures your lung function. Additionally, it can help your doctor decide if you point out how your symptoms respond to certain medications.
Once you’ve been diagnosed, your doctor will look at the combination of medications that can help to alleviate your symptoms. Neither of these illnesses can be cured and COPD is progressive so your regimen may be adjusted over time to keep up with your worsening symptoms.
Some of the medications you may be prescribed are low-dose inhaled corticosteroids (ICS), long-acting bronchodilators (LABA), and long-acting muscarinic antagonists (LAMA). An ICS will treat the inflammation in your airways while a LABA is meant to keep your airways open for up to 24 hours when combined with an anti-inflammatory. Finally, a LAMA is used to prevent your airways from tightening and making excess mucus.
Along with medication, you may also need pulmonary rehabilitation to help with the COPD aspect of ACOS. This form of rehabilitation is meant to maintain your lung function and help to ensure that you have enough oxygen circulating through your body while doing daily activities. In time, you may also need oxygen therapy so that you’ll have the necessary oxygen supply.
Depending on how the condition progresses, you may need surgery to remove damaged lung tissue that’s making your symptoms worse.
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How to Manage ACOS if You Have It
The most important part of managing ACOS is sticking to your medical regimen. Given the conditions that you’re dealing with, it’s important to manage them well. Your doctor will also ask that you identify and avoid common triggers like pollen, dust, chemical irritants, strong perfumes, smoke, and excessive physical activity.
As stated previously, COPD is a progressive condition so your treatment will have to change to accommodate it. While using your medications, it’s critical to let your doctor know if your symptoms aren’t responding as well to certain medications. It can mean that you need a different dosage or it’s time to move on to a more advanced level of treatment.
Another aspect you need to pay attention to is getting the vaccines you need. Getting sick can worsen your symptoms and can even lead to a trip to the emergency room if things are severe. Doctors recommend getting influenza, pneumonia, COVID-19, and whooping cough vaccines, in particular, so you don’t add a respiratory illness to everything you’re already dealing with. Talk to your doctor to establish a schedule for these vaccines as you may not be able to get them all at once.
Though more studies need to be done, it’s possible that more Black Americans are dealing with ACOS than they know. The only way to be sure if you have it is to pay close attention to your symptoms and let your doctor know so you can be diagnosed.
