MANILA, Philippines?Take a deep breath and fill your lungs with as much air as possible. Then, as you begin exhaling, stop about halfway to take a deep breath once more. Repeat this exercise until you could inhale no longer.

Feels constricting isn?t it? For people with chronic obstructive pulmonary disease (COPD), taking each breath can be a laborious task comparable to what you just experienced.

?In patients with COPD?even moderate but certainly more severe COPD?each breath is something they have to focus on. Walking up the stairs or playing with your kids or grandchildren can become difficult because of shortness of breath,? explained Dr. Luisito Idolor, chair of Philippine College of Chest Physicians? COPD Council.

According to Idolor, COPD is a slowly progressive disease in which a person gradually loses lung function.

In fact, COPD patients suffer as much as most lung cancer patients: ?But since COPD patients remain ill for longer, the total amount of their suffering could be argued to be greater,? he added.

Diseases of the lungs

COPD is an umbrella term for several diseases of the lungs including chronic bronchitis, chronic obstructive bronchitis or emphysema?or combinations of those conditions,? he said.

?Worldwide, it?s responsible for the deaths of over 3 million individuals each year. Locally, the Philippine Burden of Lung Disease study indicated that 12 percent or one in eight individuals 40 years and above living in Metro Manila suffers from COPD, a figure that the researchers said is much higher than earlier estimates,? he reported.

Idolor clarified that COPD is not asthma as these two are different conditions (asthma generally starts in childhood and does not worsen with age. Also, an individual with asthma is usually well and free of symptoms if factors are not present to trigger it, i.e. dust, plants, animals and certain weather condition).

Worsens over time

COPD worsens over time, which is why it usually starts later in adulthood (but as soon as the early 40s).

While cigarette smoking or inhaling secondhand smoke are the most common cause of its development, breathing in other kinds of lung irritants, like pollution (from vehicle exhaust as well as cooking over wood fires), dust, or chemicals (especially in work area), over a long period of time may also cause or contribute to COPD.

?The lungs and airways are highly sensitive to these irritants. They cause the airways to become inflamed and narrowed, and they destroy the elastic fibers that allow the lung to stretch and then return to its resting shape. This makes breathing air in and out of the lungs more difficult,? Idolor explained.

Cannot be reversed

Pulmonologist Lenora Fernandez of the University of the Philippines-Philippine General Hospital explained that once COPD develops the damage to the lungs it cannot be reversed.

?However one could help stop COPD from getting worse by reducing exposure to the dust, fume and irritating gases at work that are causing the problem,? she suggested.

Since cigarette smoking is the biggest risk factor for COPD, Fernandez urged smokers to stop the habit and those people around them avoid exposure to cigarette smoke.

?Some people think that breathing problems are just part of getting older. Sometimes they think they are getting out of shape. If you have been slowing down, or gradually cutting back on your activities for a while, it may not be normal aging. You may have COPD, but only your doctor can give you a more precise diagnosis,? she said.

Take action

The two doctors believe that individuals with COPD can take other actions to improve their respiratory function.

?Breathing exercises are common recommendations from lung specialists, as well as remaining as active as possible. However, results from a study involving 6,000 COPD patients worldwide (including those in the Philippines) show that using the combination of inhaled corticosteroid (fluticasone) and long-acting beta2-agonist (salmeterol propionate), commonly referred to as ICS/Laba, could slow the progression of COPD by 30 percent, improving the patients? quality of life during the same period,? Fernandez reported.

She is referring to the the first ICS/Laba combination that GlaxoSmithKline launched several years ago.

Idolor said the combination product is popular for several reasons, including improved patient compliance, simplified disease management and the assurance of bronchodilator and steroid co-administration.

?The ICS/Laba has a huge potential in improving the lives of COPD patients here in the Philippines. As we all know, nonadherence to treatment is a significant problem in COPD, especially in the later stages of disease, when patients have a multitude of drugs to deal with and treatment regimens can become confusing,? Idolor said.