Dr. Juan Marco Figueira Gonçalves, member of the Scientific Committee of the Year of the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) of the Airway, has warned that 51 percent of people who present respiratory symptoms continuously do not end up consulting a health professional, which is why he has insisted that "one should not wait for the symptoms to be intense to ask for help".
"Whether or not there is a previous diagnosis, getting used to breathing worse, coughing regularly or progressively reducing physical activity is not normal", he indicated, emphasizing that "recognizing the changes and consulting in time can facilitate early diagnosis, prevent the worsening of a respiratory disease from going unnoticed, help prevent it from continuing to advance and improve follow-up and quality of life".
Along the same lines, Figueira Gonçalves has asked not to assume as something normal cough, expectoration, wheezing or a feeling of shortness of breath (dyspnea), since they can be the manifestation of pathologies such as asthma, chronic obstructive pulmonary disease (COPD) or bronchiectasis. Even so, many people go adjusting their daily routine, avoiding efforts or certain tasks, without being fully aware that they are losing respiratory capacity.
"In asthma, patients may get used to experiencing episodes of cough, wheezing, chest tightness or difficulty breathing, especially if they appear intermittently or in certain situations, such as during exercise, in the cold, in the face of respiratory infections or due to exposure to certain environmental factors", he explained. He added that, in COPD, numerous smokers take cough and expectoration after years of consumption as something inherent to their habit, to the point of interpreting the so-called smoker's cough as an inevitable consequence of tobacco.
Normalizing dyspnea and other symptoms aggravates the delay in diagnosis
The specialist has detailed that dyspnea also tends to become integrated into daily life, so that the person gradually reduces physical activity to avoid the feeling of breathlessness and ends up attributing that limitation to age, smoking or poor physical condition. Thus, the deterioration of respiratory function can advance without being detected.
Regarding bronchiectasis, he has pointed out that chronic cough, the usual presence of sputum, and repeated respiratory infections can come to be assumed as something part of everyday life. "Even the repeated need to take antibiotics can become normalized, which makes it difficult to recognize that there is an underlying disease that requires assessment and follow-up," he noted, recalling that environmental and occupational exposures to smoke, dust, pollution, or other substances contribute to triggering or worsening these symptoms.
In this context, he has highlighted that in Spain nearly three out of every four people with COPD are unaware that they suffer from this disease. "Asthma also presents underdiagnosis, although the figures vary according to the population studied and the criteria used," he commented, to add that "in bronchiectasis, recent SEPAR data place the diagnostic delay in Spain at 6.2 years," a delay that "does not depend solely on the patient."
"When symptoms are normalized, a circle is created that favors diagnostic delay: the patient becomes accustomed to the symptom, stops considering it abnormal, does not consult, and the diagnosis is delayed," he summarized, also stressing that "breaking this circle requires patients to learn to recognize changes in their respiratory health and for healthcare professionals to ask about them."