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Emphysema is a lung disease that harms the air sacs or alveoli in the lungs, causing them to lose their elasticity. This can lead to the formation of blockages or obstructions that trap air inside the lungs, resulting in difficulty breathing or shortness of breath. The primary cause of emphysema is smoking, which is responsible for the majority of cases.
Alveoli are small, thin–walled, fragile air sacs that form clusters at the end of the bronchial tubes or airways deep within the lungs. When a person inhale air, it travels through the bronchial tubes until it reaches the alveoli. Once inside, the alveoli stretch, draws in oxygen, and delivers it to the blood. With emphysema, the alveoli are weakened and ruptured. This reduces the surface area of the lungs and, as a result, the amount of oxygen in circulation. The old air becomes trapped, preventing fresh, oxygen–rich air from entering.
Chronic obstructive pulmonary disease (COPD) is made up of two conditions: emphysema and chronic bronchitis. The majority of people who have emphysema also have chronic bronchitis. The most common cause of COPD is smoking. Treatment for emphysema usually involves quitting smoking and taking medications. This can only slow emphysema down but cannot heal the existing damage to the lungs.
Symptoms
Emphysema can often remain undetected for an extended period, and individuals may not experience any noticeable signs or symptoms until the condition has caused significant damage, typically destroying at least half of the lung tissue. The primary symptom of emphysema is shortness of breath, which usually begins slowly and can occur even during periods of rest.
As the disease progresses, other symptoms may include:
- Fatigue
- Coughing over an extended period, or smoker’s cough
- Increased mucus production
- Feeling of not getting enough air
- Chest tightness
- Wheezing
- Sleeping difficulties
- Unexplained weight loss
- Heart issues
People with emphysema might want to avoid activities that may trigger shortness of breath. The symptom usually does not become an issue until it interferes with daily activities.
It is recommended to call the emergency hotline or get medical assistance right away if the shortness of breath becomes severe. It may be accompanied by lips or fingernails that turned blue or gray and loss of mental alertness.
It is essential not to disregard the symptoms or delay seeking medical assistance. While the damage caused by emphysema cannot be reversed, prompt treatment can help to slow down the progression of the disease.
Causes
Emphysema is a medical condition that usually occurs as a result of prolonged smoking. Smoking causes damage to the lung tissue and irritation to the airways, which leads to inflammation and harm to the cilia. This, in turn, causes the airways to become swollen, resulting in mucus production and difficulty in clearing the airways. All of these factors contribute to shortness of breath, which is a common symptom of emphysema.
Other causal factors may include chronic exposure to:
- Marijuana smoke
- Vaping and e–cigarettes
- Air pollution
- Fumes from chemicals
- Dust
Genetic factors such as alpha–1 antitrypsin deficiency can also cause emphysema. The alpha–1–antitrypsin deficiency is caused by a hereditary lack of a protein that protects the lungs’ elastic components.
Risk factors
There are several factors that affects the risk of having emphysema, such as:
- Age: The development of emphysema–related lung damage is a slow process, but individuals who have developed tobacco–related emphysema typically start experiencing symptoms of the condition between the ages of 40 and 60.
- Smoking: The number of years and the amount of cigarette smoked affects the risk of developing emphysema. Cigarettes, cigar, and pipe smokers are all at risk.
- Exposure to secondhand smoke: This raises the chances of acquiring emphysema. This refers to the smoke that is unintentionally inhaled from other people’s cigarette, pipe, or cigar. It is also known as passive or environmental tobacco smoke.
- Occupational exposure to fumes or dust: In addition to smoke, chronic exposure to fumes, strong fragrances, cleaning chemicals, paint/varnish, dust, pollen, and pet dander may increase one’s risk of developing emphysema.
- Exposure to indoor and outdoor pollution: Pollutants from outdoor and indoor raise the risk of emphysema. This includes heating fuel fumes and car emissions.
Diagnosis
The diagnosis of emphysema often involves discussing the symptoms, evaluating the medical history, and performing a physical examination. During the physical exam, the doctor will use a stethoscope to listen to the lung sounds. The doctor will tap on the chest and listen for a hollow sound. A hollow sound indicates that the lungs are holding air.
If the doctor suspects emphysema, several tests will be required to confirm the diagnosis.
- Imaging tests:
- Chest X–ray: This procedure can examine the lungs. X–rays are frequently ineffective at detecting early stages of emphysema. It can show normal findings even with emphysema. They are more effective in detecting moderate to severe emphysema. This test can also assist in ruling out other reasons for shortness of breath.
- CT scan: It creates a three–dimensional image of the lungs. Emphysema can be detected and diagnosed using CT scans. It is also required for people who are candidates for lung surgery. A CT scan produces clearer images than an X–ray.
- Lab tests: Blood testing and genetic studies may be requested to rule out alpha–1 antitrypsin deficiency as the cause of emphysema. Blood drawn from an artery in the wrist can be examined to see how well the lungs carry oxygen into the circulation and eliminate carbon dioxide.
- Lung function tests: The tests assess the efficiency with which the lungs inhale and exhale air. Spirometry may be used in testing. Spirometry measures the flow of air through the lungs using a spirometer machine. It also calculates how much air is in the lungs.
Treatment
There is no cure for emphysema, and the treatment primarily focuses on alleviating symptoms and enhancing an individual’s quality of life. As emphysema can worsen over time, the focus of treatment is on slowing down the progression of the disease and optimizing the function of the healthy lung tissue that remains.
The specific type of treatment for emphysema is dependent on the severity of the condition. In addition to quitting smoking, the treatment may consist of medication, therapy, or surgery.
- Medications: Common medications to manage the symptoms of emphysema include:
- Bronchodilators: These drugs relax the muscles that surround the airways. These medications can help reduce coughing, shortness of breath, and other breathing difficulties. They are more effective than oral drugs. Bronchodilators are also used to treat asthma and other lung diseases.
- Inhaled steroids: Corticosteroid drugs are often taken every day to help avoid the symptoms of emphysema. Inhaled corticosteroids diminish edema and mucus production in the airways. It reduces inflammation and may aid in the relief of shortness of breath.
- Antibiotics: These aid in the treatment of bacterial infections such as pneumonia, bronchitis, and other lung diseases.
- Therapy
- Pulmonary rehabilitation: Breathing exercises and techniques can assist with minimizing the shortness of breath and enhance one’s capacity for physical activity.
- Dietary therapy: Nutritional guidance may be necessary in the early and late stage of emphysema. In most cases, people in the early stage may need to lose some weight, while those in the late stage may need to put on weight.
- Supplemental oxygen: Oxygen treatment can help if the lungs aren’t delivering enough oxygen to the blood. Most people with emphysema use oxygen the entire day. It is normally given through a machine via a nasal catheter or a facemask. Utilizing oxygen at home and during exercise might offer some comfort to people with severe emphysema and low blood oxygen levels.
- Surgery: One or more surgical procedures may be recommended to manage the emphysema. This includes:
- Lung volume reduction surgery: Eliminating the unhealthy tissue allows the remaining lung tissue to expand and function more efficiently, improving breathing. Doctors use this surgery to remove tiny wedges of diseased lung tissue.
- Bronchoscopic lung volume reduction: In bronchoscopy lung volume reduction, a one–way valve is inserted into the airway. The valve permits air to exit but not enter in certain regions of the lungs. This reduces the amount of trapped air in the lungs, making breathing easier.
- Lung transplant: In severe cases of emphysema, a lung transplant is typically viewed as a final option when all other alternatives have been explored. The procedure involves the replacement of one or both damaged lungs with healthy lungs obtained from a donor.
