Emphysema occurs when the air sacs in your lungs are gradually destroyed, making you progressively more short of breath. Emphysema is one of several diseases known collectively as chronic obstructive pulmonary disease (COPD). Smoking is the leading cause of emphysema.
As it worsens, emphysema turns the spherical air sacs — clustered like bunches of grapes — into large, irregular pockets with gaping holes in their inner walls. This reduces the surface area of the lungs and, in turn, the amount of oxygen that reaches your bloodstream.
Emphysema also slowly destroys the elastic fibers that hold open the small airways leading to the air sacs. This allows these airways to collapse when you breathe out, so the air in your lungs can’t escape. Treatment may slow the progression of emphysema, but it can’t reverse the damage.
You can have emphysema for many years without noticing any signs or symptoms. The main symptom of emphysema is shortness of breath, which usually begins gradually. You may start avoiding activities that cause you to be short of breath, so the symptom doesn’t become a problem until it starts interfering with daily tasks. Emphysema eventually causes shortness of breath even while you’re at rest.
When to see a doctor
See your doctor if you’ve had shortness of breath for several months, especially if it’s getting worse or it’s interfering with your daily activities. Don’t try to attribute it to your deconditioning or age or weight.
Immediate medical attention if:
You’re so short of breath, you can’t talk
Your lips or fingernails turn blue or gray
You’re not mentally alert
Your heartbeat is very fast
The main cause of emphysema is long-term exposure to airborne irritants, including:
-Coal and silica dust
Rarely, emphysema is caused by an inherited deficiency of a protein that protects the elastic structures in the lungs. It is called Alpha-1 antitrypsin deficiency emphysema.
RISK FACTORS :
Emphysema is most likely to develop in cigarette smokers, but cigar and pipe smokers also are susceptible. The risk for all types of smokers increases with the number of years and amount of tobacco smoked.
Although the lung damage that occurs in emphysema develops gradually, most people with tobacco-related emphysema begin to experience symptoms of the disease between the ages of 40 and 60.
Exposure to secondhand smoke.
Secondhand smoke, also known as passive or environmental tobacco smoke, is smoke that you inadvertently inhale from someone else’s cigarette, pipe or cigar. Being around secondhand smoke increases your risk of emphysema.
Occupational exposure to fumes or dust.
If you breathe fumes from certain chemicals or dust from grain, cotton, wood or mining products, you’re more likely to develop emphysema. This risk is even greater if you smoke.
Exposure to indoor and outdoor pollution.
Breathing indoor pollutants, such as fumes from heating fuel, as well as outdoor pollutants — car exhaust, for instance — increases your risk of emphysema.
Collapsed lung (pneumothorax). A collapsed lung can be life-threatening in people who have severe emphysema, because the function of their lungs is already so compromised.
Heart problems. Emphysema can increase the pressure in the arteries that connect the heart and lungs. This can cause a condition called cor pulmonale, in which a section of the heart expands and weakens.
Large holes in the lungs (giant bullae). Some people with emphysema develop empty spaces in the lungs called bullae. Giant bullae can be as large as half the lung. In addition to reducing the amount of space available for the lung to expand, giant bullae can become infected and are more prone to causing a collapsed lung (pneumothorax).
Chest X-ray. A chest X-ray can help confirm a diagnosis of advanced emphysema and rule out other causes of shortness of breath, but an X-ray alone isn’t enough to make an accurate diagnosis.
Computerized tomography (CT). CT scans combine X-ray images taken from many different directions to create cross-sectional views of internal organs. Your doctor may want you to have a CT scan if you’re considering lung surgery.
Blood taken from an artery in your wrist can be tested to determine how well your lungs transfer oxygen into, and remove carbon dioxide from, your bloodstream.
Lung function tests
These noninvasive tests measure how much air your lungs can hold and how well the air flows in and out of your lungs. They can also measure how well your lungs deliver oxygen to your bloodstream. One of the most common tests uses a simple instrument called a spirometer, which you blow into.
Emphysema can’t be cured, but treatments can help relieve symptoms and slow the progression of the disease.
Smoking cessation drugs. Prescription medications, such as bupropion hydrochloride (Zyban) and varenicline (Chantix), can help you quit smoking.
These drugs can help relieve coughing, shortness of breath and trouble breathing by relaxing constricted airways, but they’re not as effective in treating emphysema as they are in treating asthma or chronic bronchitis.
Corticosteroid drugs inhaled as aerosol sprays may help relieve shortness of breath. But prolonged use can weaken your bones and increase your risk of high blood pressure, cataracts and diabetes.
If you develop a bacterial infection, like acute bronchitis or pneumonia, antibiotics are appropriate.
A pulmonary rehabilitation program can teach you breathing exercises and techniques that may help reduce your breathlessness and improve your ability to exercise.
You’ll also receive advice about proper nutrition. In the early stages of emphysema, many people need to lose weight, while people with late-stage emphysema often need to gain weight.
If you have severe emphysema with low blood oxygen levels, using oxygen regularly at home and when you exercise may provide some relief. Many people use oxygen 24 hours a day. It’s usually administered via narrow tubing that fits into your nostrils.
Surgery Depending on the severity of your emphysema, your doctor may suggest one or more different types of surgery, including:
Lung volume reduction.
In this procedure, surgeons remove small wedges of damaged lung tissue. Removing the diseased tissue helps the remaining lung tissue work more efficiently and helps improve breathing.
Lung transplantation is an option if you have severe emphysema and other options have failed.
LIFE STYLE AND HOME REMEDIES :
This is the most important measure you can take for your overall health and the only one that might halt the progression of emphysema. Join a smoking cessation program if you need help giving up smoking. As much as possible, avoid secondhand smoke.
Avoid other respiratory irritants.
These include fumes from paint and automobile exhaust, some cooking odors, certain perfumes, even burning candles and incense. Change furnace and air conditioner filters regularly to limit pollutants.
Try not to let your breathing problems keep you from getting regular exercise, which can significantly increase your lung capacity.
Protect yourself from cold air. Cold air can cause spasms of the bronchial passages, making it even more difficult to breathe. During cold weather, wear a soft scarf or a cold-air mask — available from a pharmacy — over your mouth and nose before going outside, to warm the air entering your lungs.
Avoid respiratory infections.
Get pneumonia vaccinations as advised by your doctor. Also get an annual influenza immunization. Do your best to avoid direct contact with people who have a cold or the flu. If you have to mingle with large groups of people during cold and flu season, wear a face mask, wash your hands frequently and carry a small bottle of hand sanitizer to use when needed.