Emphysema is a chronic condition affecting the lungs. Individuals with emphysema gradually lose the natural elasticity of the lung's air sacs, which causes difficulty breathing and often painful or uncomfortable respiration. As the elasticity is lost, small holes begin to form in the lung tissue and the air sacs become damaged. Over time, emphysema leads to Chronic Obstructive Pulmonary Disease (COPD), which in turn affects the heart.
Emphysema is a gradual and progressive condition that stems from years of exposure to chemical pollutants, most often from cigarette smoking. In some cases emphysema is caused by workplace and environmental air pollutants, and in a very small percentage of people, emphysema is caused by an inherited chemical imbalance in the lung tissue. This rare, inherited condition is known as early onset emphysema or AAT deficiency-related emphysema.
Symptoms of emphysema include tightness in the chest, painful or difficult breathing, shortness of breath after mild exercise or exertion, and chronic cough, all caused by the progressive destruction of lung tissue and the air sacs. Often, emphysema is diagnosed in patients who have previously had chronic bronchitis, but are no longer responding to antibiotics. Emphysema makes it more difficult for the lungs to pass oxygen into the bloodstream. Over time, as the air sacs become further damaged, a person with emphysema may find that simply walking a short distance causes them to become short of breath.
Emphysema is an irreversible condition, but treatment exists to make living with the disease more comfortable. Treatment includes bronchodilators, prescription drugs that relax the airway, to relieve constricted airways and breathing exercises to strengthen the lungs. In severe cases, a lung transplant may be performed.
Emphysema affects more men than women, but almost always smokers or those who are regularly exposed to cigarette smoke. It is estimated that cigarette smoking is the cause of nearly 80% of all lung diseases, including emphysema. Quitting smoking will help slow the progression of emphysema.
Symptoms of emphysema are insidious in nature and may not, at first, be easy to recognize. Emphysema is among a group of lung diseases known as COPD, in which the alveoli of the lungs become damaged, causing them to enlarge and burst. Because the alveoli are where oxygen and carbon dioxide are exchanged, damage to this area makes it difficult for people with emphysema to expel all their air. This causes a build up of carbon dioxide in the body.
Currently, there is no cure for the disease and it tends to get worse over time. Recognizing the following symptoms of emphysema will lead to earlier emphysema treatment:
Shortness of Breath
Also known as dyspnea, shortness of breath is the hallmark symptom of emphysema. Learn more about breaking the dyspnea cycle, along with exercises to help you alleviate shortness of breath.
Rapid Breathing
Tachypnea is the medical term for rapid breathing, which is another common symptom of emphysema. Learn why people with emphysema suffer from tachypnea.
Chronic Cough (With or Without Sputum)
A person with emphysema usually has a history of cigarette smoking accompanied by a long-term, (chronic) cough. The cough may be either be productive (with sputum) or non-productive (without sputum). Learn more about chronic cough and find out why COPD causes increased mucus production.
Wheezing
Wheezing, especially during expiration, is a common finding among emphysema patients. Learn more about wheezing. Listen to what expiratory wheezing sounds like.
Reduced Exercise Tolerance
Many people with emphysema have a reduced capacity for any type of exercise or activity. This often gets worse over time, as the emphysema progresses. Learn why people with COPD struggle with decreased exercise tolerance.
Loss of Appetite Leading to Weight Loss
Anorexia is the medical term for loss of appetite, not to be confused with the mental condition, anorexia nervosa, which has nothing to do with COPD. Learn more about how loss of appetite leads to weight loss in people with emphysema, and discover how to control shortness of breath during mealtimes so you can get the calories you need.
Barrel Chest
Barrel chest is a rounded, bulging, barrel-like appearance of the chest, which is common in the later stages of emphysema. Learn what causes a barrel chest.
The main cause of emphysema is long-term exposure to airborne irritants, including:
Tobacco smoke
Marijuana smoke
Air pollution
Manufacturing fumes
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.
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.
Bronchodilators. 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.
Inhaled steroids. 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.
Antibiotics. If you develop a bacterial infection, like acute bronchitis or pneumonia, antibiotics are appropriate.
Pulmonary rehabilitation. 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.
Supplemental oxygen. 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.
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 transplant. Lung transplantation is an option if you have severe emphysema and other options have failed.