COPD’s Effect on the Lungs

Topic Overview

Chronic obstructive pulmonary disease (COPD)
slowly damages the lungs and affects how you breathe.

COPD’s effect on breathing

In COPD, the airways of the lungs (bronchial tubes) become inflamed and narrowed. They tend to collapse when you breathe out and can become clogged with mucus. This reduces airflow through the bronchial tubes, a condition called airway obstruction, making it difficult to move air in and out of the lungs.

The inflammation of the bronchial tubes makes the nerves in the lungs very sensitive. In response to irritation, the body forces air through the airways by a rapid and strong contraction of the muscles of respiration—a cough. The rapid movement of air in the breathing tubes helps remove mucus from the lungs into the throat. People with COPD often cough a great deal in the morning after a large amount of mucus has built up overnight (smoker’s cough).

The oxygen and carbon dioxide exchange

The lungs are where the blood picks up oxygen to deliver throughout the body and where it disposes of carbon dioxide that is a by-product of the body processes. COPD affects this process.

Emphysema
can lead to destruction of the alveoli, the tiny air sacs that allow oxygen to get into the blood. Their destruction leads to the formation of large air pockets in the lung called bullae. These bullae do not exchange oxygen and carbon dioxide like normal lung tissue. Also, the bullae can become very large. Normal lung tissue next to the bullae cannot expand properly, reducing lung function.

Chronic bronchitis affects the oxygen and carbon dioxide exchange because the airway swelling and mucus production can also narrow the airways and reduce the flow of oxygen-rich air into the lung and carbon dioxide out of the lung.

The damage to the alveoli and airways makes it harder to exchange carbon dioxide and oxygen during each breath. Decreased levels of oxygen in the blood and increased levels of carbon dioxide cause the breathing muscles to contract harder and faster. The nerves in the muscles and lungs sense this increased activity and report it to the brain. As a result, you feel short of breath.

Credits

Current as of:
October 26, 2020

Author: Healthwise Staff
Medical Review:
E. Gregory Thompson MD – Internal Medicine
Adam Husney MD – Family Medicine
Ken Y. Yoneda MD – Pulmonology

Current as of: October 26, 2020

Emphysema – Harvard Health

Emphysema is a respiratory disease that makes it hard to breathe.

Normally, when you take a breath, air travels from your nose and mouth through your windpipe and into the bronchi. These are small air passages that branch off into each lung. The bronchi branch further into thousands of smaller, thinner tubes that end in grape-like clusters of small, round air sacs called alveoli. 

Tiny blood vessels absorb oxygen from the air through the walls of the alveoli and deliver it to cells throughout the body. Carbon dioxide moves in the opposite direction. It passes out of the bloodstream, back into the alveoli, and is then eliminated from the body when you breathe out.

Emphysema destroys the walls between the alveoli. This leaves the lungs less able to absorb oxygen into the bloodstream and remove carbon dioxide from the blood.

Lung tissue also loses its resilience, which prevents it from stretching and contracting properly. When the lungs lack resilience, they cannot fully push out air. Instead, some air remains trapped in the air sacs.

Emphysema, along with chronic bronchitis, is one of the two most common forms of chronic obstructive pulmonary disease.

Smoking causes the vast majority of cases of emphysema.

Symptoms of emphysema

The main symptom of emphysema is breathlessness. At first, you have difficulty catching your breath during activity. Over time, you may feel breathless after taking just a few steps, or when sitting or lying down.

Other symptoms caused by emphysema include:

• shortness of breath
• wheezing
• weight loss
• loss of muscle
• a barrel chest, resulting from overinflation of the lungs

Diagnosing emphysema

Your medical history and symptoms can alert your doctor to test you for emphysema.

Medical history and physical exam. Your doctor will ask whether you smoke. He or she will need to know how easily you become short of breath and when. Do you have trouble climbing stairs? How long can you walk before you have to stop and rest?

Your doctor then will examine you to look for typical signs of emphysema. This may include:

• watching for shortness of breath when you perform simple activities, such as walking into the exam room
• looking at the size and shape of your chest
• looking at how your chest moves when you breathe
• listening to your lungs for wheezing or loss of the normal breath sounds
• checking your skin, lips and fingernails for a bluish tint that indicates low blood oxygen levels
• checking your fingernails for an unusual curvature (“clubbing”) that sometimes occurs with chronic lung disease

Pulmonary function tests. Pulmonary function tests show how well your lungs work. They are useful both to diagnose emphysema and to determine how far the disease has progressed. You will breathe in and out through a spirometer, a tube that is connected to various machines. These tests measure two things:

• forced vital capacity (FVC) shows the maximum amount of air you can breathe out in one breath.
• forced expiratory volume in one second (FEV1) is the maximum amount of air you can exhale in one second.

X-rays. If you have emphysema, your lungs may appear larger than normal on a chest x-ray and hold abnormally large amounts of air. Your diaphragm (the main muscle involved in breathing) may appear flattened.

Laboratory tests. Lab tests can show how much emphysema has affected your lungs’ ability to take up oxygen and eliminate carbon dioxide.

Pulse oximetry. A probe on your finger measures how saturated your blood is with oxygen.

Arterial blood gas. This blood test measures how much oxygen and carbon dioxide are in your blood.

Treating emphysema

Self-care

Don’t smoke. If you smoke, quitting is the most important thing you can do to stop emphysema from getting worse.

Participate in pulmonary rehabilitation. Pulmonary rehabilitation is a form of physical therapy. It includes a structured exercise program combined with special breathing techniques, psychological support and education. It helps people with emphysema:

• conserve energy
• improve stamina
• reduce breathlessness

Get vaccinated. If you have emphysema, ask your doctor about vaccinations against influenza (flu) and pneumococcal pneumonia. These vaccinations can help to prevent life-threatening respiratory infections in people with lung disease.

Medications

Medications and other treatments won’t cure emphysema. But they can help you breathe well enough to remain active.

Bronchodilators open up the airways. They are the cornerstone of treatment. They reduce shortness of breath and increase capacity for exercise. Bronchodilators are usually inhaled.

Corticosteroids are powerful drugs that curb inflammation and help open airways. They are available in inhalers and as pills.

Antibiotics are used to treat lung infections caused by bacteria. People with emphysema often need antibiotics for respiratory infections.

Oxygen therapy

As emphysema becomes more severe, the oxygen level in your blood may become dangerously low. If this happens, breathing in extra oxygen can help you live longer. And it can help you avoid problems that can occur when your body isn’t getting enough oxygen on its own.

Surgery

Lung volume reduction surgery. This procedure involves removing some damaged lung tissue to give healthier lung tissue more room to expand and contract. It also lets the diaphragm work more effectively.

Lung transplant. A lung transplant may be an option for people with severe emphysema who are not expected to live more than two or three years.

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Emphysema – Lung Health A-Z

Treating Emphysema

There is no treatment to repair the damage to your lungs that emphysema causes. The most important thing you can do is to quick smoking and avoid breathing in “bad air.” If you can do these two things, you may be able to prevent your emphysema from getting worse.

There are treatments, however, that can improve shortness of breath and reduce the risk of an exacerbation (worsening of breathing symptoms usually because of a respiratory infection).

Treatment Options

Inhaled Bronchodilator Medications

These medications are the cornerstone of emphysema treatment. These medications open the breathing tubes in your lungs to make it easier to get all the air out and thus easier to breathe. There are 2 types of inhaled bronchodilators, and they work in different ways to open your breathing tubes.

• Long-acting inhalers. You typically use these inhalers once or twice a day.
• Short-acting inhalers. You typically use these inhalers every 4 to 6 hours and as needed.

These inhaler types are frequently used together for greatest effect.

Oxygen

If the amount of oxygen in your blood falls below 88%, your provider may prescribe oxygen. (Your provider can measure the amount of oxygen in your blood by putting a clip called an oximeter on your finger.)

Pulmonary Rehabilitation

Starting a pulmonary rehabilitation program is the one of the best ways to improve shortness of breath, quality of life, and your ability to exercise.

Surgery

Depending on your situation, your provider may consider surgical treatments. For example, parts of your lung that are damaged or destroyed can interfere with more normal parts of your lung. A surgical procedure can remove these damaged parts.

Another surgical procedure used for people with advanced emphysema is to insert little one-way valves—called endobronchial valves—into the breathing tubes in your lungs. The lung specialist or surgeon uses a long, flexible tube, called a bronchoscope, with a camera and tools on the end to place the valves. The valves allow air to exit the healthy parts of your lungs and collapse the areas of your lungs that are damaged. Your lungs deflate, which helps your diaphragm muscle work better so that you can breathe better.

Living with Emphysema

If you have emphysema, it’s important to focus on what you can do, not on what’s difficult to do. Make sure that you know as much as possible about your condition so that you can function at the highest possible level. Know the names of the medicines you take for emphysema and how long they’re supposed to work. Also, create an action plan in case your breathing gets worse.

You can expect your emphysema to get worse if you continue to smoke or inhale second-hand smoke and other irritants in the air. Many people with emphysema find that they reduce their activities to avoid breathing difficulty. Over time, however, lack of exercise can make shortness of breath worse because less activity leads to being “out of shape” and possible weight gain.

You can expect that using inhaled medications will open your airways and make it easier to breathe. You can also expect to be able to be more active if you exercise regularly, either on your own or by participating in a pulmonary rehabilitation program. If you follow recommended treatments, your breathing may remain stable for a long time.

Managing Emphysema

Ideally, you should lead a healthy life style that includes not smoking, eating healthy foods, maintaining a normal body weight, exercising regularly, getting 7 to 8 hours of sleep each night, and avoiding too much stress. Get a yearly flu shot to reduce the chances of getting the flu. Also, you should get the two pneumonia shots to prevent the most common bacterial cause of pneumonia.

Be sure to use your inhaled medications correctly and as prescribed by your health care provider. Use your albuterol inhaler if you have difficulty breathing. This medicine opens the breathing tubes in your lungs quickly, but it lasts only 3 to 4 hours.

Finally, make sure that you get a written action plan from your health care provider. Keep it with you in case your breathing gets worse. Most action plans recommend using your rescue inhaler every 2 to 4 hours as needed and calling your health care provider if you have a chest cold or start to cough up yellow or green mucus. Call your provider if you experience any major change in your breathing, Regular appointments with your health care provider are important for monitoring your emphysema and discussing treatments.

Emphysema: Overview and More

Emphysema—a type of chronic obstructive pulmonary disease (COPD)—is a progressive chronic lung disease caused by damage to the alveoli. These are the tiny air sacs in the lung where the exchange of oxygen and carbon dioxide takes place. The result is air becoming trapped, oxygen levels in the blood decreasing (hypoxemia), and carbon dioxide levels in the blood increasing (hypercapnia). Emphysema is associated with severe disability and a loss of as many as six life-years.

Roughly three million Americans are living with emphysema. COPD is today the third leading cause of death in the United States.

Verywell / Nusha Ashjaee

Emphysema Symptoms

Emphysema primarily affects the lungs but can also affect other organs and systems, including the heart, muscles, and circulatory system, as the disease progresses.

Depending on the stage of the disease and other factors, the symptoms of emphysema may include:

In addition to respiratory symptoms, emphysema can also lead to exercise intolerance and muscle atrophy. The combination of decreased physical activity and chronic respiratory stress can promote lean muscle loss, especially in the core muscles—a situation that only increases the severity of respiratory symptoms.

Finally, emphysema is characterized by what is known as COPD exacerbations. These are periods when symptoms become worse and require hospitalization. Exacerbations may be precipitated by infections or exposure to air pollution, wood smoke, or even perfume.

People with emphysema are also at an increased risk of developing lung cancer. According to research from Northwestern University Feinberg School of Medicine, COPD increases the risk of lung cancer by anywhere from 200% to 500% when compared to smokers without COPD.

If your COPD symptoms are worsening, speak with your doctor about the possibility of lung cancer. Lung cancer is far more curable when diagnosed in the early stages of the disease.

Causes

Smoking is the most common cause of emphysema, thought to be responsible for 85% to 90% of cases. But there are many other causes that can act alone or in conjunction with smoking to cause emphysema.

While researchers can’t be entirely sure why some people get COPD and others don’t, several risk factors have been identified, including:

As many as 5% of people with COPD have a genetic disorder known as alpha-1-antitrypsin deficiency. The condition should be suspected when several family members develop emphysema, particularly if none have ever smoked.

Diagnosis

The diagnosis of emphysema or another type of COPD is often suspected through a careful history and physical examination, and then confirmed by pulmonary function tests (PFTs).

Medical History

Various factors may alert a doctor to a potential diagnosis of COPD. These factors include a patient feeling short of breath at rest or with exercising, and/or a patient experiencing a chronic cough with or without phlegm production.

A history of significant smoking, especially more than 30 to 40 pack-years, or a history of significant exposure to various air pollutants or occupational dust are additional factors that may raise suspicion for a diagnosis of COPD.

Physical Examination

Physical exam findings in emphysema will vary depending on the severity of the disease. While one’s physical exam is often normal in the early stages of the disease, over time, the following findings may appear:

• Decreased breath sounds
• Wheezing and crackles at the lung bases
• Distant heart sounds
• Use of accessory muscles of respiration and exhaling through pursed lips (in advanced emphysema)

Pulmonary Function Tests

Pulmonary function tests, specifically a test called spirometry, are needed to confirm the diagnosis of COPD.

Spirometry entails taking a very deep breath in and then breathing out as hard as you can into a tube that is connected to a machine. The machine (called a spirometer) measures the amount and speed of air going in and out of your lungs.

Two key measurements obtained from spirometry are FVC (forced vital capacity) and FEV₁ (forced expiratory volume).

• FVC is the amount of air forcefully breathed out after taking a deep breath in and inhaling as much air as possible.
• FEV₁ is the amount of air breathed out during the first second of the FVC test.

Traditionally, an FEV₁/FVC ratio of less than 70% is used to diagnose COPD. However, some doctors use a ratio defined by the American Thoracic Society (ATS), especially for diagnosing young adults or adults who do not smoke. The ATS criteria define COPD as an FEV₁/FVC ratio that is less than the fifth percentile of a healthy, non-smoking reference group.

Treatment

At the current time, emphysema remains an irreversible disease and treatment is aimed at slowing the progression and complications related to the disease. Research in lung regeneration therapy is ongoing and may help develop new treatments for COPD in the future.

Today, treatment involves a combination of approaches, and the course of treatment is largely directed by the disease stage:

• Mild: Short-acting bronchodilator and an annual flu vaccine
• Moderate: Long-acting bronchodilator and pulmonary rehabilitation
• Severe: Adding inhaled corticosteroids to treat exacerbations
• Very severe: Oxygen therapy and lung surgery if needed

Lifestyle Changes

Quitting smoking is critical for individuals living with this condition and can help to slow the progression of the disease.  Speak with your doctor about ways to support your effort.

Engaging in regular physical activity is also important, as it is what will help prevent muscle atrophy and resulting disease progression. But there’s no doubt that emphysema itself can make exercise difficult.

The best exercises for COPD include a combination of endurance, flexibility, and strength training. Your doctor can help you determine what regimen is best for you.

Medications

There are no drug treatments that have proven successful in slowing the rate of decline of lung function with emphysema. Instead, medications are used to help increase exercise tolerance, reduce COPD exacerbations, and improve overall health status.

Medications used for stable COPD include:

Get Vaccinated

Staying up-to-date with immunizations, especially the flu vaccine and the pneumonia vaccine, helps prevent infections that can worsen your emphysema. 

Oxygen Therapy

This can be given continuously, during activity, or for the relief of sudden episodes of shortness of breath. Long-term oxygen therapy of over 15 hours per day is given when a patient has low oxygen saturation levels during advanced (stage IV) COPD.

Pulmonary Rehabilitation

There are many benefits of pulmonary rehabilitation, an interdisciplinary program that should last at least six weeks. Pulmonary therapy can make a big difference for people living with emphysema by improving exercise tolerance, reducing symptoms, and decreasing hospitalizations/lengths of stay.

Lung Surgery

Lung volume reduction surgery to remove severely damaged tissue may be useful for some people with severe emphysema, especially for those who have disease predominantly involving the upper lobes. Bullectomy may be done in patients who have giant bullae. Lung transplant is another consideration.

A Word From Verywell

Emphysema can be a frustrating disease in many ways. Not only do you have to cope with the physical effects of symptoms and treatments, but the impact they can have on your mental wellness and everyday life as well. Unfortunately, many people with COPD receive inadequate support. If that applies to you, lean on your healthcare team, consider seeing a therapist, and tap into support groups (the American Lung Association is a good place to start). You are not alone.

How Does Emphysema Affect Lung Function?

Emphysema affects lung function in three main ways. First, emphysema causes holes to gradually form inside the lungs’ air sacs, thereby weakening their internal structure and inhibiting the exchange of oxygen and carbon dioxide. Second, emphysema damages the elasticity of the airways that lead to the air sacs, causing the air sacs to collapse and trap oxygen within the lungs. Third, routinely inhaling cigarette smoke destroys both the cilia (the hair-like structures tasked with clearing mucus from the lungs) and the body’s immune cells, thereby increasing the risk of lung infection.

Emphysema is an obstructive respiratory disease, meaning that the condition makes it difficult to fully exhale (as opposed to restrictive respiratory diseases, which make it difficult to fully inhale). In addition to difficulty breathing, emphysema is associated with the following symptoms:

• Coughing
• Wheezing
• Feeling of tightness in the chest

If you’re living with emphysema, the cellular therapy procedures offered at the Lung Health Institute may be able to improve your quality of life. Traditional emphysema treatment methods (including bronchodilators, inhaled corticosteroids and supplemental oxygen therapy) only address the symptoms of the disease, but not the disease itself. Cellular therapy is different, however, as it may slow the progression of emphysema. Treatment can be completed on an outpatient basis over the course of two days, during which time we take a small sample of the patient’s own blood, separate the cells from the remaining cells in the sample and then intravenously return the concentrated cells to the patient’s bloodstream. The cells can be used for the treatment of emphysema because they have the unique ability to regenerate as other forms of bodily tissue, allowing them to help with healing. Because our procedures use autologous cells (ones derived from the patient’s own body), they are considered to be a safe method of emphysema treatment.

If you would like more information on how cellular therapy may help with emphysema treatment, please contact the Lung Health Institute at 888-745-6697.

Chronic Obstructive Pulmonary Disease (COPD) and Emphysema

COPD stands for chronic obstructive pulmonary disease. Emphysema is a form of COPD.

Causes | Emphysema | vs Asthma | Medical Treatment | Pulmonary Rehab | Surgery | Next Steps

Key Info

• COPD is a group of diseases that cause damage to the lungs and restrict their ability to obtain oxygen, restricting oxygen flow in the blood.
• Medical and rehabilitation programs and therapy are available to patients with COPD to help them combat their symptoms
• Surgical treatments for COPD include lung volume reduction surgery and lung transplantation

Over 15 million Americans have been diagnosed with COPD. Evidence suggests that another 15 million have COPD but remain undiagnosed. COPD is presently the third leading cause of death in this country and the 2nd leading cause of disability.

Causes of COPD

Most COPD is related to cigarette smoking, but recent evidence suggests that 25% of those with COPD never smoked. Increasingly environmental factors are felt to play a role in the development and worsening of COPD. There is also an inherited form of COPD called alpha-1 antitrypsin deficiency.

All COPD is not the same. There are those with more of a chronic bronchitic form of COPD and some with a more emphysematous form, meaning it is related to emphysema.

Emphysema

Emphysema is a progressive, destructive lung disease in which the walls between the tiny air sacs are damaged. As a result, the lungs lose their elasticity causing exhalation, or breathing out, to become more and more difficult. Air remains trapped in the overinflated lungs, leading to progressive shortness of breath.

COPD vs Asthma

COPD and asthma are both obstructive lung diseases marked by shortness of breath but asthma is by definition reversible while with COPD the airflow obstruction is either irreversible or only partly reversible. The mainstay of therapy in asthma is inhaled corticosteroids while in COPD it is long acting bronchodilators. Over time some asthmatics may develop an irreversible component, a variant of COPD. Because both are common diseases they can occur together. Estimates suggest that as many as 20% of COPD patients have ACOS, the asthma/COPD overlap.

Medical Treatments for COPD

Treating and preventing exacerbations—or flares of disease—are critical factors in managing COPD. People with frequent exacerbations (2 or more a year), have a more rapid deterioration in lung function, more frequent hospitalizations, and higher mortality.
There are many medical options for treating emphysema/COPD.

Smoking Cessation

• The primary recommendation for preventing and treating COPD is to stop smoking.

Bronchodilators

• Bronchodilators relax the muscles of the bronchi, the major air passageway in the lungs. This allows air to get in and out easier. These medications are available in pill or liquid form (taken orally), or as an aerosol spray (inhaled).

Steroids

• Steroids are powerful anti-inflammatory medications. The only role for systemic steroid therapy in COPD is for 5-10 days during an acute exacerbation. Longer term treatment with systemic steroids in COPD has not been shown to have any benefit and can carry significant risks. The potential side effects of long term systemic steroid use include osteoporosis, diabetes, weight gain, cataracts, muscle weakness, cataracts, and hypertension.

Anti-Infective Agents

• Antibiotics are frequently used during acute bronchitis to fight bacterial infections. Flu and pneumonia vaccinations are recommended for all patients with COPD. The influenza shot is administered yearly while the pneumonia shot is administered every five years.

Oxygen Therapy

• Oxygen therapy in patients with a resting O2 saturations less than or equal to 88% has been shown to improve quality of life and survival.

Nutrition

• Proper nutrition is critical for emphysema patients. Weight loss, which is common in patients with advanced emphysema, can be caused by inadequate food intake in individuals too short of breath to eat. However, most weight loss in COPD patients is due to the increased metabolic demand of respiratory muscles that are overworked because of emphysema damage.

Pulmonary Rehabilitation for COPD

Pulmonary rehabilitation has clear benefits for patients with COPD. Exercise increases endurance, improves shortness of breath, increases maximal oxygen consumption, and improves quality of life. Numerous studies have documented improvement in symptoms, maximum oxygen consumption, and quality-of-life measures. A decrease in the number of hospitalizations has also been shown in patients who participate in pulmonary rehabilitation programs.

Benefits do vary among individuals, however, and consistent participation in an exercise regimen is necessary to maintain improvements. In addition, it has not been shown that pulmonary rehabilitation produces any change in pulmonary function tests (PFTs) or overall oxygen requirements for individuals.

Surgical Treatment for COPD

If medical treatment does not alleviate the symptoms of COPD, or symptoms and exacerbations increase, surgery may be an option. However, in order to be a candidate for surgery, there are specific criteria. These include not being a current smoker, participating in a pulmonary rehabilitation program, and being strong enough to receive surgery.

There are two types of surgery performed for COPD, Lung Volume Reduction Surgery and Bullectomy.

• Lung Volume Reduction Surgery involves removing parts of the lung that are most affected by COPD. Removal of lung tissue seems counterintuitive, but it allows the remaining, healthy parts of the lung function more efficiently.
• Bullectomy involves the removal of bullae from the lungs. Bullae are large air sacs in the lungs that form when a large number of alveoli are destroyed by COPD. These air sacs interfere with breathing.

If damage to the lungs is too severe or surgery does not alleviate symptoms, a doctor may recommend a lung transplant.

Next Steps

If you need help for a lung or chest issue, we’re here for you. Call (212) 305-1158 or request an appointment online to get started today.

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6 Keys to Living Well With Emphysema

One of smoking’s many adverse effects is the risk of developing emphysema and COPD, or chronic obstructive pulmonary disease.

Emphysema is one of two types of COPD; the other is chronic bronchitis. If you have emphysema, it is likely that the air sacs, or alveoli, in your lungs are damaged. As a result, your body is not getting the oxygen it needs to function properly.

“Think of COPD as a spectrum of disease, with chronic bronchitis on one end and emphysema on the other,” says Jeffrey Michaelson, MD, a pulmonologist with Piedmont Hospital in Atlanta. “COPD-related disease is most frequently caused by smoking cigarettes and first starts to manifest symptoms usually by the mid-fifties in continuous smokers.”

Telltale Emphysema Symptoms

Emphysema affects your body in many ways. Typical emphysema symptoms include having a hard time catching your breath — especially while exercising — and a chronic cough. “Symptoms of emphysema deal with progressive shortness of breath that limits activity,” says Dr. Michaelson.

Many people with emphysema also have chronic bronchitis, so an emphysema diagnosis may include chronic bronchitis symptoms as well. Chronic bronchitis brings with it the continual production of sputum associated with cough and chest congestion. Michaelson notes that the majority of patients fall somewhere in the middle of the COPD spectrum and display symptoms of both diseases.

Finding the Right Emphysema Treatment

Emphysema and COPD can’t be cured, but the right treatment can improve your emphysema prognosis as well as your overall health and well-being. Taking these steps will help:

• Get a diagnosis. If you’re unsure if you have emphysema and COPD, start by getting a diagnosis. Only then can your doctor begin to help you. “If you feel that you or someone you know over the age of 35 may be experiencing symptoms, a brief, five-question screener will help determine if that person might be at risk for COPD,” says Michaelson.
• Start emphysema treatment. Your doctor needs to be your primary source for getting a handle on emphysema treatment, says Michaelson. “It is important to seek treatment once diagnosed since COPD is a progressive disease. It can lead to frequent hospital admissions, poor quality of life, the need for supplemental oxygen, or a ventilatory assist device worn at night to help maintain effective breathing while asleep,” he says. Treatment — especially quitting smoking — along with using inhalers, helps lessen symptoms, delays disease progression, and enables patients to maintain an active lifestyle.
• Quit smoking. If you want to have a better emphysema prognosis and prevent the progression of emphysema symptoms, no step is more important than to quit smoking. “Stopping smoking reduces the inflammation and lung damage that leads to worsening of COPD and emphysema,” says Michael S. Nolledo, MD, an attending pulmonologist at the Deborah Heart and Lung Center in Browns Mills, N.J.
• Avoid other irritants. Tobacco smoke isn’t the only irritant that can exacerbate emphysema and COPD. “Most COPD in this country is related to smoking, but only 20 percent of smokers develop significant COPD,” says Byron Thomashow, MD, medical director at NewYork–Presbyterian Hospital in New York City and chairman of the COPD Foundation. “This suggests that other genetic or environmental factors must also play roles.” Some potential irritants include cold air or poor air quality days in your region.
• Keep immunizations up to date. Michaelson says that this is a critical step for avoiding complications to emphysema and COPD. Flu and pneumonia immunizations are especially important.
• Do the right exercises. Both breathing exercises and regular cardiovascular exercise like walking are critical to curbing symptoms and having a good emphysema prognosis. Get started by doing these exercises in a program led by a trained professional before you branch out on your own. “Exercises are best managed under the guidance of a pulmonary rehabilitation program that involves not just specific exercises, but disease counseling as well,” says Dr. Nolledo. “COPD patients who complete these programs have been shown to have significant improvement in their shortness of breath.”

Because emphysema symptoms will worsen without treatment, it’s vital that you work with your doctor to manage your condition. Taking care of yourself and taking control of your symptoms will give you the best possible prognosis.

90,000 treatment of the disease and methods of prevention – clinic “Dobrobut”

Emphysema of the lungs: symptoms, causes, diagnosis, treatment

Emphysema of the lungs is a pathological condition characterized by the expansion of the alveoli and destructive changes in their walls. Distinguish between primary (idiopathic) emphysema – an independent nosological form that develops without previous bronchopulmonary pathology, and secondary (obstructive), arising against the background of other respiratory diseases.The frequency of pathology increases significantly in the age group over 60 years old. The disease belongs to COPD (chronic obstructive pulmonary disease). You should know what pulmonary emphysema is and how to treat it.

Signs of pulmonary emphysema, causes of the disease

Symptoms of pulmonary emphysema:

1. Shortness of breath. At the first stage of the disease, it worries patients only with significant physical exertion. With the progression of emphysema, shortness of breath becomes permanent.
2. Cough. Usually harsh, unproductive.
3. Cyanosis. Typical for patients with secondary emphysema of the lungs.
4. Weight loss. Patients are slender, may look cachectic.

Signs of pulmonary emphysema when examining a patient – a barrel-shaped chest, hyperfunctioning of the auxiliary respiratory muscles (shoulder girdle, neck, abdominal muscles).

X-ray examination reveals a low location of the dome of the diaphragm, an increase in the retrosternal (retrosternal) space (the so-called Sokolov sign), the filamentous nature of the vascular pattern.The most characteristic sign of the condition is a decrease in VC (vital capacity of the lungs) with an increase in their total capacity (OEL). The ECG shows a deviation of the electrical axis of the heart to the right. Data from laboratory studies of lung disease emphysema – an increased level of hemoglobin and the number of red blood cells.

Causes of the disease

Secondary emphysema develops due to COPD. Primary pulmonary emphysema can be caused by:

1. Ecology. Environmental pollution causes damage to the alveolar walls, which leads to the development of emphysema.
2. Smoking. Tobacco smoke causes the migration of neutrophils, which produce proteolytic enzymes that destroy the walls of the alveoli.
3. Genetically determined deficiency of alpha-1-antitrypsin, a shift towards proteolysis and damage to the alveolar walls.
4. Occupational hazardous environment, eg miners.
5. Senile age.

With bullosa emphysema in the tissues of the organ there are bullae – swollen areas over 10 mm in size.There is also a decrease in the content of alpha-1-antitrypsin in the blood. This type of pulmonary emphysema is characterized by the development of spontaneous pneumothorax (accumulation of air in the pleural cavity).

Pulmonary emphysema: treatment

There is no specific treatment for emphysema, therefore, therapeutic programs common to all COPD are used. It is important to eliminate all factors that caused the development of emphysema (smoking, chronic infectious process, exposure to polluted air).

Treatment of pulmonary emphysema:

1. Drugs of choice – bronchodilators: β2-adrenomimetics, m-anticholinergics, long-acting theophylline preparations.
2. Glucocorticosteroids are given orally in short courses. In the absence of an effect, hormonal therapy is no longer prescribed. With a positive result of therapy, it is advisable to continue treatment with inhaled hormonal drugs.
3. Long-term use of acetylcysteine ​​reduces the frequency of exacerbations of COPD and, consequently, the progression of secondary emphysema.
4. Thoracoscopic bullectomy – surgical reduction of lung volume by resection of peripheral areas.After the operation, the functional state of the lungs is significantly improved.
5. With the development of spontaneous pneumothorax, drainage of the pleural cavity and removal of air are performed.
6. Oxygen therapy is indicated for severe respiratory failure.
7. A group of American researchers reported that regular intake of acetylsalicylic acid (aspirin) slows the progression of emphysema and COPD.
8. Respiratory gymnastics for pulmonary emphysema is aimed at training the respiratory muscles.

Prevention consists in quitting smoking, preventing respiratory diseases, influenza vaccination, adequate therapy for chronic inflammatory diseases of the respiratory tract, improving working conditions, spa treatment of patients with COPD. Read more about the prevention of pulmonary emphysema on our website dobrobut.com.

Pulmonary emphysema – prices for treatment, symptoms and diagnosis of pulmonary emphysema in the “CM-Clinic”

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Pulmonary emphysema is a chronic progressive disease that relatively often leads to disability. Emphysema belongs to the group of chronic obstructive pulmonary diseases along with bronchial asthma, chronic obstructive bronchitis, cystic fibrosis and bronchoectatic disease.

The terminal sections of the respiratory tract are represented by terminal bronxeoli and alveoli, where oxygen and carbon dioxide gas exchange during respiration.Emphysema is an irreversible enlargement of the end sections of the lungs due to destruction.

Factors leading to the onset of pulmonary emphysema:

• heredity,
• long-term smoking,
• the risk of developing this disease increases after 60 years,
• harmful impurities in the inhaled air,
• occupational hazards,
• respiratory tract infections,
• bronchial asthma,
• chronic obstructive pulmonary disease (COPD)

Symptoms of pulmonary emphysema

The clinical picture of emphysema does not have vivid signs inherent only to it, and this is one of the reasons why there is a concept of chronic obstructive lung diseases, which unites such closely related diseases as obstructive bronchitis, bronchial asthma and emphysema.The symptoms of obstructive bronchitis and emphysema are especially similar. As a rule, the main symptom of emphysema is shortness of breath, which occurs at rest or with little exercise.

If you experience these symptoms, we advise you to make an appointment with your doctor. Timely consultation will prevent negative consequences for your health. Phone for appointment +7 (495) 292-39-72

Treatment of pulmonary emphysema

There is no specific treatment for pulmonary emphysema.Treatment is directed at the underlying disease causing emphysema and improving quality of life. Smoking cessation is of great importance.

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Bullous emphysema of the lungs | Clinic “Oberig”

Emphysema of the lungs is a disease in which the alveoli (“sacs” in which gas exchange between blood and air occurs) stretch and contract poorly. As a result, less oxygen enters the body, and less carbon dioxide is excreted. Respiratory failure develops.

One of the types of the disease is called bullous emphysema of the lungs.A bubble filled with air is formed in the lung tissue – a bulla. Bulls average 1-5 cm in diameter. Giant bulls reach 10-15 cm in diameter. Bullae tend to enlarge and burst into the pleural space, compressing the surrounding lung tissue.

Most often they occur in the upper lobes of the lungs. The walls of the bulls are stretched and thinned, so they can break easily. Bulls can be single or multiple. According to the prevalence in the lung, localized (within 1-2 segments) and generalized (with damage to more than 2 segments) form are distinguished.

CAUSES OF EMFYZEMA BULL

The disease is more common in men than in women. The development of bullous emphysema is promoted by chronic obstructive pulmonary disease, bronchial asthma, viral respiratory tract infections.

Hereditary factors also affect – genetically determined weakness of the connective tissue. In some people, there is a congenital deficiency of the inhibitor elastase-a1-antitrypsin, as a result of which enzymatic destruction of lung tissue occurs.

The risk of disease is significantly increased in smokers. Patients usually smoke more than 20 cigarettes a day for 10 to 20 years before the first symptoms of bullous emphysema appear. Secondhand smoke also contributes to the development of the disease. Another risk factor is air pollution.

SYMPTOMS AND SIGNS OF BULLOUS PULMONARY EMphysema

Bullous emphysema may go unnoticed until the bulla ruptures. In this case, air enters the pleural cavity.This condition is called pneumothorax. It leads to complete or partial collapse of the lung and requires urgent surgery, which is performed by a thoracic surgeon. In 70-80% of cases, the cause of spontaneous pneumothorax is rupture of the bulla.

In some cases, clinical signs of bullous emphysema are manifested in the form of shortness of breath, cough, mild chest pain, scanty sputum production, weakness. Shortness of breath, which is initially felt with exertion, usually occurs 10 years after coughing.Patients often have a lean physique, underdeveloped muscles, curvature of the spine, and chest deformities.

High-resolution X-ray and CT are used to diagnose bullous emphysema. If in doubt, a diagnostic thoracoscopy is performed.

TREATMENT OF BULLOUS PULMONARY EMphysema

Bullous emphysema of the lungs increases the risk of spontaneous pneumothorax, therefore, resection (removal) of altered parts of the organ is recommended. Surgical intervention is performed thoracoscopically.All manipulations are carried out through small punctures of the chest wall, so the operation is low-traumatic.

Patients with an asymptomatic course of bullous emphysema should be monitored. They should avoid situations that can lead to rupture of bulls – physical overstrain, colds. You must quit smoking unconditionally. It is possible to use conservative methods of treating bullous enphysema.

The patient is managed by a pulmonologist, and if complications develop, by a thoracic surgeon.At the Oberig Universal Clinic you can undergo a complete examination of the respiratory system and receive modern treatment in a specialized Thoracopulmonology Center. Make an appointment by phone:

(044) 521 30 03

Emphysema of the lungs | FBUZ Treatment and Rehabilitation Center of the Ministry of Economic Development of Russia. Official site

We will start our conversation not with what is emphysema of the lungs, but with how the lungs are arranged and what happens to their tissue with age.
Why would I start with this topic? Everything is very simple. I have little doubt that you opened this article after receiving a description of your chest x-ray. In the conclusion of the radiologist, it is most likely written: “No focal and infiltrative shadows were detected. Signs of emphysema and diffuse pneumosclerosis.” To understand what the radiologist, who wrote such a conclusion, meant, it is necessary to recall the structure of the lung.

Lung structure
The lungs are composed of the airways (bronchi and bronchioles) and air sacs (alveoli).It is easiest to imagine the structure of the lungs as a tree. The branches of which are bronchi of different diameters, which branch out into small branches (bronchioles). At the ends of the bronchioles are air sacs – alveoli that look like bunches of grapes. The alveoli have a very thin wall and are braided by a network of blood vessels. It is through the thin wall of the alveoli that oxygen enters the bloodstream, and carbon dioxide is removed from the body.

What happens to the lung tissue during the development of emphysema
During life, under the influence of various harmful factors (primarily smoking) and with age, the walls of the alveoli thicken to a greater or lesser extent, cease to be as elastic as before.The partitions between some air bubbles collapse and form one large bubble or bulla. These phenomena of restructuring of lung tissue are called emphysema. Actually, the word emphysema comes from the Greek word emphysao- “to inflate.” Just the degree of “swelling” of the lungs is a manifestation of emphysema. Imagine an old rubber toy. It is impossible to squeeze out all the air from it, as before, and it no longer straightens out at such a speed when you stop squeezing it. The same thing happens in the lung tissue with emphysema: part of the air that was previously easily exhaled remains in the lungs, which means that the amount of “fresh” air with a new portion of oxygen will be less during the next inhalation.The same situation occurs with the lung tissue as in the Starostitak and with certain lung diseases.

“Age-related” emphysema of the lungs
With age, the elasticity of the lungs slowly decreases. According to scientists’ calculations, it should reach minimum values ​​by 140-150 years.
When carrying out an X-ray of the chest organs in a patient 60-70 years old, the doctor-radiologist almost always sees slightly “swollen lungs” and thickened walls of the alveoli. Most often these are the so-called “age-related” changes in the lung tissue.This is where the radiologist’s conclusion comes from: Emphysema. Diffuse pneumosclerosis.
If you still have doubts about the need to treat the identified changes in the lung tissue, then in order to get an accurate answer to the question: does the lung condition correspond to your age, you just need to ask the doctor to perform the function of external respiration, or even better bodyplethysmography and examine the diffusion ability lungs. When carrying out bodyplethysmography, not only the volume of the lungs is determined, but also how much air remains in them after exhalation.Please note that when you do this test, your doctor will ask your age, weight and height. This is necessary because for people of a certain age, height, body weight and gender, the indicators of respiratory function have their own individual indicators of the norm, which, unfortunately, decrease with age.

Pulmonary emphysema as a disease
Pulmonary emphysema can be an independent disease. In this case, the same processes develop in the lungs that we talked about, only – much faster.In this case, the lungs can no longer effectively supply oxygen to the blood, therefore, respiratory failure develops. At first, a person feels shortness of breath when running, then a lack of air appears already at rest.
The cause of pulmonary emphysema can be smoking, lack of certain enzymes (for example, alpha1-antitrypsin), congenital malformations of the lungs, some immune diseases of the lungs.
Only a doctor can determine the cause of emphysema and prescribe treatment. It is better if you see a pulmonologist.

Treatment of pulmonary emphysema
First of all, smoking cessation and breathing exercises
Of course, treatment of the underlying disease that led to the development of emphysema is necessary.
For bullous emphysema, surgical treatment is recommended, in which swollen and non-functioning areas of the lungs are removed, which leads to a decrease in shortness of breath, allowing healthy areas of the lung tissue to work.

90,000 Pulmonary fibrosis: causes, symptoms, treatment of the disease | Diffuse, interstitial, linear, focal, idiopathic pulmonary fibrosis

Fibrosis is a diagnosis indicating scarring, lung fibrosis is scarring of the lungs.In patients with such a diagnosis, the elastic properties and extensibility of the lung tissue are reduced, the passage of oxygen through the walls of the alveoli is difficult. The disease is extremely difficult to treat and can lead to irreversible consequences. Pathology is found in most cases in people over 60 years old.

Symptoms of fibrosis

Among the pronounced symptoms of pulmonary fibrosis:

• shortness of breath, which worsens after exercise,
• attacks of dry cough,
• persistent chest pain,
• wheezing,
• discoloration of lips and limbs,
• increase in phalanges,
• weight loss,
• fatigue and general weakness.

Other diseases of the respiratory system also have similar symptoms, so if unpleasant signals appear, it is best to see a doctor immediately. An accurately diagnosed diagnosis will help in a short time to make the most correct decision about the treatment regimen and start implementing it.

Causes of the disease

Pathology can be caused by various reasons:

• hereditary predisposition,
• inflammatory processes in the lungs,
• infectious diseases,
• negative impact of the environment,
• work in hazardous production,
• exposure to radiation therapy,
• chronic autoimmune diseases,
• complication of lung diseases,
• treatment with various drugs.

Bad habits, such as smoking, can also cause dangerous pathology. However, there are cases of the development of the disease without the presence of any pronounced cause. Each individual patient must undergo a full examination to identify the factors that influenced the onset of the pathology, this will help to choose the right treatment that will significantly improve the condition.

Types of disease

There are two main types of pulmonary fibrosis:

• idiopathic pulmonary fibrosis, when the cause of the disease cannot be determined,
• interstitial fibrosis when the cause is clearly established.

In addition, the form of the disease can be unilateral and bilateral, focal, when a small separate area of ​​the organ is affected, and total.

Diagnostic methods

In order to diagnose the disease, the pulmonologist will prescribe to the patient:

• general blood test,
• X-ray examination,
• CT and MRI lungs,
• tissue biopsy,
• conducting breath tests.

What are the complications?

If the symptoms of pulmonary fibrosis are left unattended, serious consequences and complications are possible:

• respiratory failure,
• pulmonary hypertension,
• chronic cor pulmonale,
• secondary infections.

Methods of prevention

In order to keep your lungs healthy, it is important to follow important rules:

• Use personal protective equipment when working in hazardous industries,
• give up bad habits,
• timely treat lung diseases and other infectious diseases,
• to monitor the state of the respiratory system while undergoing various diagnostic and treatment methods, as well as taking certain medications.

Treatment of fibrosis

Treatment of the disease is prescribed by a professional specialist, taking into account the results of the examination and the characteristics of the course of the disease in the patient. There are a number of drugs that help prevent the addition of various infections, the development of inflammation. Treatment of fibrosis is supported by therapeutic breathing exercises and the complete elimination of provoking factors. With the total form of the disease, surgical intervention is recommended.

In the early stages of the disease, therapy is used to reduce scar formation.You can consult with a pulmonologist and make an appointment by calling our clinic or through the form on the website.

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Respiratory consequences of bronchopulmonary dysplasia in children, adolescents and adults | Boytsova

https://doi.org/10.18093 / 0869-0189-2017-27-1-87-96

Full text:

Abstract

Prematurity, as well as a complication of respiratory distress syndrome of newborns and respiratory therapy in the neonatal period – bronchopulmonary dysplasia (BPD) – are currently considered as highly probable risk factors for the development of chronic obstructive pulmonary disease (COPD) in adults.Persistent decrease in the size of the lungs in premature infants and the pathological changes inherent in BPD lead to impaired ventilation capacity of the lungs and clinical symptoms of chronic respiratory failure and / or bronchial obstruction both in childhood and often in adolescents and adults. Based on our own and published data, the review provides information on the clinical, functional and structural consequences of prematurity and BPD in preschool and school children, adolescents and adults.The presented clinical data are the results of a study of respiratory function by methods of spirography, spirometry, ergospirometry, plethysmography, nitrogen washout, tests with exercise and methacholine, studies of the diffusion capacity of the lungs and indicate long-term persistence of respiratory dysfunctions at an older age, as well as structural changes in lung tissue. when carrying out computed tomography in the form of emphysema, fibrosis, thickening of the walls of the bronchi. The rationale for classifying patients with BPD in history as a risk group for early development of COPD is presented.

Keywords

Authors

E. V. Boytsova

Research Institute of Pulmonology of the Federal State Budgetary Educational Institution of Higher Education “First Saint Petersburg State Medical University named after Academician I.P. Pavlova “of the Ministry of Health

Belomorsk Central District Hospital. Chronic obstructive pulmonary disease

What is COPD?

This is a chronic condition in which a person develops severe breathing difficulties. COPD is constantly progressing – that is, the patient’s condition becomes worse over time. People with this disease often cough because of the large amount of mucus secreted and accumulated in the bronchi. In addition, they have wheezing, shortness of breath and heaviness in the chest.

What causes COPD? 80–90 percent of people with COPD either smoke or have smoked regularly for a long time. Much less common are other causes of obstructive pulmonary disease: severe air pollution, inhalation of chemical vapors and dust.

How do the lungs work? To understand why COPD develops, you need to know how the lungs work. When a person inhales, the air enters the so-called windpipe – the trachea, and then into the bronchi.The bronchial system inside the lung resembles an upturned tree or broccoli inflorescence. Instead of its flowers, there are air sacs called alveoli. In their walls, oxygen and carbon dioxide are exchanged from the lungs to the blood and vice versa. Both the airways and alveoli are resilient – they can expand on inhalation and narrow on exhalation, pushing air out.

What Happens in COPD? The destruction of the septa between the alveoli due to exposure to tobacco smoke is called emphysema.The destroyed alveoli unite with each other, forming one large cavity. As a result, the surface area on which the exchange of oxygen and carbon dioxide takes place decreases. As a result, a person’s breathing becomes more frequent and heavy – shortness of breath appears. Constant irritation and inflammation of the airways during smoking leads to a narrowing of their lumen and an increased production of mucus. This makes breathing very difficult and causes coughing and the need for expectoration. This process is called chronic bronchitis.Most patients with COPD suffer from both chronic obstructive bronchitis and emphysema.

What are the symptoms of COPD?

• Shortness of breath
• Cough with a lot of phlegm
• Constant feeling of fatigue
• Frequent respiratory tract infections (influenza, SARS, etc.)

Sometimes there is practically no cough in COPD. But if the other symptoms listed above are present, we can talk about the development of pulmonary emphysema.

How to prevent COPD? Do not start smoking. And if you smoke, try to quit as soon as possible. Even if chronic obstructive pulmonary disease (COPD) has already developed, quitting smoking will significantly slow its progression and prolong your life.

Most Important Chronic obstructive pulmonary disease is one of the most frequent consequences of long-term smoking. The person suffering from it is prone to chronic cough and shortness of breath. There is no cure for COPD, and the best way to slow it down or get sick is not to smoke at all or quit as early as possible.A smoker can call 8-800-200-0-200 (the call is free for residents of Russia), say that he needs help in quitting smoking, and he will be switched to the specialists of the Counseling Call Center for Assistance in Quitting Tobacco Use (CTC) … Psychologists and doctors provide consultations to those who apply to KTC. Psychologists help to find a replacement for the rituals of smoking, together with the applicant, they will determine the optimal ways to overcome addiction, and support in difficult moments of fighting nicotine addiction.Doctors will advise on the most effective treatment options for smoking cessation, give advice to patients with various diseases on how to better prepare for quitting smoking, taking into account existing health problems.