What Is It, Symptoms, Causes, and More

Emphysema is a disease of the lungs. It occurs most often in people who smoke, but it also occurs in people who regularly breathe in irritants.

Emphysema destroys alveoli, which are air sacs in the lungs. The air sacs weaken and eventually break, which reduces the surface area of the lungs and the amount of oxygen that can reach the bloodstream. This makes it harder to breathe, especially when exercising. Emphysema also causes the lungs to lose their elasticity.

Emphysema is one of the two most common conditions that fall under the umbrella term chronic obstructive pulmonary disease (COPD). The other major COPD condition is chronic bronchitis. Emphysema is an irreversible condition, so treatment aims to slow its progression and minimize symptoms.

Some people have emphysema for years without knowing it. Some of its first signs are shortness of breath and coughing, especially during exercise or physical exertion. This continues to get worse until breathing is difficult all the time, even when resting.

Other symptoms may include:

• exhaustion
• weight loss
• depression

Some people may develop bluish-gray lips or fingernails from lack of oxygen. If this happens, seek medical attention immediately.

According to the American Lung Association, 2 million adults (1.6 percent of people ages 18 years or older) had emphysema in 2018.

Rates were higher among males, non-Hispanic white people, and those over the age of 65. However, the rates among females have been increasing in recent decades, so the gap between the sexes has been decreasing.

Smoking tobacco is the main cause of emphysema. The more you smoke, the higher your risk of developing emphysema. This includes smoking cannabis.

Smoking leads to the death of more than 480,000 Americans a year, and 80 percent of those deaths are caused by COPD, including emphysema. Exposure to secondhand smoke also increases your risk of developing emphysema.

Other causes of, as well as potential risk factors for developing emphysema, may include:

• exposure to high pollution chemical fumes or lung irritants
• a genetic condition called alpha-1 deficiency can lead to a rare form of emphysema called alpha-1 deficiency-related emphysema.
• history of childhood respiratory infections
• a compromised immune system, especially as a result of HIV
• rare disorders such as Marfan syndrome.

Your doctor will begin by getting your background and medical history, asking in particular whether you smoke and whether you’re around hazardous fumes or pollutants at work or at home.

Various tests can detect emphysema, including:

• imaging tests, such as X-rays and CT scans, to look at your lungs
• blood tests, to determine how well your lungs are transferring oxygen
• pulse oximetry, to measure the oxygen content of your blood
• lung function tests, which measure how much air your lungs can breathe in and out and how well your lungs deliver oxygen into your bloodstream
• arterial blood gas tests, to measure the amount of blood and carbon dioxide in your blood
• electrocardiogram (ECG), to check heart function and rule out heart disease

When emphysema becomes severe or isn’t properly treated, serious complications may occur. These may include:

• pneumonia, which can bacterial or viral
• many respiratory tract infections
• cor pulmonale, which is failure of the right side of the heart
• pneumothorax, which is when air collects between the lungs and the chest cavity that can lead to lung collapse
• respiratory acidosis, which is when the lungs can’t obtain enough oxygen, leading to coma
• hypoxemia, which is when the lungs can’t adequately oxygenate the blood

There’s no cure for emphysema. Treatment aims to reduce symptoms and slow the progression of the disease with medications, therapies, or surgeries.

If you smoke, the first step in treating emphysema is to quit smoking. You may need medications to help you withdraw from nicotine. Consider discussing a cessation plan with your doctor.

Medications

Various medications can help treat the disease, including:

• bronchodilators, which help open air passages, making breathing easier and relieving coughing and shortness of breath
• steroids, which alleviate shortness of breath
• antibiotics, which fight infections that can make the condition worse

All of these medications can be taken orally or inhaled.

Therapies

Pulmonary rehabilitation or moderate exercise such as walking can strengthen breathing muscles and alleviate symptoms, making it easier to breathe and be physically active. Yoga, tai chi, and deep breathing exercises can also help relieve symptoms.

Oxygen therapy can help make breathing easier. People with severe emphysema may need oxygen 24 hours a day.

Surgery

Lung volume reduction surgery may be used to remove small parts of damaged lung, and a lung transplant can replace the entire lung. These are rare surgeries used only for people with severe emphysema.

Other treatments

Emphysema might cause you to become underweight. Eating foods rich in vitamins A, C, and E, like fruits and vegetables, is recommended to improve your overall health.

Getting vaccinated against certain infections, such as pneumonia, can help prevent you from getting an infection that could complicate emphysema. These infections include pneumonia, influenza, and COVID-19.

You may also experience anxiety and depression if you aren’t as active as you used to be. Joining a support group can help you connect with others who have the disease and share similar experiences. This can help you realize that you aren’t alone in fighting the disease.

Since emphysema is mainly caused by smoking tobacco, the best way to prevent it is to refrain from smoking. It’s also important to stay away from harmful chemicals and fumes as well as heavy pollution.

The outlook for people with emphysema varies based on its severity. There’s no cure for the disease, and it worsens with time, but you can slow its progression.

As a rule, smoking cigarettes speeds up the disease, so quitting is important.

Early detection of the disease is key, because people with emphysema can develop life threatening conditions when the lungs and heart become damaged over time.

It’s important to stay healthy by eating well and getting exercise. With the aid of medications and therapies, you can live a long, healthy life with emphysema.

Emphysema: Background, Pathophysiology, Etiology

1. Pahal P, Avula A, Sharma S. Emphysema. StatPearls [Internet]. 2019 Jan. [QxMD MEDLINE Link]. [Full Text].

2. [Guideline] Global Initiative for Chronic Obstructive Lung Disease. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. 2018. 142. [Full Text].

3. Shah PL, Herth FJ, van Geffen WH, Deslee G, Slebos DJ. Lung volume reduction for emphysema. Lancet Respir Med. 2017 Feb. 5 (2):147-56. [QxMD MEDLINE Link].

4. Cottin V, Nunes H, Brillet PY, Delaval P, Devouassoux G, Tillie-Leblond I, et al. Combined pulmonary fibrosis and emphysema: a distinct underrecognised entity. Eur Respir J. 2005 Oct. 26(4):586-93. [QxMD MEDLINE Link].

5. webmd.com”>Goss AM, Morrisey EE. Wnt signaling and specification of the respiratory endoderm. Cell Cycle. 2010 Jan 1. 9(1):10-1. [QxMD MEDLINE Link].

6. [Guideline] Reddell, H, Vogelmeier C, Decker R et al. Asthma, COPD, and Asthma-COPD overlap: A joint project of GINA and GOLD. ginaasthma.org. Available at http://ginasthma.org/2017-gina-report-global-strategy-for-asthma-management-and-prevention/. April 2017; Accessed: December 27, 2017.

7. National Center for Chronic Disease Prevention and Health Promotion, Division of Population Health. Chronic Obstructive Pulmonary Disease (COPD). CDC.gov. Available at https://www.cdc.gov/copd/index.html. August 4, 2017; Accessed: December 27, 2017.

8. Rega PP. Phosgene Toxicity. Medscape Drugs &Diseases. Available at http://emedicine.medscape.com/article/832454-overview. January 30, 2015; Accessed: August 31, 2016.

9. Liu Y, Yan S, Poh K, Liu S, Iyioriobhe E, Sterling DA. Impact of air quality guidelines on COPD sufferers. Int J Chron Obstruct Pulmon Dis. 2016. 11:839-72. [QxMD MEDLINE Link].

10. Anthonisen NR, Connett JE, Murray RP. Smoking and lung function of Lung Health Study participants after 11 years. Am J Respir Crit Care Med. 2002 Sep 1. 166(5):675-9. [QxMD MEDLINE Link].

11. American Thoracic Society/European Respiratory Society statement: standards for the diagnosis and management of individuals with alpha-1 antitrypsin deficiency. Am J Respir Crit Care Med. 2003 Oct 1. 168(7):818-900. [QxMD MEDLINE Link].

12. [Guideline] US Preventive Services Task Force. Final Update Summary: Tobacco Smoking Cessation in Adults, Including Pregnant Women: Behavioral and Pharmacotherapy Interventions. uspreventiveservicestaskforce.org. Available at https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/tobacco-use-in-adults-and-pregnant-women-counseling-and-interventions1. September 2015; Accessed: December 27, 2017.

13. Tetley TD. Macrophages and the pathogenesis of COPD. Chest. 2002 May. 121(5 Suppl):156S-159S. [QxMD MEDLINE Link].

14. Saetta M, Di Stefano A, Turato G, Facchini FM, Corbino L, Mapp CE, et al. CD8+ T-lymphocytes in peripheral airways of smokers with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 1998 Mar. 157(3 Pt 1):822-6. [QxMD MEDLINE Link].

15. Luisetti M, Ma S, Iadarola P, Stone PJ, Viglio S, Casado B, et al. Desmosine as a biomarker of elastin degradation in COPD: current status and future directions. Eur Respir J. 2008 Nov. 32(5):1146-57. [QxMD MEDLINE Link].

16. [Guideline] Sandhaus RA, Turino G, Brantly ML, Campos M, Cross CE, Goodman K, et al. The Diagnosis and Management of Alpha-1 Antitrypsin Deficiency in the Adult. Chronic Obstr Pulm Dis. 2016 Jun 6. 3 (3):668-682. [QxMD MEDLINE Link]. [Full Text].

17. Hogg JC. Pathophysiology of airflow limitation in chronic obstructive pulmonary disease. Lancet. 2004 Aug 21-27. 364(9435):709-21. [QxMD MEDLINE Link].

18. Takahashi M, Fukuoka J, Nitta N, Takazakura R, Nagatani Y, Murakami Y. Imaging of pulmonary emphysema: a pictorial review. Int J Chron Obstruct Pulmon Dis. 2008. 3(2):193-204. [QxMD MEDLINE Link].

19. ATS Committee on Diagnostic Standards for Nontuberculous Respiratory Diseases, American Thoracic Society. Definitions and classification of chronic bronchitis, asthma, and pulmonary emphysema. Am Rev Respir Dis. 1962. 85:762–9.

20. Finkelstein R, Ma HD, Ghezzo H, Whittaker K, Fraser RS, Cosio MG. Morphometry of small airways in smokers and its relationship to emphysema type and hyperresponsiveness. Am J Respir Crit Care Med. 1995 Jul. 152(1):267-76. [QxMD MEDLINE Link].

21. U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES, Office of the Surgeon General. 2014 Surgeon General’s Report: The Health Consequences of Smoking—50 Years of Progress. surgeongeneral.gov. Available at https://www.surgeongeneral.gov/library/reports/50-years-of-progress/full-report.pdf. 2014; Accessed: December 27, 2017.

22. Crothers K, Butt AA, Gibert CL, Rodriguez-Barradas MC, Crystal S, Justice AC. Increased COPD among HIV-positive compared to HIV-negative veterans. Chest. 2006 Nov. 130(5):1326-33. [QxMD MEDLINE Link].

23. webmd.com”>Buist AS, McBurnie MA, Vollmer WM, Gillespie S, Burney P, Mannino DM, et al. International variation in the prevalence of COPD (the BOLD Study): a population-based prevalence study. Lancet. 2007 Sep 1. 370(9589):741-50. [QxMD MEDLINE Link].

24. Menezes AM, Perez-Padilla R, Jardim JR, Muino A, Lopez MV, Valdivia G, et al. Chronic obstructive pulmonary disease in five Latin American cities (the PLATINO study): a prevalence study. Lancet. 2005 Nov 26. 366(9500):1875-81. [QxMD MEDLINE Link].

25. Haruna A, Muro S, Nakano Y, Ohara T, Hoshino Y, Ogawa E, et al. CT scan findings of emphysema predict mortality in COPD. Chest. 2010 Sep. 138(3):635-40. [QxMD MEDLINE Link].

26. Takei N, Suzuki M, Makita H, et al. Serum alpha-1 antitrypsin levels and the clinical course of chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis. 2019. 14:2885-93. [QxMD MEDLINE Link]. [Full Text].

27. [Guideline] Management of Chronic Obstructive Pulmonary Disease Working Group. VA/DoD clinical practice guideline for the management of chronic obstructive pulmonary disease. Washington (DC): Department of Veterans Affairs, Department of Defense; 2014. 94. [Full Text].

28. [Guideline] Yawn BB, Thomashaw B, Mannino DM, Han MK, Kalhan R, Rennard S, et al. The 2017 Update to the COPD Foundation COPD Pocket Consultant Guide. Chronic Obstr Pulm Dis. 2017 Jul 15. 4 (3):177-185. [QxMD MEDLINE Link]. [Full Text].

29. [Guideline] Qaseem A, Wilt TJ, Weinberger SE, et al. Diagnosis and management of stable chronic obstructive pulmonary disease: a clinical practice guideline update from the American College of Physicians, American College of Chest Physicians, American Thoracic Society, and European Respiratory Society. Ann Intern Med. 2011 Aug 2. 155 (3):179-91. [QxMD MEDLINE Link]. [Full Text].

30. COMBIVENT Inhalation Aerosol Study Group. In chronic obstructive pulmonary disease, a combination of ipratropium and albuterol is more effective than either agent alone. An 85-day multicenter trial. COMBIVENT Inhalation Aerosol Study Group. Chest. 1994 May. 105(5):1411-9. [QxMD MEDLINE Link].

31. Chapman KR, Rennard SI, Dogra A, Owen R, Lassen C, Kramer B. Long-term safety and efficacy of indacaterol, a long-acting beta2-agonist, in subjects with COPD: a randomized, placebo-controlled study. Chest. 2011 Jul. 140(1):68-75. [QxMD MEDLINE Link].

32. Calverley PM, Anderson JA, Celli B, Ferguson GT, Jenkins C, Jones PW, et al. Salmeterol and fluticasone propionate and survival in chronic obstructive pulmonary disease. N Engl J Med. 2007 Feb 22. 356(8):775-89. [QxMD MEDLINE Link].

33. O’Donnell DE, Fluge T, Gerken F, Hamilton A, Webb K, Aguilaniu B, et al. Effects of tiotropium on lung hyperinflation, dyspnoea and exercise tolerance in COPD. Eur Respir J. 2004 Jun. 23(6):832-40. [QxMD MEDLINE Link].

34. Tashkin DP, Celli B, Senn S, Burkhart D, Kesten S, Menjoge S, et al. A 4-year trial of tiotropium in chronic obstructive pulmonary disease. N Engl J Med. 2008 Oct 9. 359(15):1543-54. [QxMD MEDLINE Link].

35. Brusasco V, Hodder R, Miravitlles M, Korducki L, Towse L, Kesten S. Health outcomes following treatment for six months with once daily tiotropium compared with twice daily salmeterol in patients with COPD. Thorax. 2003 May. 58(5):399-404. [QxMD MEDLINE Link]. [Full Text].

36. com”>Donohue JF, van Noord JA, Bateman ED, Langley SJ, Lee A, Witek TJ Jr, et al. A 6-month, placebo-controlled study comparing lung function and health status changes in COPD patients treated with tiotropium or salmeterol. Chest. 2002 Jul. 122(1):47-55. [QxMD MEDLINE Link].

37. Kerwin EM, D’Urzo AD, Gelb AF, Lakkis H, Garcia Gil E, Caracta CF, et al. Efficacy and safety of a 12-week treatment with twice-daily aclidinium bromide in COPD patients (ACCORD COPD I). COPD. 2012 Apr. 9 (2):90-101. [QxMD MEDLINE Link].

38. Wedzicha JA, Banerji D, Chapman KR, Vestbo J, Roche N, Ayers RT, et al. Indacaterol-Glycopyrronium versus Salmeterol-Fluticasone for COPD. N Engl J Med. 2016 Jun 9. 374 (23):2222-34. [QxMD MEDLINE Link].

39. Calverley PM, Rabe KF, Goehring UM, Kristiansen S, Fabbri LM, Martinez FJ. Roflumilast in symptomatic chronic obstructive pulmonary disease: two randomised clinical trials. Lancet. 2009 Aug 29. 374(9691):685-94. [QxMD MEDLINE Link].

40. Wood-Baker RR, Gibson PG, Hannay M, Walters EH, Walters JA. Systemic corticosteroids for acute exacerbations of chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2005 Jan 25. CD001288. [QxMD MEDLINE Link].

41. Spencer S, Calverley PM, Burge PS, Jones PW. Impact of preventing exacerbations on deterioration of health status in COPD. Eur Respir J. 2004 May. 23(5):698-702. [QxMD MEDLINE Link].

42. Walters JA, Walters EH, Wood-Baker R. Oral corticosteroids for stable chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2005 Jul 20. CD005374. [QxMD MEDLINE Link].

43. Sin DD, Tashkin D, Zhang X, Radner F, Sjobring U, Thorén A, et al. Budesonide and the risk of pneumonia: a meta-analysis of individual patient data. Lancet. 2009 Aug 29. 374(9691):712-9. [QxMD MEDLINE Link].

44. Vestbo J, Anderson JA, Brook RD, Calverley PM, Celli BR, Crim C, et al. Fluticasone furoate and vilanterol and survival in chronic obstructive pulmonary disease with heightened cardiovascular risk (SUMMIT): a double-blind randomised controlled trial. Lancet. 2016 Apr 30. 387 (10030):1817-26. [QxMD MEDLINE Link].

45. Albert RK, Connett J, Bailey WC, Casaburi R, Cooper JA Jr, Criner GJ, et al. Azithromycin for prevention of exacerbations of COPD. N Engl J Med. 2011 Aug 25. 365(8):689-98. [QxMD MEDLINE Link]. [Full Text].

46. Petty TL. The National Mucolytic Study. Results of a randomized, double-blind, placebo-controlled study of iodinated glycerol in chronic obstructive bronchitis. Chest. 1990 Jan. 97(1):75-83. [QxMD MEDLINE Link].

47. Zheng JP, Wen FQ, Bai CX, Wan HY, Kang J, Chen P, et al. Twice daily N-acetylcysteine 600 mg for exacerbations of chronic obstructive pulmonary disease (PANTHEON): a randomised, double-blind placebo-controlled trial. Lancet Respir Med. 2014 Mar. 2(3):187-94. [QxMD MEDLINE Link].

48. Sasaki T, Nakayama K, Yasuda H, Yoshida M, Asamura T, Ohrui T, et al. A randomized, single-blind study of lansoprazole for the prevention of exacerbations of chronic obstructive pulmonary disease in older patients. J Am Geriatr Soc. 2009 Aug. 57(8):1453-7. [QxMD MEDLINE Link].

49. Nocturnal Oxygen Therapy Trial Group. Continuous or nocturnal oxygen therapy in hypoxemic chronic obstructive lung disease: a clinical trial. Nocturnal Oxygen Therapy Trial Group. Ann Intern Med. 1980 Sep. 93(3):391-8. [QxMD MEDLINE Link].

50. Moberley S, Holden J, Tatham DP, Andrews RM. Vaccines for preventing pneumococcal infection in adults. Cochrane Database Syst Rev. 2013 Jan 31. 1:CD000422. [QxMD MEDLINE Link].

51. Kyaw MH, Clarke S, Edwards GF, Jones IG, Campbell H. Serotypes/groups distribution and antimicrobial resistance of invasive pneumococcal isolates: implications for vaccine strategies. Epidemiol Infect. 2000 Dec. 125(3):561-72. [QxMD MEDLINE Link].

52. [Guideline] Centers for Disease Control and Prevention. Updated recommendations for prevention of invasive pneumococcal disease among adults using the 23-valent pneumococcal polysaccharide vaccine (PPSV23). MMWR Morb Mortal Wkly Rep. 2010 Sep 3. 59(34):1102-6. [QxMD MEDLINE Link]. [Full Text].

53. Hubbard RC, Crystal RG. Augmentation therapy of alpha 1-antitrypsin deficiency. Eur Respir J Suppl. 1990 Mar. 9:44s-52s. [QxMD MEDLINE Link].

54. Hurst JR, Donaldson GC, Quint JK, Goldring JJ, Baghai-Ravary R, Wedzicha JA. Temporal clustering of exacerbations in chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2009 Mar 1. 179(5):369-74. [QxMD MEDLINE Link].

55. O’Donnell DE, Parker CM. COPD exacerbations . 3: Pathophysiology. Thorax. 2006 Apr. 61(4):354-61. [QxMD MEDLINE Link]. [Full Text].

56. Lightowler JV, Wedzicha JA, Elliott MW, Ram FS. Non-invasive positive pressure ventilation to treat respiratory failure resulting from exacerbations of chronic obstructive pulmonary disease: Cochrane systematic review and meta-analysis. BMJ. 2003 Jan 25. 326(7382):185. [QxMD MEDLINE Link]. [Full Text].

57. webmd.com”>Naunheim KS, Wood DE, Mohsenifar Z, Sternberg AL, Criner GJ, DeCamp MM, et al. Long-term follow-up of patients receiving lung-volume-reduction surgery versus medical therapy for severe emphysema by the National Emphysema Treatment Trial Research Group. Ann Thorac Surg. 2006 Aug. 82(2):431-43. [QxMD MEDLINE Link].

58. Sciurba FC, Ernst A, Herth FJ, Strange C, Criner GJ, Marquette CH, et al. A randomized study of endobronchial valves for advanced emphysema. N Engl J Med. 2010 Sep 23. 363(13):1233-44. [QxMD MEDLINE Link].

59. Celli BR, Cote CG, Marin JM, Casanova C, Montes de Oca M, Mendez RA, et al. The body-mass index, airflow obstruction, dyspnea, and exercise capacity index in chronic obstructive pulmonary disease. N Engl J Med. 2004 Mar 4. 350(10):1005-12. [QxMD MEDLINE Link].

60. Rochester CL, Vogiatzis I, Holland AE, et al. An Official American Thoracic Society/European Respiratory Society Policy Statement: Enhancing Implementation, Use, and Delivery of Pulmonary Rehabilitation. Am J Respir Crit Care Med. 2015 Dec 1. 192 (11):1373-86. [QxMD MEDLINE Link]. [Full Text].

61. Spruit MA, Singh SJ, Garvey C, et al. An official American Thoracic Society/European Respiratory Society statement: key concepts and advances in pulmonary rehabilitation. Am J Respir Crit Care Med. 2013 Oct 15. 188 (8):e13-64. [QxMD MEDLINE Link]. [Full Text].

62. Creutzberg EC, Wouters EF, Mostert R, Pluymers RJ, Schols AM. A role for anabolic steroids in the rehabilitation of patients with COPD? A double-blind, placebo-controlled, randomized trial. Chest. 2003 Nov. 124(5):1733-42. [QxMD MEDLINE Link].

63. [Guideline] Wedzicha JA Ers Co-Chair, Miravitlles M, Hurst JR, Calverley PM, Albert RK, Anzueto A, et al. Management of COPD exacerbations: a European Respiratory Society/American Thoracic Society guideline. Eur Respir J. 2017 Mar. 49 (3):[QxMD MEDLINE Link]. [Full Text].

64. [Guideline] Criner GJ, Bourbeau J, Diekemper RL, et al. Prevention of acute exacerbations of COPD: American College of Chest Physicians and Canadian Thoracic Society Guideline. Chest. 2015 Apr. 147 (4):894-942. [QxMD MEDLINE Link]. [Full Text].

65. [Guideline] Wedzicha JA, Calverley PMA, Albert RK, Anzueto A, Criner GJ, Hurst JR, et al. Prevention of COPD exacerbations: a European Respiratory Society/American Thoracic Society guideline. Eur Respir J. 2017 Sep. 50 (3):[QxMD MEDLINE Link]. [Full Text].

66. [Guideline] Bolton CE, Bevan-Smith EF, Blakey JD, et al. British Thoracic Society guideline on pulmonary rehabilitation in adults. Thorax. 2013 Sep. 68 Suppl 2:ii1-30. [QxMD MEDLINE Link]. [Full Text].

67. Leung KM, Curran-Everett D, Regan EA, Lynch DA, Jacobson FL. Translation of adapting quantitative CT data from research to local clinical practice: validation evaluation of fully automated procedures to provide lung volumes and percent emphysema. J Med Imaging (Bellingham). 2020 Mar. 7 (2):022404. [QxMD MEDLINE Link].

68. Henkel M, Partyka J, Gregory AD, et al. Follistatin-like 1 attenuation causes spontaneous smoke-resistant pulmonary emphysema. Am J Respir Crit Care Med. 2019 Dec 13. [QxMD MEDLINE Link].

69. Li K, Gao Y, Pan Z, et al. Influence of emphysema and air trapping heterogeneity on pulmonary function in patients with COPD. Int J Chron Obstruct Pulmon Dis. 2019. 14:2863-72. [QxMD MEDLINE Link]. [Full Text].

Emphysema: symptoms, diagnosis, treatment

Contents

• 1 Emphysema: symptoms, diagnosis and effective treatment
  • 1.1 Emphysema: concept and causes
  • 1.2 Symptoms of emphysema

  9 0005 1.3 Diagnosis of pulmonary emphysema

  • 1.4 Causes of pulmonary emphysema
  • 1.5 Factors that can increase the manifestation of pulmonary emphysema
  • 1.6 How is pulmonary emphysema treated?
  • 1.7 Drugs for the treatment of emphysema
    • 1.7.1 Bronchodilators
    • 1.7.2 Glucocorticosteroids
    • 1.7.3 Antibiotics
  • 1.8 Procedures that help with pulmonary emphysema
    • 1.8.1 1. Oxygen therapy
    • 1.8. 2 2. Lung unloading with special devices
    • 1.8.3 3. Chest massage
    • 1.8.4 4. Respiratory gymnastics
  • 1.9 Is it possible to cure pulmonary emphysema completely?
  • 1.10 What preventive measures help prevent emphysema?
  • 1. 11 Sequelae of emphysema
  • 1.12 Related videos:
  • 1.13 Q&A:
    • • 1.13.0.1 What is pulmonary emphysema?
      • 1.13.0.2 What are the symptoms of emphysema?
      • 1.13.0.3 How is emphysema diagnosed?
      • 1.13.0.4 Can smoking cause emphysema?
      • 1.13.0.5 What are the treatment options for pulmonary emphysema?
      • 1.13.0.6 Can emphysema be prevented?

Learn about the symptoms, diagnosis, and treatment of emphysema. Get useful information about the causes of the disease and effective methods of dealing with it.

Pulmonary emphysema is a chronic disease in which the firmness and elasticity of the lung tissue is lost, which leads to the expansion of air spaces and disruption of normal respiratory function.

Basically, emphysema affects older people and is a form of chronic obstructive pulmonary disease (COPD), which is also called COPD – chronic obstructive pulmonary disease combined with emphysema.

This article is devoted to the consideration of this disease, its main symptoms, causes, diagnosis and treatment methods that will allow you to understand the problem in more detail and prevent its occurrence in the future.

Emphysema: concept and causes

Emphysema is a chronic disease of the respiratory system that leads to irreversible changes in the lung tissue. As a result of such changes, the lungs lose their elasticity, expand and lose their functionality. This leads to breathing difficulties and a deterioration in the general condition of the body.

The risk of developing emphysema is greatly increased if a person leads an unhealthy lifestyle, suffers from lung disease, or frequently comes into contact with substances that affect the respiratory system. Based on this, measures should be taken to prevent the occurrence of the disease.

Important: Emphysema is a very serious disease that requires qualified treatment. The earlier the disease is detected and diagnosed, the greater the chances for its effective treatment and prevention of severe complications.

Symptoms of pulmonary emphysema

Emphysema is a chronic disease that leads to the destruction of the walls of the alveoli, preventing them from functioning properly. Patients with emphysema experience a variety of symptoms including:

• Cough – Usually dry and without sputum, the cough may be a reaction to irritants in the air, including cigarette smoke, as well as mugwort, car exhaust and other particles.
• Breathing problems – Patients with emphysema often have difficulty breathing, especially during exercise.
• Fatigue and weakness – these symptoms may be due to the fact that the body is fighting for enough oxygen, which is necessary for the proper functioning of the organs.
• Chest pain – if chest pain occurs when breathing, this may be due to emphysema, especially if accompanied by difficulty breathing.
• Weight Loss – Patients with emphysema may lose weight due to difficulty eating and absorbing nutrients.

If you experience these symptoms, especially if you are a smoker or work in an environment with high concentrations of harmful substances in the air, see a specialist for diagnosis and treatment.

Diagnosis of pulmonary emphysema

Diagnosis of pulmonary emphysema begins with anamnesis and examination of the patient for characteristic symptoms. Important signs of the disease are cough, shortness of breath, fatigue and noisy breathing.

A number of additional tests, such as x-rays, computed tomography, spirometry, and blood gas analysis, may be done to confirm the diagnosis.

1. Radiography is the first and most accessible method for diagnosing emphysema. It allows you to detect an increase in lung volume and a decrease in its density.
2. Computed tomography (CT) provides more detailed information about the condition of the lungs and can reveal small changes in lung tissue.
3. Spirometry is a method that measures the volume and flow rate of inhalation and exhalation. It allows you to determine the presence of airway obstruction.
4. Blood gas analysis measures the level of oxygen and carbon dioxide in the blood. This method allows you to determine the degree of respiratory failure.

The combination of these methods allows you to get a complete picture of the disease and determine the further tactics of treating the patient.

Causes of emphysema

Emphysema is a disease that is associated with the destruction of lung tissue and insufficient exchange of gases in the body. Emphysema can be caused by several factors:

• Smoking. This is one of the main causes of emphysema. Tobacco smoke contains a large amount of harmful substances that destroy lung tissue and disrupt their function.
• Genetic predisposition. Some people may be susceptible to the destruction of lung tissue at the genetic level, which can lead to the development of emphysema even without the involvement of other factors.
• Polluted environment. Exposure to various chemicals and toxic substances in the air may increase the risk of developing the disease.
• Professional activity. Some occupations that involve exposure to toxic substances may increase the risk of developing emphysema.

Understanding the causes of emphysema will help you take steps to prevent it and detect it early, which increases the effectiveness of treatment. It is important to maintain a healthy lifestyle and avoid unhealthy habits such as smoking to reduce the risk of disease.

Factors that can increase the manifestation of emphysema

Emphysema is a serious disease in which the alveoli responsible for gas exchange are affected. Some factors can increase the manifestations of this disease. Among them:

• Smoking is one of the most prominent and well-known aggravators of emphysema. Tobacco smoking destroys lung tissue, which can cause blisters to form on the surface of the lungs.
• Air pollution – inhalation has harmful effects on lung tissue, which may increase the symptoms of emphysema.
• Genetic factors – there is a hereditary predisposition to emphysema, so if you have relatives with this disease, your risk of developing it is also increased.
• Inflammatory diseases – such as bronchitis, may exacerbate emphysema.
• Non-specific airway obstruction – this can also affect the development of emphysema, as it is associated with impaired gas exchange in the lungs.

Avoiding these factors is important for those at risk of developing emphysema. In addition, regular medical monitoring will help to identify the disease in a timely manner and start treatment according to the recommendations of doctors.

How is emphysema treated?

Treatment for emphysema depends on the severity of the disease and may include medication, exercise, and, in severe cases, surgery.

In addition, exercise can also help reduce the symptoms of emphysema, improve quality of life, and improve lung function. Surgical intervention can be used only in severe cases, when conservative treatment does not give the desired effect.

It is also very important to avoid smoking and exposure to toxic substances, as they can worsen the condition of the lungs. Regular monitoring by a doctor and compliance with all the recommendations of medical personnel are also important aspects of the successful treatment of emphysema.

• Drug therapy
• Physical exercise
• Surgery

Drugs for the treatment of emphysema

Emphysema is a chronic disease and treatment is aimed at improving the quality of life of the patient and preventing disease progression. For this, various groups of drugs are used.

Bronchodilators

These medicines help to relax the muscles in the bronchial tubes, widening them, making it easier to breathe. They can be presented as inhalation preparations in the form of sprays, aerosols or powders for inhalation. The main drugs in this group are beta-agonists, anticholinergics and methylxanthines.

Glucocorticosteroids

These inhaled sprays or tablets can help reduce inflammation in the lungs and reduce mucus, which can improve breathing and reduce flare-ups. However, long-term use of glucocorticosteroids is associated with a number of side effects such as osteoporosis, weight gain, and immune system deterioration.

Antibiotics

Antibiotics may be used to treat infections that can aggravate emphysema. However, their use should only be carried out under the direction of a physician after confirmation of the presence of a bacterial infection, so as not to produce antibiotic resistance in the patient.

The main principle of the treatment of pulmonary emphysema is an individual approach to each patient. Medicines can be combined depending on the severity of the disease, the presence of concomitant diseases and other factors. Treatment should be carried out only under the supervision of a physician who regularly assesses the patient’s condition and adjusts the treatment regimen.

Procedures that help with pulmonary emphysema

1. Oxygen therapy

One of the main symptoms of pulmonary emphysema is oxygen starvation. Oxygen therapy is a way to maintain the optimal level of oxygen in the patient’s body with the help of oxygen equipment. The main goal of oxygen therapy is to maintain oxygen saturation of at least 90% and reduce the degree to which the lungs have to work to pump air.

2. Unloading lungs with special devices

Typically, patients with emphysema experience the same kind of difficulty breathing and fatigue as an athlete exercising in a high altitude area. Therefore, for the treatment of such patients, special devices are used to unload the airways. They allow you to keep the most open position of the larynx and airways, thus reducing the degree of difficulty in breathing.

3. Chest massage

Chest massage is a technique in which the massage therapist gently manipulates the patient’s chest. It helps to soften and relax the muscles of the chest and therefore may improve the respiratory function of emphysema. However, before applying this procedure, it is necessary to consult a specialist and recommend a pulmonologist.

4. Respiratory exercises

One of the main causes of pulmonary emphysema is a deterioration in the ability of the lungs to bear the load. Regular respiratory exercises help to increase the level of physical activity and improve the quality of life of patients with emphysema. The results of such gymnastics may be few, but in general, it improves the quality of life of patients.

Can emphysema be completely cured?

Emphysema is a chronic disease that destroys lung tissue. As a result, the lungs lose their elasticity and cannot function properly.

Emphysema is often treated with drugs that dilate the bronchi and improve lung function. Physiotherapy and rehabilitation courses may also be prescribed.

In some cases, surgery may be required, such as pulmonary resection growth. However, such operations are performed only in the most severe cases and the choice of treatment always depends on the individual situation of the patient.

In any case, regular monitoring of the condition of the lungs and following all the doctor’s recommendations will help improve the life of a patient with pulmonary emphysema.

What preventive measures can help prevent emphysema?

Pulmonary emphysema is a serious disease that leads to a deterioration in the patient’s life. However, there are preventive measures that help prevent the development of this disease.

• Smoking cessation . This is one of the most important measures to prevent emphysema. Smoking is the main cause of the disease.
• Strengthening the immune system . This helps prevent the development of infections that can lead to emphysema.
• Avoiding polluted air . Harmful substances in the air can adversely affect lung health.
• Healthy lifestyle . Regular exercise, proper nutrition and enough sleep help maintain the health of the lungs and the whole body as a whole.

If you follow these preventive measures, you can prevent the development of emphysema and keep your lungs healthy for many years.

Sequelae of emphysema

Emphysema is a chronic disease that leads to destruction of the retina of the lung vesicles. This can cause a decrease in the functional state of the lungs and restriction of respiratory capacity.

Among the main consequences of pulmonary emphysema are:

• Oxygen starvation. Complete or partial destruction of the walls of the bubbles in the lungs reduces their ability to exchange oxygen and carbon dioxide, which leads to hypoxia of tissues and organs.
• Respiratory failure. In pulmonary emphysema, a bulky number of small vesicles function, which reduces cell turnover and has a negative effect on lung reserve capacity.
• Emphysematous bullous pneumothorax. The entry of air into the pleural cavity causes pressure on the lung tissue and contributes to the compression of the cor pulmonale.
• Increased risk of respiratory infections. Lung tissue with a light structure is the conditions for the penetration of bacteria and viruses into the body.

Emphysema is a serious and progressive disease that requires immediate treatment. Regular medical examinations and adherence to the doctor’s recommendations are the main ways to prevent this disease.

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Q&A:

What is pulmonary emphysema?

Emphysema is a chronic disease in which the walls of the alveoli collapse, leading to reduced gas exchange surfaces and poor lung function.

What are the symptoms of emphysema?

The main symptoms of emphysema are shortness of breath, cough, copious sputum, fatigue, chest enlargement and weight loss.

How is emphysema diagnosed?

Diagnosis of emphysema includes chest x-ray, computed tomography, physical tests, and blood tests.

Can smoking cause emphysema?

Yes, smoking is one of the most important causes of emphysema.

What are the treatment options for emphysema?

Treatment for emphysema includes medication, oxygen therapy, physical rehabilitation, lifestyle changes, and surgery in extreme cases.

Can emphysema be prevented?

Emphysema can be prevented by avoiding smoking, a healthy lifestyle, and regular medical check-ups to detect early lung disease.

Emphysema | LRC. Treatment and Rehabilitation Center of the Ministry of Economic Development of Russia

We will start our conversation not with what pulmonary emphysema is, but with how the lungs are arranged and what happens to their tissue with age.

Why should I start the conversation with this topic? Everything is very simple. I have little doubt that you opened this article after receiving the description of your chest x-ray. The conclusion of the radiologist most likely says: “No focal and infiltrative shadows were detected. Signs of emphysema and diffuse pneumosclerosis.” To understand what the radiologist who wrote such a conclusion meant, one must remember the structure of the lung.

Structure of the lungs

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

What happens to the lung tissue during the development of pulmonary 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 break down and form one large bubble or bulla. These phenomena of restructuring of the lung tissue are called emphysema. In fact, the word emphysema comes from the Greek word emphysao – “to inflate.” It is the degree of “swelling” of the lungs that is a manifestation of emphysema. Imagine an old rubber toy. It is impossible to squeeze all the air out of 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 breath. The same situation occurs with lung tissue both in old age and with certain lung diseases.

“Age-related” emphysema

Lung elasticity slowly decreases with age. According to scientists, it should reach its minimum values ​​by 140–150 years.

When performing a chest x-ray in a patient of 60-70 years old, a doctoral radiologist almost always sees slightly “inflated 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 condition of the lungs correspond to your age, you just need to ask the doctor to perform the function of external respiration, and even better, body plethysmography and study diffusion lung capacity. During body plethysmography, 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 study, the doctor will definitely ask your age, weight and height. This is necessary because for people of a certain age, height, body weight and gender, respiratory function indicators have their own individual norm indicators, which, unfortunately, decrease with age.

Pulmonary emphysema as a disease

Pulmonary emphysema can also be an independent disease. In this case, the same processes that we spoke about develop in the lungs, only much faster. At the same time, the lungs can no longer effectively supply oxygen to the blood, so respiratory failure develops. First, a person feels shortness of breath when running, then a lack of air appears even at rest.

Emphysema can be caused by smoking, a lack of certain enzymes (eg alpha1-antitrypsin), congenital abnormalities in the development of the lungs, and certain immune diseases of the lungs.

Only a doctor can determine the cause of emphysema and prescribe treatment. It is better if you contact a pulmonologist.