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What happens to the lungs when you have emphysema: Emphysema | American Lung Association


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.


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.


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 – 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


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 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.


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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Pulmonary Emphysema | Cedars-Sinai

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What is pulmonary emphysema?

Emphysema is a chronic lung condition in which the air sacs (alveoli) may be:

  • Collapsed
  • Destroyed
  • Narrowed
  • Overinflated
  • Stretched

Overinflation of the air sacs is a result of a breakdown of the alveoli walls. It
causes a decrease in respiratory function and breathlessness. Damage to the air sacs
can’t be fixed. It causes permanent breakdown in the lower lung tissue.

Pulmonary emphysema is part of a group of lung diseases called COPD (chronic
obstructive pulmonary disease). COPD causes airflow blockage and breathing problems.
2 most common conditions of COPD are chronic bronchitis and emphysema.

What causes pulmonary emphysema?

Pulmonary emphysema occurs very slowly over time. It may be caused by,

  • Smoking
    (the main cause)
  • Exposure
    to air pollution, such as chemical fumes, dust, vapors, fumes, gases, and other
    chemicals or substances
  • Exposure to indoor pollution. This includes irritating fumes, burning wood, smoke
    from home cooking, heating fuels, chemical fumes, environmental dust, and secondhand
    tobacco smoke.
  • A rare,
    inherited form of the disease called alpha 1-antitrypsin (AAT) deficiency-related
    pulmonary emphysema or early onset pulmonary emphysema. The World Health Organization
    advises that all people with COPD be screened once for AATD.

What are the symptoms of pulmonary emphysema?

Symptoms may be slightly different for each person. These are the most common:

Early symptoms of pulmonary emphysema may include:

  • Cough
  • Rapid breathing
  • Shortness of breath, which gets worse with activity
  • Sputum production
  • Wheezing

Other symptoms may include:

  • Anxiety
  • Depression
  • Extreme
    tiredness (fatigue)
  • Heart problems
  • Overinflation of the lungs
  • Sleep problems
  • Weight loss

The symptoms of pulmonary emphysema may look like other lung conditions or health
problems. See a healthcare provider for a diagnosis.

How is pulmonary emphysema diagnosed?

Along with a complete health history and physical exam, your healthcare provider may
pulmonary function tests. These tests help measure the lungs’ ability to exchange
and carbon dioxide. The tests are often done with special machines into which you
breathe. They may include:


A spirometer is a device used to check lung function. Spirometry is one of the simplest,
most common tests. It may be used to:

  • Determine the severity of a lung disease
  • Find
    out if the lung disease is restrictive (decreased airflow) or obstructive
    (disruption of airflow)
  • Look for lung disease
  • See how well treatment is working

Peak flow monitoring

This device measures how fast you can blow air out of your lungs. Cough, inflammation,
and mucus buildup can cause the large airways in the lungs to slowly narrow. This
slows the speed of air leaving the lungs. This measurement is very important in seeing
how well or how poorly the disease is being controlled.

Blood tests

These are done to check the amount of carbon dioxide and oxygen in the blood. A
blood test may be done to check eosinophil counts and vitamin D levels, and to
monitor your hematocrit and hemoglobin levels for anemia.

Chest X-ray

This test takes pictures of internal tissues, bones, and organs. A chest X-ray is
not recommended to diagnosis COPD, but it can help identify other conditions.

CT scan

This test uses a combination of X-rays and computer technology to make images of the
body. A CT scan can show details such as the width of airways in the lungs and the
thickness of airway walls.

Sputum culture

This test is done on the material that is coughed up from the lungs and into the
mouth. A sputum culture is often used to see if an infection is present. It may also
be done to check eosinophil levels. It generally takes 2 days to get the results.

Electrocardiogram (ECG)

This is a test that records the electrical activity of the heart, shows abnormal rhythms
(arrhythmias), and can help find heart muscle damage.

How is pulmonary emphysema treated?

goal of treatment for people with pulmonary emphysema is to live more comfortably
the disease, control symptoms, and prevent the disease from getting worse, with minimal
side effects. There is no way to repair or regrow the damaged lung tissue.

Treatment may include:

  • A
    pulmonary rehab program. Community-based and home-based programs work as well as
    hospital-based programs as long as they are as often and of the same intensity.
    Standard home-based pulmonary rehab programs help with trouble breathing in people
    with COPD. Supervised, traditional pulmonary rehab remains the standard of care and
    best option for people with COPD. These programs help manage your disease, breathing
    methods, exercise, support, and counseling. To find one, ask your provider or call
    your local hospital. Also talk with your healthcare provider about which rehab or
    self-management program is best for you.
  • Antibiotics for bacterial infections
  • Staying
    away from the smoke of others and removing other air pollutants from your home and
  • Medicines (bronchodilators) that widen the airways of the lungs and can be either
    taken by mouth (oral) or inhaled
  • Getting
    the flu and pneumococcal vaccines
  • Nutritional support since you may develop malnutrition and lose weight. It’s
    important to stay at your ideal weight. Being overweight or underweight can affect
    your health.
  • Other
    types of oral and inhaled medicines that are used to treat symptoms such as coughing
    and wheezing
  • Oxygen
    therapy from portable containers. Talk with your healthcare provider about long-term
    oxygen therapy.
  • Quitting smoking. Smoking is the main cause of COPD. Quitting will help you be able
    to better manage your emphysema. Also don’t use e-cigarettes or vaping products. Ask
    your healthcare provider about ways to help you quit smoking.
  • Surgery
    to remove the damaged area of the lung
  • An endobronchial valve system to treat
    breathing problems. This device is for people with severe emphysema. It is the first
    minimally invasive device to treat emphysema available in the U. S.
  • Lung transplant for severe emphysema

During each appointment, your provider will assess your ability to:

  • Cope in your usual environment (focusing on supportive,
    palliative, end-of-life care)
  • Correctly use inhaler techniques for your medicine delivery
  • Cope with other conditions you have and the medicines you

Key points about pulmonary emphysema

  • Pulmonary emphysema is a chronic lung condition. It’s part of COPD, a group of lung
    diseases that cause airflow blockage and breathing problems.
  • It
    develops very slowly over time. It’s most often caused by smoking.
  • It
    causes shortness of breath that often gets worse with activity and many other
    symptoms, such as wheezing, cough, anxiety, and heart problems.
  • There is
    no way to repair or regrow the damaged lung tissue. The goal of treatment for people
    with pulmonary emphysema is to live more comfortably, control symptoms, and prevent
    the disease from getting worse.
  • A key
    part of treatment is to quit smoking, including e-cigarettes.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

  • Know the reason for your visit and what you want to happen.
  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your healthcare
    provider tells you.
  • At the
    visit, write down the name of a new diagnosis and any new medicines, treatments, or
    tests. Also write down any new instructions your healthcare provider gives you.
  • Know
    why a new medicine or treatment is prescribed and how it will help you. Also know
    what the side effects are.
  • Ask if your condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know
    what to expect if you don’t take the medicine or have the test or procedure.
  • If you have a follow-up appointment, write down the date, time, and purpose for that
  • Know how you can contact your healthcare provider if you have questions.

Medical Reviewer: Allen J Blaivas DO

Medical Reviewer: Ronald Karlin MD

Medical Reviewer: Daphne Pierce-Smith RN MSN

© 2000-2021 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional’s instructions.

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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.


COPD has no cure yet. However, lifestyle changes and treatments can help you feel better, stay more active, and slow the progress of the disease.

The goals of COPD treatment include:

  • Relieving your symptoms
  • Slowing the progress of the disease
  • Improving your exercise tolerance or your ability to stay active
  • Preventing and treating complications
  • Improving your overall health

To assist with your treatment, your family doctor may advise you to see a pulmonologist. This is a doctor who specializes in treating lung disorders.