Emphysema is a disease of the lungs. It occurs most often in smokers, 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 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 include:
- weight loss
- fast heartbeat
Affected people may develop bluish-gray lips or fingernails from lack of oxygen. If this happens, seek medical attention immediately.
Causes and risk factors
According to the American Lung Association, in 2011 more than 4.5 million people in the United States had emphysema. The majority of these people are over 65 years old. Men and women are at about an equal risk of getting the disease.
Smoking tobacco is the main cause of emphysema. The more you smoke, the higher your risk of developing emphysema. Smoking marijuana can also lead to emphysema. According to the American Lung Association, smoking kills 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 getting emphysema.
Additionally, people who live or work in areas exposed to high pollution, chemical fumes, or lung irritants are at higher risk of developing the disease.
Genetics can play a factor in a form of early onset emphysema, but this is rare.
Your doctor will begin by getting your background and medical history, asking in particular if you are a smoker and if you are 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 functioning tests, which often involve blowing into a device called a spirometer to 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
There is no cure for emphysema. Treatment aims to reduce symptoms and slow the progression of the disease with medications, therapies, or surgeries.
If you are a smoker, the first step in treating emphysema is to quit smoking, either with medications or cold turkey.
Various medications can help treat the disease, including:
- bronchodilators, to help open air passages, making breathing easier and relieving coughing and shortness of breath
- steroids, to alleviate shortness of breath
- antibiotics, to fight infections that can make the condition worse
All of these medication can be taken orally or inhaled.
Pulmonary therapy 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.
Lung 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.
People with emphysema are often 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 getting an infection that could complicate emphysema.
People with emphysema often experience anxiety and depression because they aren’t as active as they used to be. In some cases, they may be bound to an oxygen tank. 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.
Prevention and outlook
Since emphysema is mainly caused by smoking tobacco, the best way to prevent it is to refrain from smoking. Also, stay away from harmful chemicals and fumes, and heavy pollution.
The outlook for people with emphysema varies based on its severity. There is no cure for the disease, and it gets worse 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 important, 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. Quitting smoking is also an important step in the treatment process. With the aid of medications and therapies, you can live a long, healthy life with emphysema.