Obstructive emphysema causes the air sacs in the lungs to rupture and enlarge. This leads to fewer but larger air sacs, limiting airflow in and out of the lungs.

Obstructive emphysema, or emphysema, is a chronic and progressive lung disease characterized by a progressive rupture and enlargement of the air sacs (alveoli).

Emphysema is a subtype of chronic obstructive pulmonary disease(COPD), an umbrella term for a group of lung conditions, including emphysema, chronic bronchitis, and sometimes asthma.

While all of these subtypes involve some degree of obstruction, the term “obstructive” may be added to specifically emphasize or refer to airway blockage. This blockage leads to difficulty in exhaling and limiting airflow in and out of the lungs.

The primary cause of emphysema is prolonged exposure to harmful gases, with cigarette smoking being the top reason. In fact, evidence from 2023 suggests that 80–90% of individuals with COPD have a history of smoking, and approximately 10–15% of smokers will develop COPD.

Additional factors contributing to emphysema include passive smoke, lung infections, and allergies. And, individuals with low birth weight are more prone to developing COPD later in life.

In developing countries, the use of biomass fuels and exposure to environmental pollutants like sulfur dioxide and particulate matter are major risk factors for emphysema, particularly among women and children.

A rare cause of emphysema is alpha-1 antitrypsin deficiency, an inherited autosomal recessive disease. This accounts for only 1–2% of COPD cases, according to the 2023 evidence mentioned earlier.

Obstructive emphysema has several characteristic symptoms, which include:

  • Shortness of breath: One of the primary symptoms is a persistent feeling of breathlessness, especially during physical activity. As the condition progresses, shortness of breath can occur even during rest.
  • Chronic cough: A persistent cough is common in obstructive emphysema. The cough may produce phlegm, which tends to worsen over time.
  • Wheezing: Many individuals with obstructive emphysema experience wheezing, a high pitched whistling sound during breathing. The narrowing of the airways causes wheezing.
  • Chest tightness: Some people with obstructive emphysema may feel a sensation of tightness or pressure in their chest.
  • Fatigue: As the condition impairs lung function and limits oxygen intake, individuals may experience chronic fatigue and reduced stamina.
  • Recurrent respiratory infections: Due to damaged lung function and impaired ability to clear mucus, individuals with obstructive emphysema may be prone to frequent respiratory infections such as bronchitis or pneumonia.

An emphysema diagnosis usually involves your doctor reviewing your medical history, including symptoms, smoking history, and exposure to environmental pollutants.

Your doctor will then conduct a thorough physical exam, listening to your lungs for any unusual breath sounds and signs of respiratory distress.

Pulmonary function tests, such as spirometry, play a crucial role in diagnosing obstructive emphysema. Spirometry measures how much air you can forcefully exhale and how quickly you can do so, providing information about the presence and severity of airflow limitation.

Spirometry can identify emphysema even before you have any obvious symptoms, according to National Heart, Lung, and Blood Institute. Spirometry helps determine the severity of COPD and establish treatment goals.

Imaging tests, including chest X-rays and CT scans, help evaluate your lungs and detect signs of emphysema. CT scans provide detailed images and help differentiate between various types of emphysema.

Your doctor may recommend arterial blood gas analysis to assess oxygen and carbon dioxide levels in your blood, providing insights into lung function and gas exchange efficiency.

In some cases, additional tests, such as alpha-1 antitrypsin deficiency testing, may be recommended to identify rare hereditary causes of emphysema.

The primary goals of emphysema treatment include:

  • symptom relief
  • enhancing lung function
  • preventing exacerbations (a period when emphysema symptoms are much worse than usual)
  • addressing any underlying causes or comorbidities (any coexisting health conditions)

Here are some common approaches to treating obstructive emphysema:

  • Smoking cessation: The most important step is to quit smoking (if you smoke) and avoid exposure to tobacco smoke or other harmful substances that can worsen lung damage.
  • Medications: Various prescription medications may help manage symptoms and improve lung function. These can include:
  • Pulmonary rehabilitation: This comprehensive program involves exercise training, breathing exercises, education, and counseling to improve physical fitness. This program would help reduce breathlessness and enhance overall well-being.
  • Oxygen therapy: In advanced cases, doctors may prescribe supplemental oxygen therapy to increase the oxygen levels in the blood and alleviate breathlessness.
  • Surgery: In some cases, surgical interventions like lung volume reduction surgery or lung transplantation may be helpful for selected individuals with severe emphysema.

The outlook for obstructive emphysema depends on various factors, including:

  • disease severity
  • lifestyle changes
  • treatment adherence
  • your overall health

While emphysema is a progressive and chronic condition, appropriate management can help slow down its progression, relieve symptoms, and improve your quality of life.

Researchers are continuously exploring new treatments and approaches for emphysema, including the following:

  • Bronchoscopic lung volume reduction: This minimally invasive procedure involves placing valves or coils into the airways to improve lung function and reduce hyperinflation.
  • Stem cell therapy: Stem cell therapy aims to regenerate damaged lung tissue by introducing healthy stem cells into the lungs. Evidence from a 2021 study suggests that stem cell therapy is a promising treatment with the potential to restore lung function and improve the quality of life in people with COPD.
  • Targeted lung denervation: This procedure involves disrupting the nerve signals that contribute to airway constriction and inflammation in the lungs, potentially reducing symptoms and improving lung function. A 2015 study suggests this procedure is feasible, safe, and well-tolerated.
  • Anti-inflammatory therapies: Researchers are developing new emphysema medications, targeting specific inflammatory pathways to improve symptoms and slow disease progression. One 2017 study highlights the potential of RV568, an anti-inflammatory agent that improved lung function among people with COPD. The study paves the way for further research.

If you want to get involved in trials for the latest obstructive emphysema treatments, go to ClinicalTrials.gov to learn which trials are currently looking for participants.

Obstructive emphysema is a progressive lung disease involving the destruction and enlargement of the air sacs in the lungs, leading to airflow limitation.

It’s primarily caused by chronic exposure to harmful gases, with cigarette smoking being the most common risk factor.

While there’s no cure for emphysema, treatments such as medications, pulmonary rehabilitation, and supplemental oxygen can help manage symptoms and improve quality of life.

Early diagnosis, lifestyle modifications, and ongoing medical care are essential in effectively managing the condition. Research into new treatment options and advancements in medical technologies continue to offer hope for improved outcomes.