Chronic obstructive pulmonary disease (COPD) is an umbrella term that refers to inflammation in the airways that makes it hard to breathe. Emphysema is a chronic lung disease that falls under the COPD umbrella.

If you have emphysema, you also have COPD, but not everyone with COPD has emphysema.

Emphysema is a lung condition that damages the small air sacs, called alveoli, in the lungs. Damage can be caused by smoking, inhaling secondhand smoke, or exposure to pollution and chemicals. Emphysema makes it hard to breathe and can cause wheezing and chest tightness.

In the United States, more than 3 million people live with emphysema. There’s no cure for emphysema, but there are treatments to help manage the symptoms.

Chronic obstructive pulmonary disease (COPD) is a classification that’s used for a group of chronic lung diseases. Emphysema and chronic bronchitis are two of the most common diseases that fall under the COPD umbrella.

In the United States, about 12.5 million people live with COPD. Many people may have COPD even though a doctor hasn’t diagnosed their condition as COPD.

Although COPD can’t be cured, the right treatment can help manage and control symptoms. If left untreated, COPD can progress quickly and lead to serious lung and heart problems.

About 85% to 90% of people with COPD have some history of smoking. Other causes of COPD include:

  • exposure to secondhand smoke
  • exposure to certain chemicals
  • exposure to air pollution

Irritation from smoke, chemicals, or pollution can cause inflammation throughout the lungs and airways. Inflammation can narrow the airways and also damage the alveoli in the lungs.

COPD is a progressive condition, but treatments can help manage symptoms.

Emphysema is a condition in which the alveoli in your lungs are damaged.

The alveoli pick up the incoming oxygen you inhale and circulate it through your blood to all the tissues in your body. They also release the outgoing carbon dioxide that you exhale. When alveoli become damaged, it’s harder for this air exchange to happen in your lungs and for your body to get the oxygen it needs.

Healthy alveoli are like tiny balloons that inflate and deflate when you breathe in and out. Damaged alveoli no longer stretch normally and can’t hold as much air. Many also break down, resulting in fewer alveoli.

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Illustration by Paul Lawrence

The early symptoms of emphysema are shortness of breath and coughing, especially during physical activity or if you try to exert yourself. Over time it can become harder to breathe, even if you’re just resting.

As emphysema progresses, other symptoms can include:

  • wheezing
  • chest tightness
  • fatigue
  • weight loss
  • coughing that produces lots of mucus

Smoking is by far the most common cause of damage to alveoli. Exposure to air pollution and some chemical fumes can also cause damage.

There’s no cure for emphysema, but there are treatments and lifestyle changes that can help.

If you currently smoke, the most important step you can take to help manage your symptoms is to quit smoking. It’s also important to avoid exposure to secondhand smoke and workplace chemicals.

Some types of breathing techniques can also help manage shortness of breath. Helpful breathing exercises for emphysema include:

There are also several medications and treatments that can be used to help treat the symptoms of emphysema. These include:

  • Inhaled bronchodilators: Bronchodilators help by relaxing the bronchial muscles, making it easier to breathe.
  • Steroids: Steroids help reduce inflammation in the lungs and airways, making it easier to breathe. They can be inhaled, or they can be oral medications such as prednisone.
  • Supplemental oxygen: If emphysema is more advanced, supplemental oxygen can help meet the body’s oxygen needs
  • Pulmonary rehabilitation programs: Pulmonary rehabilitation programs teach breathing techniques and exercise strategies. They may also help provide a connection with others living with COPD.
  • Expectorants: This type of medication helps reduce mucus production. Mucinex and Robitussin are two over-the-counter (OTC) options.

A healthcare team can discuss the different treatment options with you and help you understand what will work best for you.

What is the outlook?

Emphysema is a progressive condition. Over time there tends to be greater damage to the alveoli, and symptoms tend to get worse. This can significantly impact your quality of life. Early diagnosis and treatment can help slow the progression and make it easier to manage symptoms.

The outlook for people living with emphysema depends on several factors, including:

  • results of lung testing
  • smoking history
  • age
  • presence of other chronic health conditions

Living with emphysema increases your risk of respiratory illness. It’s recommended that you stay up to date with vaccinations, including:

  • the annual flu shot
  • the primary COVID-19 vaccine series and recommended boosters
  • the pneumococcal vaccine to protect against pneumonia

Living with a chronic condition such as emphysema can be challenging, but you don’t need to navigate treatment alone. There are resources that may help you quit smoking and also programs that may help you connect with others who are living with COPD.

The American Lung Association has several resources, such as:

  • Better Breathers Club, a group that meets throughout the United States and virtually
  • Freedom From Smoking, a program that includes a virtual program to help you quit smoking, a bilingual quit line staffed by registered nurses and respiratory therapists, and self-help guides

Support groups provide an opportunity to connect with others living with COPD. They are also places to learn strategies for living with COPD. Ask a doctor about support groups that may be right for you.

Pulmonary rehabilitation programs have also helped many people living with COPD. These programs provide:

  • education about living with COPD
  • guidance on how to exercise to improve strength and breathing
  • support from a variety of healthcare professionals
  • a chance to connect with other people living with COPD

Talk with a healthcare professional or team if you’re interested in pulmonary rehabilitation.

Medication resources

Medications are an important part of managing emphysema, but they can be expensive. The cost keeps many people from taking medications as prescribed.

If you’re having trouble with the cost of medications, the Medicine Assistance Tool (MAT) is one resource that may be able to help with the cost of medications. Enter the names of the medications you take on the website, and it will let you know how you can save money.

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COPD refers to a group of chronic lung diseases that make it difficult to breathe. Two of the most common lung diseases that fall under the COPD umbrella are emphysema and chronic bronchitis.

Emphysema is primarily caused by smoking, which damages the alveoli in the lungs and causes them to lose elasticity. Over time, it can become harder for air exchange to happen in the alveolus. As a result, breathing becomes more difficult, and your body isn’t able to get the oxygen it needs.

There’s no cure for emphysema, but there are treatments to help manage your symptoms. If you smoke, quitting is the most important step you can take to manage your emphysema symptoms. Medication, breathing techniques, and pulmonary rehabilitation may also be part of your treatment plan.