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
- weight loss
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.
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.
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.
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.
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.