What Is Emphysema? Symptoms, Causes, Diagnosis, Treatment, and Prevention

Emphysema is one of the main two types of chronic obstructive pulmonary disease (COPD ). Most people with COPD experience both emphysema and chronic bronchitis , the other main form of COPD.e60dc2a1-f33c-4a05-9b50-8e3e8e597629db1c2a96-aec3-43dc-a1b6-bed848a4bb6e More than three million people in the United States have an emphysema diagnosis.e60dc2a1-f33c-4a05-9b50-8e3e8e5976292ceab7c6-1f77-4aa3-a19d-6e9be6ae82d3 Historically, emphysema has been more common among men than women. Over the past two decades, however, rates have come closer together as incidence in men has gone down and incidence in women has increased.e60dc2a1-f33c-4a05-9b50-8e3e8e5976295a9aee47-5b0e-4cb7-9b23-196a23a31c4e Read on to learn all you need to know about emphysema, including the causes, symptoms, and how to best treat the condition.
What It Is What Is Emphysema? Emphysema occurs when the tiny air sacs of the lungs (alveoli) become damaged and enlarged, leading to breathlessness and other symptoms. Each lung has an average of 480 million alveoli, according to research.e60dc2a1-f33c-4a05-9b50-8e3e8e597629b1a881fb-6038-41f0-93e5-625c653bae9d When you breathe in, the alveoli expand and stretch, taking in oxygen and transporting it to the blood in the small capillary vessels within their thin walls. At the same time, carbon dioxide waste moves into the air sacs from the capillaries. The process is called gas exchange. When you breathe out, the alveoli deflate, expelling the carbon dioxide out of the body through the airways. But for people with emphysema, the walls of the alveoli are damaged and the air sacs lose their normal elasticity. As a result, the alveoli are no longer able to support the airways to the lungs. These are called the bronchial tubes. The tubes collapse and cause a blockage, or obstruction. This traps air inside the lungs and makes it hard to breathe.e60dc2a1-f33c-4a05-9b50-8e3e8e59762943827fbc-eb0a-4fbc-aea6-060764255d3e In addition, emphysema can cause some of the alveoli to rupture or burst, resulting in fewer, larger alveoli. Ultimately, this reduces the surface area available for gas exchange and further contributes to shortness of breath.e60dc2a1-f33c-4a05-9b50-8e3e8e5976297dc5ca11-0dbf-4f8a-b1bd-add04c921e35
Symptoms What Are the Symptoms of Emphysema? Some people may have emphysema for years without noticeable signs or symptoms.e60dc2a1-f33c-4a05-9b50-8e3e8e59762987c7cf35-62c5-4bf0-a213-9d5e1633911e In many cases, a person doesn’t notice any symptoms until they start interfering with everyday activities. Symptoms of emphysema include: Shortness of breath, especially while climbing stairs or doing light exercise Chronic (or “smoker’s”) cough Wheezing Increased production of mucus Chest tightness Ongoing feeling of not being able to get enough air Frequent respiratory infections Long-lasting fatigue
Causes What Causes Emphysema? Emphysema is considered one of the most preventable respiratory diseases because cigarette smoking is its leading cause. About 85 to 90 percent of all COPD cases in high-income countries are caused by cigarette smoking, according to the American Lung Association (ALA).e60dc2a1-f33c-4a05-9b50-8e3e8e59762910d30c29-f5d1-43fb-b2b3-6d50ad1250c7 That said, some people who have COPD never smoked cigarettes, especially in low-income countries. Other risk factors for emphysema include: Exposure to air pollution (indoor and outdoor) Secondhand smoke Workplace chemicals, dust, and fumes A history of childhood respiratory infection In rare cases, a genetic disorder called alpha-1 antitrypsin (AAT) deficiency can cause COPD. If your body doesn’t make enough of the protein AAT, the lungs can be more easily damaged from smoking and environmental pollution, notes the National Heart, Lung, and Blood Institute (NHLBI).e60dc2a1-f33c-4a05-9b50-8e3e8e5976299f665141-76ab-4f44-a47d-cc0fc6e5d020
Diagnosis Type and Stages of Emphysema Doctors tend to break emphysema down into different subtypes as well as stages of the condition. Types Emphysema is sometimes split into three subtypes.e60dc2a1-f33c-4a05-9b50-8e3e8e597629dbba95ee-0b18-47ec-9c8d-b96c8358d71a Centriacinar: This type of emphysema is the most common and linked to long-term smoking. It begins in the respiratory bronchioles and spreads mainly in the upper half of the lungs. Panacinar: This type is linked closely with the genetic condition alpha-1 antitrypsin (AAT) deficiency. It starts in the lower half of the lungs, destroying air sac tissue and leading to an enlargement of air spaces. Paraseptal: This type is associated with previous lung infections and inflammatory conditions. Stages There are four stages of COPD that are based on the Global Initiative for Chronic Obstructive Lung Disease (GOLD).e60dc2a1-f33c-4a05-9b50-8e3e8e597629c979c090-82f7-4e07-b213-83a9224a821c They are characterized by the level of lung function. Stage 1: Lungs operate at least at 80 percent of normal level for someone with healthy lungs of the same age, height, and sex. This is called mild emphysema. Stage 2: Lungs operate 50 to 79 percent of the normal level of someone with healthy lungs and same age, height, and sex. This is called moderate emphysema. Stage 3: Lungs operate 30 to 49 percent of the normal level of someone with healthy lungs and same age, height, and sex. This is called severe emphysema. Stage 4: Lungs operate below 30 percent of the normal level of someone with healthy lungs and same age, height, and sex. This is called very severe emphysema.
Diagnosis How Is Emphysema Diagnosed? A doctor will generally diagnose emphysema via a series of tests, including:e60dc2a1-f33c-4a05-9b50-8e3e8e5976290473966f-27ab-4787-b7a8-f9b0e3f0253e Listening With a Stethoscope: One simple test is to tap on your chest and listen with a stethoscope for a hollow sound. This can indicate that air is trapped in your lungs. Pulse Oximetry: Also called an oxygen saturation test, this is used to measure the oxygen content of the blood and is often done by attaching a monitor to your finger, forehead, or earlobe. Spirometry: This is one of the most useful tests. It evaluates lung function by having you take a deep breath and then blow into a machine that measures airflow. X-Rays: Though X-rays are generally not useful for detecting early stages of emphysema, a plain chest X-ray or a CAT (computer-aided tomography) scan can help diagnose moderate or severe cases. Electrocardiogram (ECG): ECGs check heart function and are used to determine if heart disease is a cause of shortness of breath. Arterial Blood Gas: Often performed as emphysema gets worse, this test measures the amount of oxygen and carbon dioxide in blood from an artery. It can be used to determine if you need extra oxygen or are retaining carbon dioxide, a common finding in advanced emphysema.
Treatment How Is Emphysema Treated? There is no cure for COPD, but quitting smoking and undergoing treatment can ease symptoms and slow progression of the disease. An overall treatment plan for emphysema may include:e60dc2a1-f33c-4a05-9b50-8e3e8e597629ba9670f0-bac7-4d6f-9b46-7c4fa6b47411 Bronchodilator Medications: These medicines relax the muscles around the airways and are given through handheld inhalants and sometimes through a machine called a nebulizer. Anti-Inflammatory Medication: These medications reduce inflammation in the airways. Oxygen Therapy: This is prescribed for patients whose lungs are not getting enough oxygen to the blood (hypoxemia). Lung Volume Reduction Surgery: This involves removing a portion of diseased lung tissue, then joining together the remaining tissue. It can help relieve pressure on the breathing muscles and improve lung elasticity and gas exchange, but very few patients are candidates for this procedure. Pulmonary Rehabilitation: Pulmonary rehabilitation programs are personalized treatment programs that involve exercise, breathing, and nutrition tips individually tailored to your COPD. The goal of these programs is to help you stay active and carry out your everyday activities.
Prevention How Can You Prevent Emphysema From Getting Worse? The most important step you can take to curb the disease’s progress is to quit smoking , says the ALA.e60dc2a1-f33c-4a05-9b50-8e3e8e597629558a8c51-f936-4692-9279-7d00850344a1 In addition, there are a number of lifestyle changes that can help ease your symptoms and slow the progression of emphysema. Here are some strategies that can help improve your quality of life. Eat a healthy diet: Your body uses food to fuel all its activities, and that includes breathing. Talk to your doctor and a registered dietitian about diet changes that may help ease your emphysema symptoms and increase your energy. Maintain your ideal body weight: Being overweight will make breathing even more difficult. Being underweight, on the other hand, can leave you feeling weak and tired and can also increase your risk of chest infections.e60dc2a1-f33c-4a05-9b50-8e3e8e5976291c5db3db-b450-4fa1-9fc3-42b66d37915e Avoid lung irritants: Smoking isn’t the only thing that exacerbates emphysema. Avoid secondhand smoke, exhaust fumes, strong perfumes, cleaning products, paint and varnish, excessive dust, and other pollution. Stay active: Regular exercise can reduce shortness of breath by improving the body’s use of oxygen and strengthening your respiratory muscles. Talk to your doctor about the amount and type of exercise you should do. Get vaccinated: Stay up to date on vaccinations, including those for the flu, COVID-19, and pneumonia, to prevent chest infections, which can be dangerous — even life-threatening — for people with COPD.
Takeaway The Takeaway Emphysema is one of the main two types of COPD (the other being chronic bronchitis). The biggest cause is smoking in more developed countries, and there are several symptoms. The most common ones include shortness of breath, chest tightness, and wheezing. There is no cure for emphysema, though anti-inflammatory medications and oxygen therapy can help reduce symptoms. The best way to avoid emphysema and COPD is to quit smoking and avoid other causes, such as air pollution. Eating a healthy diet, staying active, and maintaining a healthy body weight are also great preventive measures. If you are concerned that you may have COPD, talk to your doctor to get a full diagnosis and learn how to best manage your condition.

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