What is emphysema?

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.

What are the symptoms of emphysema?

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:

 exhaustion
 weight loss
 depression
 fast heartbeat

Affected people may develop bluish-gray lips or fingernails from lack of oxygen. If this
happens, seek medical attention immediately.

Who is at risk for emphysema?

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.

How is emphysema diagnosed?

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
How is emphysema treated?
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.

Medications

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.

Therapies

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.

Surgery

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.
Other treatments

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.