Emphysema

Overview

Definition

Emphysema is a problem with the tiny air sacs that make up the lungs. These sacs should stretch to fill with air and get smaller as air moves out of the lungs. Emphysema is when the air sacs are damaged. It makes it hard to breathe.

Emphysema is a type of chronic obstructive pulmonary disease (COPD).

Normal Lung versus Emphysemic Lung
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Causes

Damage to the air sacs may be caused by:

  • Smoking
  • Breathing toxins or other irritants
  • Alpha1-antitrypsin deficiency (A1AD)—a genetic problem that can cause emphysema at an early age

Risk Factors

Emphysema is more common in people over 40 years old. Other things that may raise your risk are:

  • Smoking
  • Being around smoke
  • Exposure to irritants at work
  • Having alpha-1 antitrypsin deficiency
  • Indoor air pollution

SymptomsandDiagnosis

Symptoms

Early symptoms include:

  • Problems breathing
  • Coughing
  • Coughing up mucus

Later symptoms may be:

  • Breathing that worsens
  • A choking feeling when you are lying flat
  • Fatigue
  • Problems concentrating
  • An enlarged chest
  • Coughing up bloody mucus
  • Weight loss

Diagnosis

You will be asked about your symptoms and health history. A physical exam will be done.

Your doctor will need to test how how well your lungs are working. This may be done with:

  • Pulmonary function tests, called spirometry—to test the force of your breath
  • Arterial blood gas test—to test oxygen and carbon dioxide levels in the blood

Your doctor may also need to look at pictures of your lungs. This may be done with:

  • Chest x-ray
  • CT scan

Treatments

Treatment

There is no cure. Your doctor will focus on helping you manage symptoms and improve your quality of life.

Treatment may be:

Stop Smoking

Quitting smoking slows the disease. It is a critical part of treatment. There are many things that can help:

  • Behavior change programs
  • Medicines
  • Both behavior programs and medicines

Breathe Clean Air

Limit the number of irritants in the air you breathe. Avoid smoke, dust, smog, extreme heat or cold, and high altitudes.

Medication

Medicine for emphysema may help:

  • Open airways
  • Relax breathing passages
  • Reduce swelling
  • Treat lung infections with antibiotics

Some medicines may be taken as pills or liquids. Others are inhaled medicines that are delivered directly to the lungs.

Vaccines

The flu and pneumonia can make your symptoms worse. Get vaccinated against pneumonia and the flu . The flu vaccine may also reduce flare-ups.

Oxygen

Oxygen therapy may be helpful if the oxygen levels in your blood are too low. It can help you breathe and improve your level of energy. You may only need it for specific activities or it may be given throughout the day.

Exercise

Special exercises can strengthen chest muscles. This can make it easier to breathe.

Regular physical activity can reduce how hard your lungs work by building up endurance. Follow your doctor's advice about what is right for you.

Breathing and Coughing Methods

Special methods of breathing can help bring more air into the lungs. They can also help force trapped air out of the lungs. Coughing methods can also help clear mucus. Ask your doctor if these methods can help you. Some examples include:

  • Pursed lip breathing
  • Controlled coughing

Diet

Eating can help improve your breathing. Here's how:

  • Eat a healthy diet. It should be low in fat. It should also be rich in fruits, vegetables , and whole grain foods.
  • Try to stay at a healthy weight. Extra weight causes the lungs and heart to work harder than they need to.
  • It may be hard to eat because you feel full. Try eating many smaller meals during the day instead of a few large ones.
  • Eat slowly. This will make it easier to breathe.
  • If you need to gain weight, add food or drinks during the day. Talk to a dietitian about how many calories you need in one day.

Lifestyle Changes

To manage symptoms:

  • Pace your activities.
  • Learn relaxation methods and other ways to manage stress.
  • Get support from therapists, family, and friends. Anxiety can raise your breathing rate.

Surgery

A small number of people may benefit from surgery. You may need to have a part of your lung removed. Or you may need alung transplant.

Prevention

To prevent emphysema:

  • If you smoke, talk to your doctor about how to quit
  • Avoid exposure to secondhand smoke
  • Avoid exposure to air pollution or irritants
  • Wear protective gear if you are around irritants or toxins on the job

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

Edits to original content made by Denver Health.

RESOURCES

American College of Chest Physicians http://www.chestnet.org 

American Lung Association http://www.lung.org 

CANADIAN RESOURCES

Health Canada https://www.canada.ca 

The Lung Association http://www.lung.ca 

References

COPD. American Lung Association website. Available at: http://www.lung.org/lung-disease/copd. Accessed August 28, 2018.

COPD. EBSCO DynaMed Plus website. Available at:  http://www.dynamed.com/topics/dmp~AN~T115557/COPD . Updated August 13, 2018. Accessed August 28, 2018.

COPD. National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/copd. Accessed August 28, 2018.

COPD and asthma. National Lung Health Education Program website. Available at: http://www.nlhep.org/Pages/COPD-and-Asthma.aspx. Accessed August 28, 2018.

Emphysema. American Lung Association website. Available at: http://www.lung.org/lung-disease/emphysema. Accessed August 28, 2018.

Petrache I, Diab K, Knox KS, et al. HIV associated pulmonary emphysema: A review of the literature and inquiry into its mechanism. Thorax. 2008;63(5):463-469.