Emphysema
Emphysema
Emphysema and another lung condition known as chronic bronchitis (persistent cough with phlegm) are both features of a common lung disease called
chronic obstructive pulmonary disease (COPD)
.
Emphysema is generally caused by cigarette smoking or long-term exposure to certain industrial pollutants or dusts. A small percentage of cases are caused by a familial or genetic disorder, alpha-1-antitrypsin deficiency. While damaged airways don’t regenerate and there is no cure, emphysema is preventable and treatable.
Symptoms of emphysema
The symptoms of emphysema include:
breathlessness with exertion, and eventually breathlessness most of the time in advanced disease
susceptibility to chest infections
cough with phlegm production
fatigue
barrel-shaped chest (from expansion of the ribcage in order to accommodate enlarged lungs)
cyanosis (a blue tinge to the skin) due to lack of oxygen.
Structure of the lungs
The lungs are sponge-like structures that lie within the chest, protected by the ribcage. They are made up of progressively branching air passages. The largest of these is the windpipe (trachea), which divides into the two bronchi, which divide into the smaller bronchioles.
Bronchioles end in minute air sacs (alveoli), where inhaled oxygen is transferred to the blood stream and carbon dioxide is transferred from the blood into the exhaled breath. This exchange of oxygen and carbon dioxide takes place via a fine mesh of capillaries.
Damaged airways and lungs
After repeated exposure to chemical irritants, such as cigarette smoke, the air passages and air sacs of the lungs become inflamed and damaged.
The airways of healthy lungs have elastic properties, but in lungs that are repeatedly exposed to irritants, the airways lose their elasticity and become thickened and swollen. This swelling means that the passageway for air becomes narrower.
If the same person also has chronic bronchitis (ongoing inflammation of the lining of the bronchial tubes), the mucus present can further contribute to narrowing of the air passages and clogging of the air sacs, further reducing their ability to function. As the number of functional air sacs reduces, the number of capillaries servicing the damaged alveoli also gradually reduces.
These changes result in:
partial blockage of the passages carrying inhaled and exhaled breath
reduced capacity for the lungs to extract the oxygen from inhaled air.
This means that the person has to breathe harder to get enough oxygen.
Complications of emphysema
Complications of emphysema can include:
pneumonia
– this is an infection of the alveoli and bronchioles. People with emphysema are more prone to pneumonia
collapsed lung – some lungs develop large air pockets (bullae), which may burst, resulting in lung deflation (also called pneumothorax)
heart problems – damaged alveoli, reduced number of capillaries and lower oxygen levels in the blood stream may mean that the heart has to pump harder to move blood through the lungs. Over time, this can place considerable strain on the heart.
Diagnosis of emphysema
Chronic obstructive pulmonary disease, including emphysema, is diagnosed mainly using a lung function test called spirometry. Other tests that may help in diagnosis of emphysema include:
other lung function (or breathing) tests
chest x-rays
CT scans.
Treatment for emphysema
There is no cure for emphysema, although it is treatable. Appropriate management can reduce symptoms, improve your quality of life and help you stay out of hospital.
Management includes:
stopping smoking immediately and completely – this is the most effective treatment for COPD and emphysema
avoiding other air pollutants
respiratory (pulmonary) rehabilitation programs
oxygen treatment, in advanced cases
medications such as
anti-inflammatory medications
medicine to widen the airways (bronchodilators) and loosen the phlegm
antibiotics
stress management techniques
gentle, regular exercise to improve overall fitness
influenza vaccination
(yearly) and
pneumococcal vaccination
to protect against certain types of respiratory infection.
Respiratory rehabilitation programs
A person with emphysema can take part in a respiratory rehabilitation program, commonly known as ‘pulmonary rehab’. These programs:
provide information and education on emphysema
introduce people to a supervised exercise program proven to improve emphysema symptoms
improve lung function through specific breathing exercises
teach stress management techniques
offer advice on adapting to life with emphysema
provide emotional support through shared experiences.
To find out about a program near you, call
Lung Foundation
Australia
External Link
on 1800 654 301.
Oxygen treatment for emphysema
If a person with emphysema is found to have exceptionally low levels of oxygen in their blood, they will be given oxygen to use at home. The oxygen is usually breathed through the nose via nasal prongs (cannulae). The person will need to use the oxygen treatment for at least 16 hours every day.
Where to get help
Your
GP (doctor)
Lung Foundation
Australia
External Link
Tel.
1800 654 301
QUITline
External Link
Tel.
13 78 48