Cigarette smoking is the most common cause of emphysema. Tobacco smoke and other pollutants are thought to cause the release of chemicals from within the lungs that damage the walls of the air sacs. This damage becomes worse over time. Persons with this disease have air sacs in the lungs that are unable to fill with fresh air. This affects the oxygen supply to the body.

A naturally occurring substance in the lungs called alpha-1 antitrypsin may protect against this damage. People with alpha-1 antitrypsin deficiency are at an increased risk for this disease.

Symptoms

Shortness of breath
Chronic cough with or without sputum production
Wheezing
Decreased ability to exercise

Additional symptoms that may be associated with this disease include the following:

Anxiety
Unintentional weight loss
Ankle, feet, and leg swelling
Fatigue

Exams and Tests

A physical examination may show wheezing, decreased breath sounds, or prolonged exhalation (exhalation takes more than twice as long as inspiration). The chest may be barrel-shaped. There may be signs of chronically insufficient oxygen levels in the blood.

These tests help confirm the diagnosis:

Pulmonary function tests
Chest x-ray
Arterial blood gases showing low levels of oxygen in the blood (hypoxemia), and high levels of carbon dioxide (respiratory acidosis)

This disease may also alter the results of the following tests:

Pulmonary ventilation/perfusion scan
Chest CT scan

Treatment

Smoking cessation is the most important and effective treatment. Only quitting smoking can stop the progression of lung damage once it has started. Medications used to improve breathing include bronchodilators, diuretics, and corticosteroids. Antibiotics may be prescribed when respiratory infections occur. Vaccines against the flu and pneumonia are recommended for people with emphysema.

Low-flow oxygen can be used during exertion, continuously, or at night. Pulmonary rehabilitation can improve exercise tolerance and quality of life in the short-term. Lung transplantation is an option for patients with severe disease.

Carefully selected patients may be eligible for lung reduction surgery. This procedure removes the damaged portions of the lung, which allows the normal portions of the lung to expand more fully and take advantage of increased aeration. When successful, those who undergo the surgery report improvement in walking distance and quality of life.

Outlook (Prognosis)

The outcome is better for patients with less damage to the lung. Prognosis is largely determined by initial shortness of breath, exercise tolerance, and results from lung function tests (spirometry). Death may occur from respiratory failure, pneumonia, or other complications.

Possible Complications

Recurrent respiratory infections
Pulmonary hypertension
Cor pulmonale (enlargement and strain on the right side of the heart)
Erythrocytosis (increased red blood cell count)
Death

When to Contact a Medical Professional

Call your health care provider if you develop symptoms of emphysema.

If you know you have emphysema, call your health care provider if breathing difficulty, cough, sputum production or fever develops or changes.

Prevention

Avoiding smoking or quitting if you do smoke - can greatly decrease risk for this disease.

Emphysema is chronic and progressive disease that affects the lungs. Emphysema happens when there is damage to the small air sacs and the small airways in the lungs.

The severe damage of the small air sacs and the small airways prevent the patient to breathe properly that is why patients of emphysema experience shortness of breath. And shortness of breath limits the capacity of the person to perform strenuous activities.

When emphysema reached the advanced stage, the patient would find it hard to expel air from the lungs that is why the process of breathing itself can really be strenuous on the patient's part.

Emphysema is hard to detect in the early stage unless the patient feel the symptoms of having shortness of breath and most of the time, this happens when emphysema is already in advanced stage.

The treatments that is available for emphysema is used to relieve its symptoms thus avoiding more severe complications.

Causes of Emphysema

1.Smoking

The most common cause of emphysema is smoking. Damage to your lungs begins when the smoke from the cigarettes paralyzes the microscopic hairs found in your bronchial tubes.

The microscopic hairs acts as a sweeper of irritants and germs away from your airways but with the regular presence of smoke, the irritants would remain in your bronchial tubes and enter the alveoli thus resulting to inflammation of the tissues and damaging the elastic fibers.

2.Deficiency in protein

The presence of protein also plays a key role in developing emphysema. Lacking the alpha-1-antitrypsin (AAt) protein can also lead to the early development of emphysema.

The AAt deficiency is a genetic disorder where the individual had inherited two defective genes from both parents. This condition is not common but if this is present with an individual, he is likely to have to have lung problems when he reaches his 30's to 40's

Consult with your doctor if you have AAt deficiency and you may also consider checking your other family members as well for AAt deficiency.

Understanding Emphysema Recommended Resources:

Penn State Milton S. Hershey Medical Center

Cedars-Sinai