What Is Emphysema?

What Happens When You Have Emphysema?

diagram of alveoli showing emphysema
What is emphysema?. A.D.A.M. Medical Encyclopedia

Definition: Emphysema

Emphysema is a chronic lung disease caused by damage to the alveoli, the tiny air sacs in the lung where ​the exchange of oxygen and carbon dioxide takes place. With emphysema, damage to the alveoli results in air becoming trapped, causing them to expand and rupture.

Damage to alveoli, and the resultant compromise in air exchange results in a decreased level of oxygen in the blood (hypoxemia) combined with an increased level of carbon dioxide in the blood (hypercapnia.)

Emphysema and COPD

Emphysema is one type of chronic obstructive pulmonary disease (COPD), a category of lung diseases that also includes chronic bronchitis and bronchiectasis.

Symptoms of Emphysema

Symptoms of emphysema may include:

  • Shortness of breath - The most common symptom of emphysema is shortness of breath
  • Cough - A cough with emphysema may be dry or be productive of sputum.
  • Wheezing.
  • Chest pain.
  • Exercise intolerance - Some people do not notice shortness of breath directly, but instead note that they are unable to as physically active as they once were, for example, it becomes difficult to walk as far or to climb as many flights of steps.
  • Muscle atrophy - The combination of decreased exercise along with other effects of the disease can result in muscle wasting and atrophy.

Causes

Smoking is the most common cause of emphysema, but there are many other causes which can act alone, or in conjunction with smoking, to causes emphysema.

Causes may include:

  • Smoking - As noted above.
  • Secondhand smoke
  • Occupational exposures to fumes, dust, and vapors.
  • Air pollution.
  • Alpha-1-antitrypsin deficiency - The inherited disorder alpha-1-anti-trypsin deficiency may cause emphysema which appears in patients who are much younger in general.

Emphysema Treatments

Emphysema is irreversible and progressive over time, so the goals of emphysema treatments are too slow the progression of the disease and to improve symptoms.

Some treatments include:

  • Medications - Medications such as bronchodilators, steroids, and antibiotics to treat infections are primary treatments for emphysema.
  • Quitting smoking is very important for individuals living with this condition, and can help to slow the progression of the disease.
  • Pulmonary rehabilitation - There are many benefits of pulmonary rehabilitation or physical therapy for the lungs." Pulmonary therapy can make a big difference for some people living with emphysema both in improving exercise tolerance.
  • Immunizations - It is important for people to stay up to date with immunizations, especially the flu vaccine and the pneumonia vaccine to help prevent infections which can result in worsening of the disease. 
  • Regular exercise routine - A significant problem with emphysema is that it creates a vicious circle. The disease itself makes it difficult to exercise, and the atrophy of muscles can, in turn, make the disease worse. The best exercises for COPD include a combination of endurance, flexibility, and strength training.

    Complications

    Emphysema is characterized by what is known as COPD exacerbations - periods in which the symptoms become worse, often requiring hospital admission. These exacerbations are often precipitated by infections, but may be set off by other conditions such as exposure to air pollution, wood smoke, or even perfumes in a mall.

    People with emphysema are also at increased risk of developing lung cancer. We now have lung cancer screening available for those who are between the ages of 55 and 80 and have smoked for at least 30 pack-years. That said, emphysema is an independent risk factor for COPD and some people may wish to be screened even if they have not smoked, or have smoked less than 30 pack years. Learn about lung cancer screening.

    Coping and Support

    Emphysema can be a frustrating disease all the way around. Not only do you have to cope with symptoms and treatments, but those symptoms and treatments can affect nearly every other area of our life. Check out these tips on how to live and cope with COPD.

    Sources:

    U.S. National Library of Medicine. MedlinePlus. Emphysema. Updated 02/17/16. https://medlineplus.gov/emphysema.html

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