• Emphysema


    Emphysema is a long-term disease of the lungs. It is a problem with the tiny air sacs that make up the lungs. These tiny elastic sacs should stretch to fill with air and then get smaller as air move out of the lungs. Emphysema is caused by the destruction of these air sacs. This makes it difficult to move air in and out of the lungs.
    Emphysema is a type of chronic obstructive pulmonary disease (COPD).
    Normal Lung vs Emphysemic Lung
    Nucleus factsheet image
    Copyright © Nucleus Medical Media, Inc.


    Emphysema is caused by damage to the air sacs of the lung. This damage may be caused by:
    • Smoking
    • Inhaling toxins or other irritants
    • Alpha1-antitrypsin deficiency (A1AD)—a genetic defect which can cause emphysema at an early age in nonsmokers

    Risk Factors

    Factors that may increase your risk of emphysema include:
    • Smoking
    • Long-term secondhand or passive smoke exposure
    • Family members with emphysema
    • Exposure to pollutants at work
    • History of frequent childhood lung infections
    • Age: 40 or older


    Early symptoms include:
    • Coughing
    • Increased sputum production (mucus from deep in the lungs)
    • Wheezing
    • Shortness of breath with activity
    As the disease progresses, you may have:
    • Increased shortness of breath
    • Rapid breathing
    • Choking sensation when lying flat (may need to prop up with many pillows or even sleep in a chair)
    • Fatigue
    • Trouble concentrating
    • Increase in chest size (barrel chest)
    • Increased risk of serious lung infections
    • Heart problems
    • Coughing up thick and/or bloody mucus
    • Weight loss
    • Breathing through pursed lips
    • Desire to lean forward to improve breathing
    • More frequent flare-ups (periods of more severe symptoms)


    The doctor will ask about your symptoms and medical history. A physical exam will be done.
    Your doctor will need to test how impaired your lungs may be. This may be done with:
    • Lung function tests (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 detailed pictures of your lungs. This may be done with:


    There is no treatment to cure emphysema. Treatment aims to ease symptoms and improve quality of life.
    Treatment includes:

    Smoking Cessation

    Quitting smoking slows the disease. It the most important part of treatment. There are many programs to help you quit including:
    • Behavior change program
    • Medication
    • Combination of behavior program and medication

    Environmental Management

    Limit the number of irritants in the air you breathe. It may help make breathing easier. Avoid smoke, dust, smog, extreme heat or cold, and high altitudes.


    Medication for emphysema may help by:
    • Opening the airways
    • Relaxing the breathing passages
    • Decreasing swelling
    • Treating lung infections (antibiotics)
    Some medication may be taken as pills or liquids. Others are inhaled medication that is delivered directly to the lungs.


    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 therapy may be helpful if the oxygen levels in your blood are too low. It can relieve trouble breathing and improve energy. You may only need it for specific activities or it may be given throughout the day.


    Special exercises can strengthen chest muscles. This can make it easier to breathe.
    Regular physical activity can reduce the workload on your lungs by building you endurance. Physical activity is also associated with improved quality of life. Follow your doctor's recommendations for activity levels and restrictions.

    Breathing and Coughing Techniques

    Special methods of breathing can help bring more air into the lungs. They can also help force trapped air out of the lungs. Effective coughing techniques can also help clear mucus from your lungs. Ask your doctor if these techniques can help you. Some examples include:
    • Pursed lip breathing
    • Controlled coughing technique


    Eating habits to consider with emphysema:
    • Eat a healthy diet. It should be low in saturated fat. It should also be rich in fruits, vegetables, and whole grain foods.
    • Maintain a normal weight. Excess weight causes the lungs and heart to work harder.
    • It may be hard to eat because you feel full. Try eating several smaller meals during the day instead of a few large meals.
    • Slow down your eating pace. This will make it easier to breathe.
    • If you need to gain weight, add food or drinks throughout the day. Talk to a dietitian about how many calories you need each day.

    Lifestyle Changes

    The following may help you manage emphysema symptoms and avoid flare-ups:
    • Pace your activities.
    • Learn relaxation techniques and other methods to manage stress.
    • Seek emotional support from professionals, family, and friends. Anxiety can increase your breathing rate.


    A small number of people may benefit from surgery. Surgery options include removing a part of the lung or a lung transplant.


    You can reduce you chances of developing emphysema by:
    • Not smoking
    • Avoiding exposure to secondhand smoke
    • Avoiding exposure to air pollution or irritants
    • Wearing protective gear if exposed to irritants or toxins at work


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

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


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

    Health Canada http://www.hc-sc.gc.ca/index-eng.php


    Chhabra SK, Gupta RK, Singh T. Cutis laxa and pulmonary emphysema. Indian J Chest Dis Allied Sci. 2001;43(4):235-237.

    COPD. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us. Updated September 25, 2012. Accessed October 1, 2012.

    COPD and asthma. National Lung Health Education Program website. Available at: http://www.nlhep.org/Pages/default.aspx. Accessed October 1, 2012.

    Emphysema. American Lung Association website. Available at: http://www.lung.org/lung-disease/emphysema/. Accessed October 1, 2012.

    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. Review.

    What is COPD? National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/dci/Diseases/Copd/Copd%5FWhatIs.html. Updated June 8, 2012. Accessed October 1, 2012.

    Revision Information

  • Can we help answer your questions?

    Wellmont Nurse Connection is your resource for valuable health information any time, 24 hours a day, seven days a week. Speak to a Nurse any time, day or night, at (423) 723-6877 or toll-free at 1-877-230-NURSE.