• Emphysema: How You Get It and How to Fight It

    IMAGEEmphysema is a chronic respiratory condition most often caused by the destruction of lung tissue by toxins contained in cigarette smoke. This, in turn, leads to chronic overinflation of the lungs, greatly decreasing their ability to function.
    Like chronic bronchitis, emphysema is a chronic obstructive pulmonary disease (COPD) that evolves over a period of time. Emphysema results in destruction of the alveoli, the tiny air sacs in the lungs. Oxygen is delivered to the lungs and carbon dioxide is carried from the lungs across the walls of the alveoli. As more and more alveoli are damaged, it becomes harder and harder for the lungs to function, which can cause these symptoms:
    • Shortness of breath
    • Increasing difficulty exercising
    • Great difficulty exhaling
    • Chronic coughing
    • Cough with mucus production
    As the disease progresses, breathing becomes increasingly difficult. In its most severe stage, virtually any physical activity becomes extremely difficult, if not impossible.

    What Causes Emphysema?

    Emphysema is usually the result of long term exposure to harmful particles or gases, such as:
    • Tobacco smoke
    • Occupational dusts and chemicals
    • Indoor air pollutants, such as fuel burned in confined spaces
    • Outdoor air pollutants

    Diagnosis and Treatment

    When a patient complains of the chronic presence of the symptoms of emphysema, a physical exam and various lung capacity tests are done to confirm the diagnosis. Chest x-rays may also be done.
    Since, at present, emphysema cannot be cured, the goals of treatment are to:
    • Relieve the symptoms of the disease
    • Prevent further loss of lung function

    Relieving Symptoms

    To relieve symptoms, one or more of the following treatments may be used:
    • Bronchodilator medicines—to help relax the lung's airways
    • Anticholinergic medicines—to help open the airway passages.
    • Breathing exercises and a physical conditioning program—to help improve lung capacity and general overall physical condition
    • Anti-inflammatory medicines (eg, corticosteroids)—to decrease inflammation and swelling in the breathing passages
    • Oxygen therapy—may be used for patients with severely impaired lung function.
    Emphysema may also be treated with surgery, such as:
    • Bullectomy—removal of an area on the lungs
    • Lung volume reduction surgery—removal of seriously damaged part of the lung
    • Lung transplant

    Stop Smoking

    To slow emphysema's progression, the agent causing it must be removed. And since long-term smoking causes an overwhelming number of cases of emphysema, the only effective way to slow the progression of emphysema is to quit smoking.
    There are many smoking cessation therapies available. Your doctor may also be able to prescribe a medication that may help you stop smoking.

    Prevention

    To prevent the onset of emphysema, take the following steps:
    • If you smoke, quit. Talk to your doctor about strategies to quit.
    • Avoid exposure to secondhand smoke
    • Avoid workplace and environmental pollutants.
    Emphysema does not suddenly occur. It develops over a long period of time. Unfortunately, many sufferers ignore their condition until it becomes serious, at which point treatment options are less effective. Therefore, at the first sign of any of the symptoms, talk to your doctor.

    RESOURCES

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

    Smoke Free.gov http://www.smokefree.gov/

    CANADIAN RESOURCES

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

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

    References

    COPD. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated July 27, 2012. Accessed September 3, 2012.

    Emphysema. EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary/. Updated September 1, 2011. Accessed September 3, 2012.

    Tutic M, Lardinois D, Imfeld S, Korom S, Boehler A, Speich R, et al. Lung-volume reduction surgery as an alternative or bridging procedure to lung transplantation. Ann Thorac Surg . 2006 Jul;82(1):208-13.

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