Emphysema is a form of chronic lung disease and is one of the main types of chronic obstructive pulmonary disease (COPD). This disease is termed as obstructive because people who are suffering from emphysema exhale air as if there is an obstruction. There are various factors that can cause emphysema, but one of the main factors is smoking. Even though there is no cure for emphysema, if a person stops smoking, it can reduce the progression of the disease.
Emphysema slowly affects the air sacs in the lungs, known as alveoli, making it difficult to breathe. When a person suffering from emphysema exhales, the damaged air sacs don’t function properly because old air gets trapped inside, making it difficult for fresh air to enter. The treatment for emphysema can reduce the progression of the disease, but it cannot repair the damage already done to lungs.
What are the symptoms of emphysema?
Emphysema can remain undetected for many years because it does not show any symptoms. The main symptom of emphysema is difficulty in breathing. However, such symptom begins slowly. Initially, the person suffering from emphysema may avoid activities that can cause difficulty in breathing. Hence, the condition is not treated as a problem unless it starts affecting the daily activities of the patient. As the disease progresses, most patients find it difficult to breathe even while resting.
When to consult a doctor?
People must consult a doctor if they are experiencing unexplained difficulty in breathing for a few months, particularly if it is getting worse with time, and it is interfering with daily activities. Moreover, one must seek immediate medical assistance in the following cases:
- Finding it difficult to breathe and unable to climb stairs
- When lips or fingernails turn blue or gray without any form of physical exertion
- Not mentally alert
What are the causes of emphysema?
The main cause of emphysema is exposure to airborne irritants, which include tobacco smoke, marijuana smoke, manufacturing smoke, and other air pollutants. Very rarely, emphysema is caused by a hereditary condition, wherein the person has a shortage of a protein that guards the elastic structure in the lungs known as alpha-1 antitrypsin deficiency.
What are the risk factors of emphysema?
The risk factors associated with emphysema are:
- Smoking – The risk of developing emphysema is greater in people who smoke cigarettes including cigar and pipe smokers. The risk can be greater depending on the number of years a person is smoking and the amount of tobacco smoked.
- Age – Even though the symptoms of emphysema gradually occur, people with tobacco-related emphysema mostly start to experience the symptoms between 40-60 years.
- Passive smokers – The secondhand smoke inhaled from someone else’s cigarette, cigar, or pipe can cause emphysema.
- Occupational exposure to fumes – A person working in an environment where he or she is exposed to certain chemicals or dust from grains, cottonwood, or mining products are more prone to developing emphysema.
- Exposure to air pollution – Breathing indoor or outdoor pollutants increases a person's risk of having emphysema.
What are the complications of emphysema?
Some of the complications associated with emphysema include:
- Collapsed lung - can be a life-threatening situation for a person who has severe emphysema. This occurs in very rare situations. However, if it does, it can lead to serious complications.
- Heart problems - since emphysema increases the pressure in the arteries that are connected to the heart and lungs. It can lead to a problem called cor pulmonale, in which a part of the heart expands and weakens.
- Bullae in the lungs - are large holes in the lungs of people who have emphysema. Sometimes, a giant bulla can be as large as half of the lung. These holes reduce the space for the lungs to function properly.
What are the tests for diagnosing emphysema?
To know if a person is suffering from emphysema, the doctor will suggest the following tests:
- Imaging tests
- Laboratory tests
- Lung function tests
What are the treatment options for emphysema?
Emphysema cannot be cured, but treatment can help the patient get some relief from the symptoms as well as slow down the progress of the disease. Treatment of this condition can be done in a number of ways depending on the condition of the patient and the intensity of the disease. In most cases, a step-by-step approach is followed to treat emphysema.
1) Quit smoking
More of a lifestyle change, quitting smoking is one of the first things to be done by any patient suffering from a lung condition like emphysema. Smoking aggravates any lung disorder towards an irreparable damage that can quickly worsen the condition of the patient. Quitting may help slow down the progression of the disease to a large extent and also help the lungs to function better.
Naturally, the lungs begin to slow down in their function as a person ages. When lung function is reduced, the risks associated with chronic lung disorders such as COPD becomes higher. Smoking only contributes to the deterioration of the normal functioning of the lungs. Quitting unhealthy habits like smoking can help increase the life of the lungs and bring its functioning to optimal levels. If you are addicted to smoking and wish to get rid of the habit, your doctor may prescribe you certain medications to help stop your urge to smoke. Besides, you could also seek the help of certain support groups that work towards helping people get rid of such addiction.
In some mild cases, the doctor may prescribe certain lung exercises that can help improve the patient's lung functioning. Such exercises include the spirometer exercise, which requires patients to blow into the spirometer device. These exercises should be done under strict medical supervision and are known to have a great impact in improving lung performance.
3) Bronchodilating medications
Bronchodilators are medicines that help in opening up your airways for a better and smoother exchange of air in the lungs. It is the first type of medicine that a doctor would likely to prescribe to treat conditions like emphysema. In the first stage of less intensive cases of emphysema, bronchodilators may be recommended only when required for breathlessness. The most commonly recommended bronchodilator for treating mild cases of emphysema is albuterol (Proventil or Ventolin). This medication is known to show prompt action, and even when a small dosage is taken, it can have a lasting impact for about 4-6 hours. Albuterol is normally available in the form of an inhaler, which provides immediate relief.
For patients who suffer from shortness of breath even during the resting period, the doctor may prescribe albuterol to be administered at regular intervals either through a direct inhaler or through nebulization. In nebulization, the medication goes into the lungs in a slow vaporized manner and is known to provide relief to the patient by opening up the airways and facilitating a smooth flow of air to and from the lungs.
Ipratropium bromide (Atrovent) is another bronchodilator, which is used to treat mild cases of emphysema. The function of this medicine is very similar to albuterol and is available as a capsule for nebulization as well as in the inhaler form. This medicine is recommended to take at frequent intervals and is not a medicine for immediate relief. Moreover, the medicine may not be helpful in case of chronic emphysema patients.
There are other bronchodilator medicines such as methylxanthines (theophylline), which are available in various forms including tablets, inhalers, and syrups.These oral medicines are known to have a longer impact that helps in keeping the airways open for a longer duration of time. The medicine has a short-term effect. Hence, it is not recommended very often these days.
The levels of theophylline could suddenly increase in the blood causing an overdose effect. For this reason, the drug's level needs to be constantly monitored. Too little of this drug may show no impact at all in improving the condition of the patient. Thus, the doctors only recommend this drug after careful consideration and checking upon its interaction with other drugs that the patient may be consuming. Before taking theophylline, it is important to discuss the patient’s medical history and all the other medications that the patient has been taking.
Steroids are often used to treat various lung-related issues due to their anti-inflammatory properties and effects in the body. Steroids can help reduce the inflammation of the airways and can immediately cause the lungs to come back into normal functioning. However, the use of steroids for treating any medical condition can only be done after careful consideration or else it can show various forms of side effects. Some patients may not even respond well to steroid treatments. Hence, the patient receiving steroid treatment needs constant monitoring. Steroids can be given in the form of IV injections, inhalers, or as oral medications.
Antibiotics are normally given to treat various forms of bacterial infections. Moreover, in cases where a patient is suffering from breathlessness, antibiotics may be administered. Even in cases where an X-ray report shows a negative result for pneumonia or any lung infection, antibiotics may be given to immediately provide relief from shortness of breath. Even for patients suffering from COPD, antibiotics and steroids are extremely helpful when it comes to preventing worse lung conditions. The immediate administration of steroids and antibiotics could even reduce the chances of hospitalization.
If a patient with emphysema is suffering from breathlessness, an immediate admission to the hospital may be required to provide oxygen support to the patient. An oxygen tube may be inserted into the windpipe and the external machine helps in assisted breathing. This method of treatment is also known as tracheal intubation. In certain cases, patients are recommended to get oxygen even at home. Oxygen cylinders for home use are available to allow the patients to be comfortable as far as breathing is concerned. These units are portable, which allow patients to perform their day-to-day activities with complete ease.
- Pulmonary rehabilitation - In this therapy, patients will be taught breathing exercises and methods that will help reduce breathlessness as well as increase their ability to exercise.
- Nutrition therapy – Patients will be advised about proper nutrition. During the initial stages of emphysema, most patients need to lose weight. On the contrary, patients need to gain weight in the later stage.
- Supplemental oxygen – For patients suffering from severe emphysema with very low blood oxygen levels, supplemental oxygen at home and during exercise may be given to get some relief. Some patients are provided with oxygen throughout the day. This supplemental oxygen is administered through narrow tubes that fit into the nostrils of the patient.
Some people suffering from a highly advanced form of emphysema may require surgery to decrease the pressure in their lungs, thereby managing the symptoms better. Surgery is normally not preferred for older adults suffering from emphysema since undergoing the procedure only increases their risk for other health complications. People who have upper lobe lung damage are more likely to sustain and experience the benefits associated with surgery.
If a patient is suffering from severe emphysema, the doctor may suggest surgery options, which include:
- Lung volume reduction surgery (LVRS) – In this option, the surgeon will remove small portions of the damaged lung tissue. By doing so, the remaining lung tissues expand and function properly. It can also help improve the breathing of the patient.
- Lung transplant – This is an option for patients in the later stage of emphysema and when no other option has been effective in improving the condition of the patient.
What are the lifestyle changes and home remedies for emphysema patients?
For patients suffering from emphysema, certain lifestyle changes and home remedies can help reduce the progression of the disease and other health complications.
- Quit Smoking – This is one of the most important remedies that people will have to take for the overall improvement of their health. Quitting smoking can also reduce the progression of emphysema. Patients can join a smoke cessation program to help them effectively quit smoking. Moreover, avoid inhaling secondhand smoke as much as possible.
- Avoid respiratory irritants – People must avoid fumes from paint and automobile exhaust, certain cooking odors, perfume scents, burning candles, or incense. Moreover, change furnace and air conditioner filters regularly to reduce the pollutants in the air.
- Work out regularly – Don't avoid working out regularly because of your breathing problems, as physical exercise will help increase your lung capacity.
- Protection from cold air – Cold air can increase breathing problems, so during cold weather, wear a scarf and mask that can cover your nose and mouth to warm the air entering the lungs.
- Avoid respiratory infections – Take pneumonia vaccinations and yearly flu shots. In addition, avoid people who have a cold or flu. During social gatherings, especially during cold and flu season, wear a mask, wash your hands regularly, and use a hand sanitizer.
Emphysema cannot be completely cured. However, the symptoms can be managed to slow down the progress of the disease. Lifestyle changes can also go a long way in treating the condition.
- The main symptom of emphysema is difficulty in breathing, which slowly progresses.
- The primary factors responsible for this condition include breathing in polluting irritants.
- People who are at more risk of developing emphysema are between the ages of 40 and 60 years old.