Emphysema

What is Emphysema

Emphysema is a lung disease caused by damage to the walls of the alveoli, the small, fragile air sacs clustered at the ends of the bronchial tubes deep within your lungs. This damage can lead to the development of blockages that trap air inside the lungs. Excessive air trapped in the lungs can cause the chest to appear fuller, giving a barrel-chested appearance. With fewer functional alveoli, less oxygen is able to enter the bloodstream. In a healthy lung, there are approximately 300 million alveoli. When you inhale, air travels through the bronchial tubes and reaches the alveoli. The alveoli expand, taking in oxygen and transferring it into the bloodstream. When you exhale, the alveoli contract, expelling carbon dioxide from the body.

What are the stages of emphysema?

The Global Initiative for Chronic Obstructive Lung Disease (GOLD) classifies COPD into four stages, which also describe emphysema:

Stage 1: Mild emphysema, where lung function is at least 80% of that expected for a person of similar age, height, and sex.
Stage 2: Moderate emphysema, with lung function ranging from 50% to 79% of normal.
Stage 3: Severe emphysema, where lung function ranges from 30% to 49% of normal.
Stage 4: Very severe emphysema, where lung function is less than 30% of normal for someone of the same age, height, and sex.

What are the first signs of emphysema?

Emphysema symptoms often go unnoticed until more than 50% of lung tissue is damaged. Initial signs include gradual onset of shortness of breath and fatigue.

Other symptoms of emphysema include:

Persistent cough (often referred to as smoker’s cough).
Wheezing.
Shortness of breath, particularly during light physical activities like climbing stairs.
Persistent sensation of not getting enough air.
Chest tightness.
Increased production of mucus.
Abnormal mucus color (yellow or green).
Persistent fatigue.
Heart problems.
Difficulty sleeping.
Feelings of anxiety or depression.
Unintended weight loss.

How is emphysema diagnosed?

Your healthcare provider diagnoses emphysema through a series of steps. They begin with a physical examination, listening to your lung sounds using a stethoscope. By tapping your chest, they can detect a hollow sound indicating trapped air in your lungs. However, emphysema cannot be diagnosed based solely on symptoms. Further tests are necessary to confirm the condition.

How is emphysema treated?

Emphysema progression calls for treatments aimed at slowing it down and optimizing remaining lung function, tailored to its severity:

Smoking cessation: Vital to protect lung health; quitting with support from healthcare providers enhances effectiveness.
Bronchodilators: Relax airway muscles to improve airflow, faster and more effective than oral medications, beneficial for asthma and other lung conditions.
Inhaled corticosteroids: Reduce airway swelling and mucus production, often used daily for symptom prevention.
Oral corticosteroids: Prescribed briefly during emphysema exacerbations (flares).
Antibiotics: Combat bacterial infections affecting lungs like pneumonia or bronchitis.
Anti-inflammatory drugs: Reduce airway inflammation.
Oxygen therapy: Delivers supplemental oxygen through nasal catheters or masks to alleviate hypoxemia.
Lung volume reduction surgery (LVRS): Removes diseased lung tissue to ease breathing and enhance lung elasticity; not suitable for all.
Bronchoscopic lung volume reduction: Involves placing one-way valves in airways to release trapped air, aiding breathing; candidacy varies.
Lung transplant: For severe cases unresponsive to other treatments, replaces damaged lungs with healthy donor lungs.

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