Emphysema – The Facts

Emphysema is a form of chronic obstructive pulmonary disease, and is a long term and progressive lung disease which causes shortness of breath. This is a result of the tissues that are used to support the shape of the lungs being destroyed. Due to the destruction of the tissue around the alveoli (small sacks within the lungs), they are then unable to hold their functional shape during exhalation. Here we will look in a little more detail at the symptoms, causes and treatments for emphysema.

Symptoms

The main symptom of emphysema is shortness of breath (AKA dyspnea). This is because they are not able to get enough oxygen, nor to remove the carbon dioxide from the blood. At first this will only be during physical exercise when the individual needs larger quantities of oxygen and is required to dispel carbon dioxide at a more rapid rate. However it will eventually occur after any physical exertion and eventually at all times even when relaxing. The patient might also find that they have difficulty with coughing and that they produce less sputum. Weight loss is also common, and the individual may also find that the anteroposterior diameter of the chest increased resulting in their appearing ‘barrel chested’. In some cases leaning forward may help them to breathe when they are struggling. On chest percussion, hyperresonant sound is heard. In extreme cases the dyspnea may lead to blueish discoloration of the skin.

Causes

The majority of emphysema cases are caused by smoking tobacco. Here the smoke is inhaled through the lungs into the alveoli where it can damage the surrounding tissue. This is what is known as ‘primary emphysema’, while other etiologies of the condition are known as secondary emphysema.

These secondary causes include deficiencies in alpha 1-antitrypsin. To an extent emphysema is also expected to a degree with aging as the lungs deteriorate over time. After the age of 20 people stop developing new alveoli tissue which of course means that deterioration is more likely.

Of course exposure to other toxins can also result in emphysema whether this is air pollution or second hand smoke.

Treatment

There is unfortunately no ‘cure’ for emphysema. However it is nevertheless possible to treat the condition and to manage the symptoms. It is recommended for those who have the condition to seek medical attention as soon as possible. The main focus then should be on preventing further progression and this should mean quitting smoking, avoiding other irritants and optimizing the quality of life in other ways.

Breathing can also be supporting with the use of anticholinergics, bronchodilators, steroids (inhaled or oral) and improvement in body posture. Supplemental oxygen may usually be useful, and can help to prolong life expectancy in patients. Lightweight portable oxygen systems can be carried helping to improve patient mobility.

There are also various surgical techniques available which include ‘lung volume reduction surgery’ which has been shown to improve the quality of life in selected patients. There are various different techniques for this procedure, with some being minimally invasive. Another surgical method involves the insertion of tiny valves in passages that lead to the diseased lung areas. This method has good results, but 7% of patients suffer partial lung collapse.

In extreme circumstances a lung transplant can be used in order to cure the condition. However only few patients suffering with lung emphysema will be able to survive the process and this will be based on age, oxygen deprivation, medications etc. It is also of course a highly invasive procedure with many possible complications including infection and rejection.

Promising research is currently being done into the use of multipotent lung stem cells, and this might mean there is a non-surgical solution available soon.

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Anne Wolski

Anne Wolski has worked in the health and welfare industry for more than 30 years. She is a mother and grandmother and is passionate about anything to do with family and social issues.

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