Emphysema

What Is Emphysema?

Emphysema is an irreversible, chronic lung condition that results from damage to the walls of air-sacs (alveoli). Emphysema is part of a group of diseases known as Chronic Obstructive Pulmonary Disease (COPD). It damages the air sacs (alveoli) in the lungs, making it hard to breathe. Over time, the walls between air sacs break down, reducing the amount of oxygen that reaches your bloodstream.

As the disease progresses, breathing becomes more difficult—even during basic activities like walking or climbing stairs.

Who Is Affected?

Emphysema mostly affects people over the age of 40 who have a history of smoking. However, it can also develop in non-smokers, especially those with long-term exposure to air pollutants or a rare genetic condition called alpha-1 antitrypsin deficiency.

Not Controllable

• Age: Risk increases after age 40
• Genetics: Alpha-1 antitrypsin deficiency, a rare inherited condition

Controllable

• Smoking (the most significant risk factor)
• Exposure to secondhand smoke
• Occupational exposure to dust, chemical fumes, or pollutants
• Air pollution in high-smog areas

Who Is Most at Risk?

• Current or former smokers
• People with a family history of lung disease
• Individuals who work in mining, construction, or manufacturing
• Those with chronic bronchitis

How Can You Reduce Your Risk?

• Quit smoking and avoid secondhand smoke
• Use protective masks in work environments with dust or fumes
• Stay away from indoor and outdoor air pollution
• Get vaccinated against the flu and pneumonia to prevent lung infections
• Maintain a healthy lifestyle with regular exercise and a balanced diet

What Are the Symptoms?

 Symptoms of emphysema often develop slowly and may not be noticeable until lung damage is significant. Common symptoms include:

• Shortness of breath, especially with activity
• Chronic cough
• Wheezing or chest tightness
• Fatigue
• Frequent respiratory infections
• Bluish lips or fingernails (in later stages)
• Weight loss and loss of appetite (advanced disease)

How Is Emphysema Diagnosed?

Diagnosis begins a review of your symptoms and health history and a physical exam. Your provider may order one or more tests to confirm the diagnosis and assess the severity.

Common Diagnostic Tests:

• Pulmonary function tests: This includes spirometry,  which measures how much air you can breathe in and out and how quickly. It also includes lung volume studies and diffusion studies to evaluate how well your lungs are working.
• Chest X-ray or Chest CT scan: Shows signs of lung damage or air trapping
• Arterial blood gases: Measures oxygen and carbon dioxide levels in your blood. This test is typically dine in advanced stages of COPD.
• Alpha-1 antitrypsin blood test: Checks for genetic deficiency

How Is Emphysema Treated?

There is no cure for emphysema, but treatments can relieve symptoms, slow disease progression, and improve quality of life.

Lifestyle Changes

• Quit smoking
• Avoid environmental triggers
• Stay physically active to strengthen breathing muscles
• Eat a nutrient-rich diet and stay hydrated

Devices

• Nebulizers for medication delivery
• Oxygen therapy for those with low blood oxygen levels

Medical Treatments

• Inhalers and nebulizer medications to help relax airway muscles
• Inhaled steroids to reduce inflammation
• Antibiotics for respiratory infections
• Oral or IV steroids for exacerbations
• Vaccines (flu, pneumonia and COVID 19) to prevent complications

Surgical Treatments

Not every patient has surgery. Only some patients are appropriate for these procedures.

• Endobronchial valve placement: Helps in collapsing the damaged lung portion so that the healthier portion of the lung can participate in breathing better.
• Lung volume reduction surgery: Removes damaged lung tissue.
• Bullectomy procedure removes large air sacs (bullae) that interfere with breathing.
• Lung transplant: For advanced emphysema when other treatments fail

Other Therapies

• Pulmonary rehabilitation: A program that combines exercise, education, and breathing techniques
• Counseling or support groups to manage anxiety or depression

When to Seek Care

When to See Your Doctor

Make an appointment if you:

• Have a chronic cough that won't go away
• Experience shortness of breath during routine tasks
• Get frequent chest infections
• Are concerned about your lung function, especially if you smoke or have a family history of emphysema

When to Seek Emergency Medical Care

Call emergency services if you:

• Sudden or severe struggle to breathe or speak
• Notice blue lips or fingertips
• Have chest pain, confusion, or fainting
• Experience sudden worsening of symptoms
  
  

What Should You Do Next?

If you’re experiencing symptoms of emphysema or have risk factors, talk with your primary care provider. They may order additional diagnostic tests or refer you to a pulmonologist for further evaluation.

Quitting smoking and avoiding environmental triggers is critical. Talk to your doctor about ways to quit.