Emphysema: What is it? Causes, Symptoms, and More

What is emphysema? 

Emphysema is a type of Chronic Obstructive Pulmonary Disease (COPD).

Emphysema is a chronic lung disease that causes the alveoli (tiny air sacs in the lungs) to deteriorate gradually and suffer damage over time. This damage eventually leads to rupturing of the air sacs, resulting in the formation of a single large air pocket rather than numerous smaller ones. 

Due to the reduction in the lung surface area, the air is trapped in the injured tissue, making it difficult for oxygen to get transported through the bloodstream. The lungs also gradually overfill as a result of this obstruction, making breathing more challenging.

(IMAGE: Picture of Healthy alveoli vs emphysema)

Stages of emphysema 

Emphysema has been classified into four stages of severity by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) based on the results of pulmonary function tests.

• GOLD stage 1 – Mild: Forced expiratory volume in one second (FEV1) is 80% of anticipated
• GOLD stage 2 – Moderate: FEV1 is between 50% and 80% of expected
• GOLD stage 3 – Severe: FEV1 is between 30% and 50% of expected
• GOLD stage 4 – Extremely severe: FEV1 30% of expected

Pulmonary function testing is done in a medical laboratory. However, devices that offer a portable and reasonably reliable estimate of FEV1 have been developed for hospital and home use.

Causes of emphysema 

Air pollution 

Higher outside concentrations of the pollutants ozone, fine particulate matter, and nitrogen oxides (NOx) at an individual’s home were linked to an increase in emphysema-like lung tissue on CT scans.

Tobacco smoking 

People who smoke have considerably higher rates of emphysema than non-smokers. Emphysema actually develops earlier, worsens faster, and has a more significant influence on a person’s life the more cigarettes they smoke.

(IMAGE: Cigarette and lung disease)

Chemical fumes and dust 

An individual is more prone to get emphysema on breathing fumes from specific chemicals or dust from cotton, grain, wood or mining materials. If a person smokes, the risk increases even more. 

Marijuana smoking 

Marijuana usage for a long period of time may increase the risk of developing emphysema, a lung condition in which cysts replace tissue. Marijuana smoke contains the same toxins, allergens and carcinogens as tobacco smoke. 

In addition, smoking marijuana can increase the risk of bronchitis, coughing and mucus production. However, these symptoms usually subside once marijuana users stop using them.

Symptoms  

Shortness of breath 

Emphysema damages the alveoli, the tiny air sacs in the lungs, to the point where they eventually rupture. This limits the amount of surface area available for gas exchange and instead creates one bigger air space rather than several smaller ones. Shortness of breath results due to this lung disease, emphysema.

Frequent coughing 

The air sacs in the lungs deteriorate and stretch due to emphysema. As a result, the patient has persistent cough and breathing problems.

Wheezing 

Emphysema causes the breathing passages in the lungs to become more constricted, which causes air to leave the lungs more slowly. This causes airflow blockage, resulting in wheezing.

Tightness in chest 

Millions of small air sacs in the lungs that are responsible for absorbing oxygen into the body are damaged by emphysema. Tightness in the chest may result from this. Air may become trapped in the lungs due to damaged air sacs. It becomes more difficult to exhale completely.

Diagnosis

A doctor will likely question the patient’s medical history and lung function tests for diagnosing emphysema. The tests could consist of

• Spirometry: The forced expiratory volume exhaled after one second test (FEV1) is measured using spirometry. The test calculates the amount of air one can exhale in a single second. The forced vital capacity (FVC) test calculates how much air the lungs can expend in total. These are the most typical evaluations of lung function.

• High-resolution CAT scan or chest X-ray: A scan is frequently required to rule out the potential of other medical disorders, such as lung fibrosis or other lung illnesses.

• Pulmonary function test: Spirometry is one of them, along with evaluations of oxygenation, lung size, and gas diffusion tests.

• Arterial blood gases: Blood tests can measure the amount of blood gases— carbon dioxide and oxygen—in the bloodstream.

• Oximetry: A tiny instrument that clips onto a finger, toe or ear measures the amount of oxygen in the blood.

Treatment 

Oxygen therapy 

As a patient’s disease worsens, they might need help breathing and find it harder to breathe on their own. Different devices, including ones that can be used at home, can increase the oxygen available during each breath.

Pulmonary rehabilitation 

Pulmonary rehabilitation, which entails instruction in specialised breathing methods, dietary counselling, assistance with quitting smoking, and the beginning of an exercise programme, is a crucial component of the treatment of emphysema. 

Emphysema patients frequently have physical limitations. Therefore, they might refrain from engaging in any form of exercise. However, regular exercise might enhance a patient’s health and happiness.

Surgery 

For certain emphysema patients, lung transplantation may be required. Others might benefit from a surgical procedure called lung volume reduction, in which a few regions of diseased lung tissue are removed.

Protein therapy 

Alpha-1 antitrypsin (AAT) infusions may be administered to patients with emphysema spurred on by an AAT deficit in order to stop the progress of lung damage.

Medicine 

• Bronchodilators

Bronchodilator drugs work by relaxing and widening the airways in the lungs, which may help to reduce the symptoms of emphysema when inhaled as aerosol sprays or taken orally.

• Steroids

Steroids, when inhaled as an aerosol spray, can aid in easing emphysema symptoms brought on by asthma and bronchitis. However, long-term usage of inhaled steroids can result in negative side effects such as cataracts, Diabetes, high blood pressure and weak bones. Before using steroids, it’s vital to check for these adverse effects with a doctor.

• Antibiotics

Acute bronchitis, pneumonia and the flu are among the respiratory infections that antibiotics may be used to treat in emphysema patients.

Vaccination

To avoid infections, patients with emphysema should get the flu shot or vaccination every year and the pneumonia immunisation every five to seven years.

Complications 

Holes in lung 

Bullae, which are lungs with empty gaps, form in some emphysema patients. They are capable of being the size of one lung. 

Giant bullae can raise the risk of pneumothorax in addition to decreasing the space available for the lungs to expand.

Collapsed lung 

Since the lungs’ ability to function is severely impaired due to the disease, individuals with severe emphysema may face a collapsed lung which is a life-threatening condition. 

Heart problems 

The pressure in the arteries leading from the heart to the lungs may rise as a result of emphysema. Cor pulmonale, a condition where a portion of the heart enlarges and weakens, may result from this.

Prevention 

Avoid respiratory irritants 

Also, it’s crucial to make an effort to stay away from lung or respiratory irritants like secondhand smoke, air pollution, chemical odours and dust, as they can trigger emphysema.

Stop smoking 

Emphysema can be directly linked to tobacco smoke. The best preventive measure to avoid developing emphysema is to quit smoking. Eighty to ninety per cent of all emphysema is caused by smoking.

Get vaccinated 

Flu and pneumonia vaccinations, as prescribed by a doctor, can help prevent respiratory diseases like emphysema. Emphysema cannot be treated with vaccination. However, this can lessen flare-ups.

Conclusion

Emphysema is a disease of the lungs developed due to damage in the air sacs called alveoli. Shortness of breath is a common symptom of this condition.

Most emphysema patients also have chronic bronchitis. Long-term exposure to irritants present in the air, including smoke, is the leading cause of emphysema. 

On exhaling, the injured alveoli are unable to function efficiently, trapping the old air and preventing the entry of new, oxygen-rich air.

Consult a medical professional when there is unexplained shortness of breath for a while, especially if it’s becoming worse or interfering with daily activities. 

Getting medical help is essential when a patient experience

Shortness of breath, making climbing stairs impossible.

Blue or grey lips or fingernails

Lack of cognitive thinking.

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