Emphysema is one of three conditions grouped under the more general term chronic obstructive pulmonary disease (COPD). The 2 other subtypes are chronic bronchitis and chronic obstructive asthma. Emphysema causes the air sacs in your lungs to deteriorate. This reduces the surface area of your lungs, which leads to progressive difficulty in breathing. When you’re having trouble breathing, your vital organs don’t receive as much oxygen as they should. This causes tissue injury and can eventually be fatal. There’s no direct cure for emphysema once the lung damage is done, but treatments can relieve symptoms and prevent further lung damage. People with emphysema who smoke should quit smoking immediately. After you’ve quit smoking, there are several treatments available for emphysema. Bronchodilators are medications that relax the bronchial muscles and improve airflow. Bronchodilators are available as inhalers in both metered dose form and powder inhalers, and through nebulizer machines (they convert a liquid to aerosol). Bronchodilators may be used for short-term quick relief from symptoms, or for long-term daily use. Steroids can also be used to treat emphysema. Your doctor may prescribe corticosteroids in an inhaler form. Corticosteroids relieve symptoms by reducing inflammation. Some popular inhalers, such as Advair, combine a bronchodilator with a corticosteroid. In addition to using an inhaler, people with emphysema may be prescribed an oral steroid like prednisone. Antibiotics are also popular treatments, preventing infections that can lead to dangerous conditions like pneumonia. Mucolytic agents are sometimes prescribed to help lessen mucus. These treatments come in the form of expectorants. Expectorants are medications that help bring mucus up from the lungs. Mucinex and Robitussin are popular over-the-counter versions. Many people with emphysema will eventually need daily oxygen treatment. As the disease progresses, the need for oxygen often increases. Some will eventually require oxygen all the time. Not everyone with emphysema will need the large mobile tank often associated with oxygen supplementation. A much lighter and more portable device called a concentrator can extract oxygen from the air and convert it. Older versions of these devices initially required a power outlet to operate. Newer versions operate on battery power, making them easier to use every day. However, some portable oxygen concentrators are not recommended for use during sleep. The device may have problems recognizing when someone sleeping is inhaling, which affects the amount of oxygen delivered. When emphysema is advanced, your doctor may recommend lung volume reduction surgery (LVRS) or lung transplant. Also called reduction pneumoplasty, LVRS reduces lung volume to decrease symptoms. This surgery is not for everyone, so your doctor will want to consider your health and preferences. In LVRS, a surgeon will reduce the lung volume by removing areas most affected by emphysema. You may want to consider LVRS if you have advanced emphysema that is upper lobe predominant, or you have a low exercise tolerance even with pulmonary rehabilitation and medications for COPD. LVRS is associated with potentially serious complications. You may qualify for a procedure called bronchoscopic lung volume reduction (BLVR), which uses endobronchial valves. This way, your doctor can reduce lung volume via a flexible bronchoscope and eliminate the need for surgery. Your doctor may also recommend pulmonary rehabilitation. This may include breathing exercises that can help strengthen your lungs. In addition to breathing exercises, you may be encouraged to speak with other people who have emphysema during these sessions. This can help build confidence and increase overall well-being. A medical professional may also work with you to give you a better understanding of medications and available treatments. Yoga can improve the quality of life in patients with COPD. There is some research to suggest that yoga may increase a person’s lung function and exercise capacity. How long these benefits can last is unknown. Breathing exercises appear to be safe for people with COPD. Yoga breathing, pursed lip breathing, and diaphragmatic breathing have been shown to improve the distance walked by patients, though this can vary from person to person with COPD. People with COPD who practice mindfulness may see an improvement in quality of life and reduction in stress. Mind-body interventions can reduce anxiety and depression and can improve fatigue in those with COPD. You should always talk with your doctor before you start any alternative or complementary therapies. Unfortunately, there is currently no direct cure for emphysema once the lung damage is done. Research is ongoing to hopefully get closer to a cure, which may include stem cell research. However, your doctor may recommend an evaluation for a single or double lung transplant, which can improve your ability to breathe and be active. Like any major operation, you should consider the risks and complications, such as organ rejection or needing to take immune-suppressing medications daily. When it comes to medications, most treatments can only manage symptoms or decrease the frequency of COPD flares. If you smoke, quitting is the best thing you can do to help manage your symptoms. Talk to your doctor if you need help quitting smoking. They can provide resources that will help you quit.
Medically reviewed by Stacy Sampson, D.O. — Written by Robin Madell — Updated on September 8, 2017
What is emphysema? Smoking is the most common cause of a serious lung condition called emphysema. With emphysema, the air sacs (alveoli) weaken and lose their ability to contract after expanding. Air can also get trapped in these sacs, causing some to break. This can make breathing difficult and ultimately decrease the amount of oxygen you get into your blood stream. Emphysema typically occurs slowly in stages, usually due to years of smoking cigarettes or other types of tobacco. Smoking causes 80 percent of all emphysema. Other causes include:
People over 40 years old, or people who smoked for long periods, are at higher risk for this condition. Once developed, emphysema can’t be reversed. If you have emphysema, your doctor will likely diagnose the condition as chronic obstructive pulmonary disease (COPD). This is an umbrella term for lung diseases that get worse over time. They tend to cause increased breathlessness due to the combination of chronic bronchitis, emphysema, and obstructed lung airways. While COPD isn’t exactly the same, people who have emphysema are also more likely to have other lung diseases such as bronchitis, asthma, and lung cancer. It’s common for most people to not feel the symptoms of emphysema until there’s 50 percent or more damage to the lung tissue. Early symptoms may appear gradually as shortness of breath and on-going fatigue. Sometimes they may only affect your body when you’re physically active. But as the condition progresses, you may see an increase in:
Eventually the feeling that you aren’t getting enough air may will also occur when you’re resting. Other symptoms that may also appear due to strained breathing include a poor appetite and weight loss. Your doctor will determine your stage by looking at your symptoms and the results of your breathing tests. If left untreated, emphysema can develop into serious complications, such as: Holes in lungs (giant bullae): These large holes make it difficult for your lung to expand. They can also get infected and may lead to a collapsed lung. Collapsed lung: This is a life-threatening conditionfor people with emphysema because their lungs are already damaged. Heart problems: Emphysema often increases pressure in the arteries connecting your lungs to your heart. This can cause an area of your heart to expand and then weaken. The outlook for people with emphysema depends on the severity of the condition and how early they start treatment. The earlier you start your treatment, the better your outcome. Lung damage from emphysema is irreversible. But you can slow the progression and improve your quality of life. The prediction of life expectancy in COPD is correlated with your symptoms and the results of one of the PFT parameters, the FEV1. This is also known as your forced expiratory volume of air within the first second of forcefully breathing out (performed right after breathing in as much air in as possible). You can also use this calculator to get an estimate of your survival rates. People who stop smoking and take steps to protect their lungs from further damage usually have a longer life expectancy. Talk to your doctor about your outlook. Everyone’s outlook depends on the severity of their stage, treatment, and what steps they take to manage their condition. There’s no cure for emphysema. Current treatments aim to slow the progression of the disease and reduce symptoms. Your doctor will recommend a treatment based on the severity and stage of your condition. The first line of treatment is to stop smoking, if you haven’t yet. MedicationsYour doctor may prescribe medication, such as:
Your doctor may also recommend therapies to improve breathing and relieve symptoms. These include pulmonary rehabilitation where you’ll learn various breathing exercises. For people who need extra oxygen, your doctor may prescribe oxygen therapy. You will use a nasal cannula device or wear a facemask to breathe oxygen through a machine. TherapiesYou may also need nutrition therapy if you have other conditions such as obesity that interferes with your health and contribute to breathlessness. For more severe cases that affect younger adults without additional complications, your doctor may recommend surgery to remove damaged lung tissue or a lung transplant. Read more: Understanding emphysema treatments » Clinical trialsResearchers who are studying emphysema are actively looking for participants. These trials range from evaluating current treatments to new management options for people with severe emphysema. If you’re interested in participating in a clinical trial, visit CenterWatch.com. Make a doctor’s appointment if you have shortness of breath that lasts for several months and doesn’t improve. Especially if breathlessness interferes with your daily activities. See a doctor even if your symptoms worsen, even if you already received a diagnosis. The Mayo Clinic recommends seeking medical attention if you experience:
Over 11 million people in the United States have COPD, according to the American Lung Association. Of those people, three million people have emphysema, according to the Cleveland Clinic. Once you’ve developed emphysema, the damage is irreversible. The first step you can take to manage your health is to stop smoking, if you smoke. You can also wear a mask to avoid secondhand smoking or inhaling dust and chemical fumes. Following these steps can help prevent emphysema complications from occurring. You can also talk to your family, friends, or a counselor to relieve stress that may come with this condition. You may want to consider joining a support group for people with emphysema or lung diseases. This can be a good way to express your feelings, find out about new treatments, and coping strategies. Contact your local chapter of the American Lung Association to find a support group near you. Read more: What happens when you quit smoking? » Last medically reviewed on November 29, 2016 |
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