Dying to get enough air? Emphysema explained

Emphysema is a lung condition where the air sacs are damaged, leading to shortness of breath.

The damage happens to the inner walls of the air sacs causing them to weaken and rupture, creating larger air spaces instead of many small ones.

This reduces the surface area of the lungs and, in turn, the amount of oxygen that reaches the bloodstream. Many people who also have emphysema also have chronic bronchitis.

This is inflammation of the tubes that carry air to the lungs (bronchial tubes), which leads to a persistent cough.

Smoking is the leading cause of emphysema. When it worsens, emphysema eventually causes shortness of breath even while at rest.

If one has had unexplained shortness of breath for several months, especially if it’s getting worse or is interfering with daily activities please seek urgent medical attention.

One can have emphysema for many years without noticing any signs or symptoms.

To prevent emphysema, don’t smoke and avoid breathing secondhand smoke. Wear a mask to protect the lungs if you work with chemical fumes or dust.

Causes

The main cause of emphysema is long-term exposure to airborne irritants, including:

• Tobacco smoke
• Marijuana smoke
• Air pollution
• Chemical fumes and dust
• Rarely, emphysema is caused by an inherited deficiency of a protein that protects the elastic structures in the lungs. It’s called alpha-1-antitrypsin deficiency emphysema.

Risk factors

• Smoking – The risk for all types of smokers increases with the number of years and amount of tobacco smoked.
• Age – Most people with tobacco-related emphysema begin to experience symptoms of the disease between the ages of 40 and 60.
• Exposure to secondhand smoke – Being around secondhand smoke increases the risk of emphysema.
• Occupational exposure to fumes or dust – If one breathes fumes from certain chemicals , dust from grain, cotton, wood or mining products, one is more likely to develop emphysema. This risk is even greater if you smoke.
• Exposure to indoor and outdoor pollution – Breathing indoor pollutants, such as fumes from heating fuel, as well as outdoor pollutants – car exhaust, for instance – increases the risk of emphysema.

Complications

Collapsed lung (pneumothorax) – A collapsed lung is life-threatening because the function of the lungs is already so compromised by the emphysema.

Heart problems – Emphysema can increase the pressure in the arteries that connect the heart and lungs. This can cause a condition called corpulmonale, in which a section of the heart expands and weakens.

Large holes in the lungs (bullae) – Some people with emphysema develop empty spaces in the lungs called bullae.

They can be as large as half the lung. In addition to reducing the amount of space available for the lung to expand, giant bullae can increase the risk of pneumothorax.

Diagnosis

The doctor will take a full history and do a medical examination. A lung function test (spirometer) can be done to check the capacity of the lungs.

A chest X-ray is very important to rule out other causes of shortness of breath. But the chest X-ray can also show normal findings if one has emphysema.

Computerised tomography scans can be useful for detecting and diagnosing emphysema. Blood tests can also be taken to check the amount of oxygen in the arteries.

Treatment

Emphysema cannot be cured, but there are medications that can help relieve symptoms and slow the progression of the disease.

Depending on the severity of the symptoms, a doctor might suggest:

Bronchodilators – These drugs can help relieve coughing, shortness of breath and breathing problems by relaxing constricted airways.

Inhaled steroids – Corticosteroid drugs inhaled as aerosol sprays reduce inflammation and may help relieve shortness of breath.

Antibiotics – If one has a bacterial infection, like acute bronchitis or pneumonia, antibiotics are appropriate.

A pulmonary rehabilitation programme can teach breathing exercises and techniques may help reduce breathlessness and improve the ability to exercise.

If one has have severe emphysema with low blood oxygen levels, using oxygen regularly at home and during exercise may provide some relief.

Many people use oxygen 24 hours a day. It’s usually administered via narrow tubing that fits into the nostrils. As a last resort, surgery might be needed if there is no improvement. For example lung transplant.

Lifestyle and home remedies

Stop smoking – This is the most important measure for overall health and the only one that might halt the progression of emphysema.

As much as possible, avoid secondhand smoke. Avoid other respiratory irritants.

These include fumes from paint and automobile exhaust, some cooking odours, certain perfumes, even burning candles and incense. Change furnace and air conditioner filters regularly to limit pollutants.

Exercise regularly – This can significantly increase lung capacity.

Protect oneself from cold air – Cold air can cause spasms of the bronchial passages, making it even more difficult to breathe.

During cold weather, wear a soft scarf over the mouth and nose before going outside, to warm the air entering the lungs.

Get recommended vaccinations. Be sure to get an annual flu shot and pneumonia vaccinations as advised by a doctor.

Prevent respiratory infections – Avoid direct contact with people who have a cold or the flu. When mingling with large groups of people during cold and flu season, wear a face mask, wash and sanitise hands frequently.