Symptoms and treatment of Emphysema

Description

Emphysema is a long-term of the lungs that causes difficulty breathing. Over time, the condition of the damage of the thin walls of the air sacs in the lungs, called alveoli. In healthy lungs, these bags are stretched and filled with air when you breathe. The elastic of the bags of help that the air leave when you exhale. But when the air bags are damaged in emphysema, it is difficult to get the air out of your lungs. This leaves no room for fresh, oxygen-rich air to enter the lungs.

The symptoms of emphysema include shortness of breath, especially with activity, and a sound of wheezing when breathing out. How serious is the condition may vary.

Smoking is the main cause of emphysema. The treatment can help with symptoms and may slow down how quickly the disease gets worse. But can't reverse the damage.

Symptoms

You may have emphysema for many years without noticing any symptoms. They usually begin gradually and are:

Shortness of breath, especially with physical activity. This is the main symptom of emphysema.
Wheezing, whistling or squeaky sound when you breathe out.
Cough.
Tightness in the chest or a feeling of heaviness.
Feeling very tired.
Weight loss and swelling of the ankles, which can occur as the condition gets worse with time.

You can begin to avoid activities that cause you to be of short duration, so that the symptoms do not become a problem until that prevent you from doing your daily tasks. Emphysema, finally, causes difficulty breathing, even while you are resting.

Emphysema is one of the two most common types of chronic obstructive pulmonary disease (COPD). The other common type is chronic bronchitis. In chronic bronchitis, the lining of the tubes that carry air to the lungs, called bronchioles, become irritated and inflamed. This inflammation is limited space for air to move in and out of the lungs and produces more mucus that obstructs the airway. Emphysema and chronic bronchitis often occur together, so that the general term of COPD can be used.

Exacerbations

Even with the ongoing treatment, you may have times when the symptoms get worse over days or weeks. This is called an acute exacerbation (eg-zas-er-bay-shun). It can lead to lung failure if you do not receive timely treatment.

Exacerbations can be caused by a respiratory infection, air pollution or other things that trigger inflammation. Whatever the cause, it is important that you get medical help right away if you notice a continuous worsening of cough and extra mucus, or if you have difficulty breathing.

When to see a doctor

Consult your health care professional if you have had the shortness of breath that can not be explained by several months, especially if it is getting worse, or if it prevents you from doing your daily activities. Do not ignore it or tell yourself it's because you're aging, or out of shape.

Go to the emergency room of a hospital if:

You're having a hard time breathing, or speaking.
Your lips or fingernails turn blue or gray with physical activity.
That others see that you are not mentally alert.

Causes

Emphysema results from the long-term exposure to airborne irritants, including:

Cigarette smoking, which is the most common cause.
Vapors of chemicals, especially in the workplace.
Vapors and dusts, especially in the workplace.

Rarely, emphysema results from a change in the gene hereditary. This change in the gene causes low levels of a protein called alpha-1-antitrypsin (AAT). The AAT is produced in the liver and passes into the bloodstream to help protect the lungs from damage caused by smoke, fumes, and dust. Low levels of AAT, a condition called alpha-1-antitrypsin deficiency, can cause damage to the liver, lung diseases, such as emphysema or both. With AAT deficiency, there is usually a family history of emphysema, and symptoms begin at a younger age.

Risk factors

Lung damage in emphysema develops gradually. In most people with the condition, symptoms begin after the age of 40.

Factors that increase your risk of developing emphysema include:

The habit of smoking. Smoking or have smoked in the past is the greatest risk factor for emphysema. But people who smoke cigarettes, pipes or marijuana are also at risk. The risk for all types of smokers increases with the number of years of smoking and the amount of tobacco smoked.
Being around second-hand smoke. The second-hand smoke is the smoke that is breathed in the other a cigarette, pipe or cigar. Being around second-hand smoke increases the risk of emphysema.
Work exposure to fumes, vapours or dust. If you inhale the smoke or fumes of certain chemicals or dust grain, cotton, timber or mining products, you are more likely to develop emphysema. This risk is even greater if you also smoke.
Exposure to air pollution. The breath of indoor pollutants, such as vapors of fuel for heating, as well as outdoor pollutants, such as pollution and automobile exhaust, increases the risk of emphysema.
Genetics. The rare condition called AAT deficiency increases the risk of emphysema. Other genetic factors can make sure that the smokers most likely to develop emphysema.

Complications

People who have emphysema are more likely to develop:

High blood pressure in the arteries of the lung. Emphysema can cause high blood pressure in the arteries that carry blood to the lungs. This serious condition is called pulmonary hypertension. Pulmonary hypertension can cause the right side of the heart to expand and weaken, a condition called cor pulmonale.
Other heart problems. For reasons that are not fully understood, emphysema may increase your risk of heart disease, including heart attack.
Large air spaces in the lungs. Large air spaces called bullae are formed in the lungs when the inside walls of the alveoli are destroyed. This leaves a large air sac instead of a cluster of many small ones. These bullae can become very large, even as large as half of the lung. The bullae decrease the space available for the lung to expand. In addition, the giant bullae can increase the risk of a collapse of the lung.
Collapse of the lung. A collapsed lung called pneumothorax can be life-threatening in people who have severe emphysema because their lungs are already damaged. This is not common, but it is serious when it happens.
The lung cancer. People with emphysema have a higher risk of getting lung cancer. Smoking increases this risk even more.
The anxiety and depression. Breathing problems can prevent you from doing activities that you enjoy. And have a serious medical condition, such as emphysema can sometimes cause anxiety and depression.

Prevention

To prevent emphysema, or to prevent worsening of the symptoms:

Do not smoke. Talk with your health care professional about options for quitting smoking.
Stay away from second hand smoke.
Use a special mask or the use of other measures to protect your lungs, if you work with toxic gases, vapors or dust.
Avoid exposure to tobacco smoke and air pollution when possible.

Diagnosis

To find out if you have emphysema, your doctor or other health care professional will ask about your medical and family history, smoking, and if you're often around other lung irritant. Your health care professional performs a physical exam that includes listening to your lungs. You may have imaging tests, pulmonary function tests and laboratory tests.

Imaging tests

X-ray of the chest. This test can show some of the changes of the lung caused by emphysema. You can also rule out other causes of your symptoms. But the chest x-ray may not show changes, even if you have emphysema.
Computed tomography (CT scan). A ct scan combines X-ray images taken from different angles to create images of the internal structures of the body. A ct scan gives much more detail of the changes in the lungs of an x-ray of the chest is done. A ct scan of the lungs can show emphysema. It can also help you decide if you can benefit from the surgery. A ct scan can be used to check for lung cancer also.

Pulmonary function tests

Also called pulmonary function tests, pulmonary function tests measure the amount of air you can inhale and exhale, and if your lungs to supply enough oxygen to the blood.

Spirometry is the most common test to diagnose emphysema. During spirometry has to blow into a tube connected to a small machine. This measures the amount of air that the lungs can hold and how quickly you can blow air out of your lungs. Spirometry indicates the amount of air flow is limited.

Other tests include the measurement of lung volumes and diffusion capacity, six-minute walk test, and pulse oximetry.

Pulmonary function tests and imaging tests can show if you have emphysema. And it can also be used to check your condition over time and see how the treatments are working.

Laboratory tests

Blood tests cannot be used to diagnose emphysema, but it can give you more information about your condition, find the cause of your symptoms or to rule out other conditions.

Arterial blood gas analysis. This blood test measures how well your lungs are bringing oxygen into the blood and remove carbon dioxide.
Testing for AAT deficiency. Blood tests can determine if you have the change in the gene hereditary cause of the condition alpha-1-antitrypsin.

Treatment

The treatment is based on severity of symptoms and frequency of exacerbations. Effective therapy can control the symptoms, slow down how quickly the condition worsens, decrease the risk of complications and exacerbations, and help you lead a more active life.

Stop smoking

The most important step in any treatment plan for emphysema is to stop smoking. Quitting smoking can keep the emphysema worse and it is more difficult to breathe. Talk with your healthcare provider about smoking cessation programs, nicotine replacement products and medications that could help.

Medicine

Several types of medications are used to treat the symptoms and complications of emphysema. You can take some medications on a regular basis and others as needed. Most medications for emphysema are given using an inhaler. This small hand-held device, it delivers the medication directly to the lungs when you inhale the fine mist or dust. Talk with your health care professional so that you know the correct way to use the inhaler as prescribed.

Medications may include:

Bronchodilators. Bronchodilators are drugs that usually come in inhalers. Bronchodilators relax the muscles around the airways. This may help to relieve the cough and make breathing easier. Depending on the severity of the emphysema, you may need a short-acting bronchodilator before activities, a long-acting bronchodilator that you use every day, or both.
The inhaled steroids. Inhaled corticosteroids can reduce the inflammation of the airways and help keep the flare-ups that happen. Side effects may include bruising, infections of the mouth and hoarseness. These medications are useful if you often have exacerbations of emphysema.
The combination of inhalers. Some inhalers combine bronchodilators and inhaled steroids. There are also combination inhalers that include more than one type of bronchodilator.
Antibiotics. If you have a bacterial infection, such as acute bronchitis or pneumonia, antibiotics can help.
The oral steroids. For exacerbations, a short course, for example, five days of oral corticosteroids can prevent the symptoms from getting worse. But the long-term use of these medications can have serious side effects, such as weight gain, diabetes, osteoporosis, cataracts and an increased risk of infection.

Lung therapies

Pulmonary rehabilitation. These programs generally combine education, exercise training, nutrition advice and counseling. It works with a variety of specialists that can tailor your rehabilitation program to meet your needs. Pulmonary rehabilitation can help reduce your shortness of breath and allow you to be more active and exercise.
Nutrition therapy. You can benefit from advice on nutrition by working with a dietitian. In the early stages of emphysema, many people who need to lose weight, while people with the last stage of emphysema often need to gain weight.
Oxygen therapy.If you have severe emphysema with low levels of oxygen in the blood, which may need extra oxygen in the home. You can get this extra oxygen to the lungs through a mask or a plastic tube with prongs that fit on your nose. These are attached to an oxygen tank. Lightweight, portable units can help some people to move more. Supplemental oxygen can help your breathing during physical activity helps you sleep better. Many people use oxygen 24 hours a day, even in moments of rest.

Oxygen therapy. If you have severe emphysema with low levels of oxygen in the blood, which may need extra oxygen in the home. You can get this extra oxygen to the lungs through a mask or a plastic tube with prongs that fit on your nose. These are attached to an oxygen tank. Lightweight, portable units can help some people to move more.

Supplemental oxygen can help your breathing during physical activity helps you sleep better. Many people use oxygen 24 hours a day, even in moments of rest.

The management of exacerbations

When exacerbations occur, you may need added medications, such as antibiotics, oral steroids or both. You may also need supplemental oxygen or treatment in the hospital. Once symptoms improve, your healthcare provider may talk with you about what steps to take to help stop the future exacerbations.

Surgery

Depending on the severity of the emphysema, your health care professional may suggest one or more different types of surgery, including:

The surgical reduction of lung volume. In this surgery, the surgeon removes small portions of lung tissue damaged in the upper part of the lungs. This creates an extra space in the chest for the rest of the more healthy lung tissue can expand, and the muscle that aids in breathing may work better. In some people, this type of surgery can make your quality of life better and help you to live a more.
Endoscopic reduction of lung volume. Also called valve surgery endobronchial, this is a minimally invasive procedure for the treatment of people with emphysema. A small one-way endobronchial valve is placed in the lung. The air can come out of the damaged part of the lung through the valve, but not the air that enters. This allows the majority of the damaged lobe of the lung to reduce so that the healthy part of the lung that has more space to expand and function.
Bullectomy. Large air spaces called bullae are formed in the lungs when the inside walls of the alveoli are destroyed. This leaves a large air sac instead of a cluster of many small ones. These bullae can become very large and cause breathing problems. In a bullectomy, the surgeon removes the bullae in the lungs to allow air to circulate.
Lung transplant. A lung transplant may be an option for some people who meet specific criteria. Get a new lung can make breathing easier and to allow for a more active lifestyle. But it is a major surgery, which has serious risks, such as the rejection of organs. To try to keep the organ rejection happens, it is necessary to take the life of the medicine that weakens the immune system.

The alpha-1-antitrypsin

For adults with emphysema associated with AAT deficiency, the treatment options include those used for the people with the most common types of emphysema. Some people can be treated also a replacement for the lack of the protein AAT. This can stop more damage to the lungs.

Lifestyle and home remedies

If you have emphysema, you can take steps to slow down the speed with which it gets worse and to protect against the complications:

Stop smoking. This is the most important step you can take for your health in general. Continuing to smoke can cause more damage to your lungs and worsen emphysema. If you need help to quit smoking, join a smoking cessation program or to speak with your healthcare provider about ways to quit smoking. As much as possible, avoid second-hand smoke. The second-hand smoke can add to lung damage.
To avoid the triggers.These include paint fumes and car exhaust, some cooking odors, certain perfumes, and even the burning of candles and the incense. Change furnace and air conditioning filters regularly to limit the pollutants. Get your home checked for radon. The pollution of the air also can irritate the lungs, so check the daily air quality forecasts before you leave. Find out what you can trigger exacerbations for you and to avoid them as much as possible.
Control the breathing. Talk with your health care professional or respiratory therapist about techniques for managing your breathing is easier breathing throughout the day. We also talk about the positions that make it easier to breath, ways to save your energy, such as sitting for the tasks where possible, and the relaxation of the strategies to use when you have trouble breathing.
Get regular physical activity. It may seem difficult to be physically active when you have trouble breathing. But the physical activity and exercise can help your overall strength, how long can you be active, and the muscles used for breathing. Ask your health care professional activities that are best for you.
Eat healthy foods. Eating healthy foods can help maintain your strength. If you're underweight, your health care professional may recommend nutritional supplements. If you are overweight, losing weight can be of great help to breathe, especially during activities.
Consult your health care professional regularly. Stay with your scheduling appointments, even if you feel well. It is important to regularly monitor the function of their lungs. Call your health care professional if your symptoms get worse or if you notice symptoms of infection.
Prevent respiratory infections.Do your best to stay away from people who have a cold or the flu. If you should be with large groups of people during the cold and flu season, a facial mask. Also wash your hands frequently and carry a small bottle of alcohol-based hand sanitizer for use when needed. And be sure to get your annual flu vaccine in the fall to help prevent infections that can worsen your emphysema. Ask if you need the pneumococcal vaccine, COVID-19 vaccines and other vaccines.
Protect yourself from the cold air. The cold air can cause spasms of the airways, which makes it even more difficult to breathe. During the cold weather, use a soft cloth scarf or a cold air of the mask is available in a pharmacy — on their mouth and nose before leaving. This can warm the air that goes into your lungs.

To avoid the triggers. These include paint fumes and car exhaust, some cooking odors, certain perfumes, and even the burning of candles and the incense. Change furnace and air conditioning filters regularly to limit the pollutants. Get your home checked for radon.

The pollution of the air also can irritate the lungs, so check the daily air quality forecasts before you leave. Find out what you can trigger exacerbations for you and to avoid them as much as possible.

Prevent respiratory infections. Do your best to stay away from people who have a cold or the flu. If you should be with large groups of people during the cold and flu season, a facial mask. Also wash your hands frequently and carry a small bottle of alcohol-based hand sanitizer for use when needed.

And be sure to get your annual flu vaccine in the fall to help prevent infections that can worsen your emphysema. Ask if you need the pneumococcal vaccine, COVID-19 vaccines and other vaccines.

Coping and support

Difficulty breathing may limit your ability to perform daily activities. You may have to forego some of the activities you used to enjoy. Your family and your friends find they need to adjust some of these changes as well. Here are some suggestions that may help:

Express your feelings. If you and your family can talk openly about the needs of the other, you will be better able to comply with the differences that living with emphysema may cause.
Consider a support group. Think about joining a support group for people with emphysema. Support groups are not for everyone, but they can be a good source of information and coping strategies. And it can be encouraging to spend time with other people who have the same experiences. Talk with your health care professional or verification of the American Lung Association of the web page for local and online support groups.
Get help when needed. Be alert to changes in your mood and your relationships with others, and don't be afraid to ask for help. Talk with your health care professional or a mental health professional, if necessary. You may benefit from counseling or medication if you feel overwhelmed or depressed.

Preparing for your appointment

If your primary healthcare professional thinks that you may have emphysema, probably refers to a doctor who specializes in diseases of the lungs is called a pulmonologist.

What you can do

You might want to take a friend or family member with you to your appointment. Someone who goes with you can help you remember the information. Take notes if that helps.

Before your appointment, make a list of the following information:

The symptoms and when they started. Include anything that makes your symptoms worse or better.
All the drugs, vitamins, herbs and supplements that you take. Include the dose.
The history of the family, as if someone in your family has emphysema, or COPD.
The treatment that you have had for emphysema, if any. Include what the treatment was and if it helped.
Other medical conditions you may have, and their treatments.
If you smoke or have ever smoked. If you are regularly around people who smoke.
Any jobs that were around chemical fumes or vapors of industrial dust.
Questions to ask your health care professional.

Questions may include:

What is likely causing my symptoms?
What kinds of tests do I need?
What treatment do you recommend it?
I have other health conditions. How is emphysema affect them?
Are there any restrictions that I need to follow?

Feel free to ask questions.

What to expect from your doctor

Your health care professional may ask you questions, such as:

Do you have difficulty breathing with ease?
Is there shortness of breath, or prevent you from doing your daily tasks?
When did you first notice the shortness of breath?
Do you cough, every day? If so, when did that start?
If you smoke, have you tried to quit smoking? Would you like help to stop smoking?
Does anyone in your family suffer from emphysema or COPD?
Have you ever noticed the nails, or lips turning blue?
Have you recently gained or lost weight?

Be prepared to answer questions that you have time to talk about what's most important to you.