Emphysema

Emphysema begins as a stealthy disease with few or no symptoms, gradually blocking air flow in and out of your lungs as it progresses. The lack of adequate air flow damages your lungs’ ability to absorb the oxygen your body needs.

If you're showing emphysema signs and symptoms, you can trust your Advocate Health Care team to provide the most up to date treatments related to the condition.

What is emphysema?

Emphysema and chronic bronchitis are the primary diseases that make up chronic obstructive pulmonary disease (COPD). Many people with COPD have both chronic bronchitis and emphysema.

To understand the lung damage caused by emphysema, you need to understand how the lungs function.

When you breathe in, the air goes into your lungs by traveling through bronchial tubes, into bronchioles (smaller tubes) and finally into tiny alveoli (air sacs). In the air sacs, tiny blood vessels absorb oxygen and release carbon dioxide. When you breathe out, the carbon dioxide is removed from your body.

In pulmonary emphysema, those air sacs lose their shape, or their walls are damaged. Eventually, you have fewer or larger air sacs instead of many tiny ones.

When you have pulmonary emphysema and develop larger air sacs, air gets trapped inside them and takes up room in your lungs. At the same time, there are fewer small air sacs to handle oxygen and carbon dioxide. These two things block the lungs’ ability to absorb oxygen. You’ll start to experience symptoms of pulmonary emphysema such as shortness of breath or other breathing difficulties.

Causes of emphysema

Research shows that smoking is the main cause of emphysema. It can also be caused by heavy exposure to other things that irritate the lungs such as secondhand smoke, chemical fumes, air pollution and dust from some kinds of manufacturing.

People with a rare condition called alpha one antitrypsin deficiency (AATD) may develop emphysema, but they make up a small percentage of total cases.

Who gets emphysema?

White males are slightly more likely to have emphysema than White females and African Americans of all genders. Having a family history of chronic obstructive pulmonary disease (COPD) or being older than 40 increases your risk of getting emphysema.

People who have coal worker pneumoconiosis have more severe emphysema than other groups regardless of whether they ever smoked.

Emphysema symptoms

When emphysema starts developing, you may not notice any symptoms.

When it gets worse, it causes other symptoms such as:

• Frequent coughing or wheezing
• Coughing that produces a lot of mucus
• Shortness of breath, especially with physical activity
• Whistling or squeaky sound when you breathe
• Tightness in your chest

When the disease becomes severe, emphysema symptoms may include:

• Weight loss
• Weakness in your lower muscles
• Swelling in your feet, ankles or legs

Talk to your doctor if you have some of these potential emphysema symptoms, particularly if you’ve been chronically exposed to things that irritate the lungs.

Emphysema complications

Emphysema can be life threatening and there is no known cure. It can lead to many complications involving breathing and oxygen, including:

• Pneumonia
• Air trapped in areas besides the lungs
• Enlarged right ventricle (lower section) of the heart
• Repeating respiratory tract infections
• Accumulation of carbon dioxide
• Body doesn’t get enough oxygen
• Coma

Living with emphysema also makes you more at risk for other diseases such as lung cancer. You may also be more prone to bacterial and viral infections like pertussis, the flu, RSV and COVID.

Call your health care provider if your symptoms get worse or you have signs of an infection, such as a fever. Seek emergency care if you have severe trouble with talking or catching your breath.

Diagnosis of emphysema

To reach an accurate diagnosis, your doctor will perform a physical exam and talk to you about your symptoms and medical history. They’ll consider the results of a variety of tests to determine the condition of your lungs. Some of those tests are:

• X-ray: Rules out other potential causes for your symptoms and shows changes in your lungs associated with emphysema.
• Spirometry: Measures the amount and speed of the air you blow out.
• Arterial blood gas test (oximetry): Measures oxygen in your blood.
• Blood test for alpha one antitrypsin deficiency (AATD): Tests for a rare condition that may cause emphysema.
• CT scan: Shows whether you have chronic bronchitis or emphysema.

Treatment for emphysema

Emphysema is a serious lung disease that slowly destroys lung tissue and makes it hard to breathe. Since there is no cure, treatments for emphysema manage symptoms to preserve quality of life as much as possible..

Medications for emphysema

Medications like bronchodilators relax muscles related to breathing which helps you breathe more freely. Anti-inflammatory medications may be added to help reduce swelling, inflammation and mucus production. If you develop an infection, you may receive antibiotics or steroids to control your symptoms.

Your doctor will talk to you about getting vaccinations to protect you from bacterial and viral diseases that may make your COPD worse or be life-threatening. They may recommend being vaccinated against pneumonia, pertussis, shingles, COVID, RSV or the flu. Asking your family and friends to get these vaccines will help protect you.

Oxygen therapy

Some people may benefit from oxygen therapy, which supplies enough oxygen for their bodies to function well. It may help them be less short of breath, feel less fatigued, sleep better and be more active. Several different methods of oxygen therapy are available. Talk to your doctor about whether oxygen therapy might be right for you and which type would work best.

Your Advocate team may also suggest supportive therapies such as pulmonary rehabilitation, which may include exercise programs, disease management training, nutritional counseling and psychological counseling.

Surgery for emphysema

Surgery may be recommended in some situations to remove damaged lung tissue or remove large air spaces that can form when air sacs are destroyed. Such surgeries will be done in a minimally invasive way when possible. In extreme cases, a lung transplant may be suggested.

Lifestyle habits for emphysema

Since having emphysema makes you more at risk for other diseases, it’s vital to do what you can to protect yourself.

Eating nutritious meals

When you have COPD, your muscles may require 10 times more calories than they used to. Consuming fewer carbohydrates and more healthy fats may help you breathe easier and have enough energy. Working with a nutritionist will help you plan to eat well with COPD.

Maintaining physical activity

Moderate exercise improves how your body uses oxygen, energy levels, sleep quality, muscle strength, fitness and shortness of breath. Work with a physical therapist or personal trainer to plan your exercise routine.

Avoiding lung irritants

Avoid secondhand smoke, strong fragrances and fumes from chemicals. Check the pollen count and air quality index before leaving home. Use air conditioning when it’s hot. When you’re outside in cold or windy weather wear a scarf around your mouth and nose.

Wash your hands frequently, avoid people who are sick and consider wearing a mask when you’ll be around large groups of people.

Managing your emotions

People who have COPD – or any serious disease – often have depression or anxiety about their disease. Depression can make it hard to stay active, follow your treatment plan and enjoy life. Anxiety can change your breathing pattern and contribute to more shortness of breath. Use some of the following techniques to manage depression, anxiety and stress:

• Use relaxation techniques like meditation and deep breathing exercises
• See friends, stay active and get outside
• Ask for help from family members, friends or health care providers
• Find a support group where you can connect with others who have COPD either online or in person