Emphysema is a problem with the tiny air sacs of the lungs. These sacs should stretch to fill with air and get smaller as air moves out of the lungs. Emphysema is when the air sacs are damaged. It makes it hard to breathe.
Emphysema is a type of chronic obstructive pulmonary disease (COPD).
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Damage to the air sacs may be caused by:
- Breathing toxins or other irritants
- Alpha1-antitrypsin deficiency (A1AD)—a genetic problem that can cause emphysema at an early age
Emphysema is more common in people over 40 years old. Other things that may raise your risk are:
- Being around smoke
- Exposure to irritants at work
- Having alpha-1 antitrypsin deficiency
- Indoor air pollution
Early symptoms include:
- Problems breathing
- Coughing up mucus
Later symptoms may be:
- Breathing that worsens
- A choking feeling when you are lying flat
- Problems concentrating
- An enlarged chest
- Coughing up bloody mucus
- Weight loss
You will be asked about your symptoms and health history. A physical exam will be done.
Your doctor will need to test how how well your lungs are working. This may be done with:
- Pulmonary function tests, called spirometry—to test the force of your breath
- Arterial blood gas test—to test oxygen and carbon dioxide levels in the blood
Your doctor may also need to look at pictures of your lungs. This may be done with:
There is no cure. Your doctor will focus on helping you manage symptoms and improve your quality of life.
Treatment may be:
Quitting smoking slows the disease. It is a critical part of treatment. There are many things that can help:
- Behavior change programs
- Both behavior programs and medicines
Breathe Clean Air
Limit the number of irritants in the air you breathe. Avoid smoke, dust, smog, extreme heat or cold, and high altitudes.
These medicines may be used:
- Bronchodilators to open and relax airways
- Corticosteroids to ease swelling
- Antibiotics to treat lung infections
Some medicines may be taken as pills or liquids. Others are inhaled medicines that are delivered directly to the lungs.
Oxygen therapy may be helpful if the oxygen levels in your blood are too low. It can help you breathe and improve your level of energy. You may only need it for specific activities or it may be given throughout the day.
Special exercises can strengthen chest muscles. This can make it easier to breathe.
Regular physical activity can improve how your body uses oxygen. It can reduce workload on your lungs.
Breathing and Coughing Methods
Special methods of breathing can help bring more air into the lungs. They can also help force trapped air out of the lungs. Coughing methods can also help clear mucus. Ask your doctor if these methods can help you. Some examples include:
- Pursed lip breathing
- Controlled coughing
Excess weight causes the lungs and heart to work harder, which they are already doing because of emphysema. For some people, the extra work of breathing can make eating enough food difficult. This can result in weight loss. A dietitian may be needed to help with weight management.
Emphysema can be stressful. Therapists, support groups, and family members and friends can provide support. Relaxation methods can also help.
A small number of people may benefit from surgery. Part of the lung may be removed. This will let healthier areas open.
A lung transplant may be an option. A healthy, donor lung will be placed. It will require lifelong medicine.
To prevent emphysema:
- If you smoke, talk to your doctor about how to quit
- Avoid exposure to secondhand smoke
- Avoid exposure to air pollution or irritants
- Wear protective gear if you are around irritants or toxins on the job
American College of Chest Physicians
American Lung Association
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COPD. National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/copd. Accessed August 28, 2018.
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Last reviewed May 2018 by EBSCO Medical Review Board Daniel A. Ostrovsky, MD Last Updated: 5/10/2019