Medical Guides - Emphysema

What Is Emphysema?
Emphysema is a condition in which there is over-inflation of structures in the lungs known as alveoli or air sacs. This over-inflation results from a breakdown of the walls of the alveoli, which causes an abnormal change in the way the lungs work; and often this manifests as breathlessness.

Symptoms
Early symptoms of emphysema include shortness of breath and cough.

Causes Of Emphysema
The lung has a system of elastic fibers. The fibers allow the lungs to expand and contract. It is known from scientific research that the normal lung has a remarkable balance between two classes of chemicals with opposing action. When the chemical balance is altered, the lungs lose the ability to protect themselves against the destruction of these elastic fibers. This is what happens in emphysema. There are a number of reasons this chemical imbalance occurs. Smoking is responsible for 82 percent of chronic lung disease, including emphysema. Exposure to air pollution is one suspected cause. Irritating fumes and dusts on the job also are thought to be a factor.

A small number of people with emphysema have a rare inherited form of the disease called alpha 1-antitrypsin (AAT) deficiency-related emphysema, or early onset emphysema. This form of disease is caused by an inherited lack of a protective protein called alpha 1-antitrypsin (AAT).

How Does Emphysema Develop?
Emphysema begins with the destruction of air sacs (alveoli) in the lungs where oxygen from the air is exchanged for carbon dioxide in the blood. The walls of the air sacs are thin and fragile. Damage to the air sacs is irreversible and results in permanent "holes" in the tissues of the lower lungs.

As air sacs are destroyed, the lungs are able to transfer less and less oxygen to the bloodstream, causing shortness of breath. The lungs also lose their elasticity. The patient experiences great difficulty exhaling.

Emphysema doesn't develop suddenly, it comes on very gradually. Years of exposure to the irritation of cigarette smoke usually precede the development of emphysema.

A person may initially visit the doctor because he or she has begun to feel short of breath during activity or exercise. As the disease progresses, a brief walk can be enough to bring on difficulty in breathing. Some people may have had chronic bronchitis before developing emphysema.

Treatment For Emphysema
Unfortunately, once the alveoli have become damaged and overinflation occurs, the damage is permanent. The treatment of emphysema is to reduce risk factors thereby preventing further damage and paliative measures to reduce the discomfort of the symptoms.

Common treatment advice:

Quitting smoking - the single most important factor for maintaining healthy lungs.
Bronchodilator drugs (prescription drugs that relax and open air passages in the lungs): may be prescribed to treat emphysema if there is a tendency toward airway constriction or tightening. These drugs may be inhaled as aerosol sprays or taken orally.
Antibiotics - if you have a bacterial infection, such as pneumococcal pneumonia.
Exercise - including breathing exercises to strengthen the muscles used in breathing as part of a pulmonary rehabilitation program to condition the rest of the body.
Treatment - with Alpha 1-Proteinase Inhibitor (A1PI) only if a person has AAT deficiency-related emphysema. A1PI is not recommended for those who develop emphysema as a result of cigarette smoking or other environmental factors.
Lung transplantation - most recent reports have been encouraging and the success rate continues to increase.
Lung reduction surgery - this new technique shows promise.

How Do I Reduce My Risk of Getting Emphysema
If an individual has emphysema, the doctor will work hard<

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