Emphysema is a lung disease that results from damage to the walls of the alveoli in your lungs. A blockage (obstruction) may develop, which traps air inside your lungs. If you have too much air trapped in your lungs, your chest may appear fuller or have a barrel-chested appearance. With fewer alveoli, less oxygen moves into your bloodstream.
Alveoli are small, thin-walled, fragile air sacs arranged in clusters at the end of the bronchial tubes (airways) deep inside your lungs. In a typical set of lungs, there are about 300 million alveoli. As you breathe in air (inhale), the air travels through the bronchial tubes until it reaches the alveoli. Once the air gets there, the alveoli stretch, draw in oxygen and transport oxygen to your blood. As you breathe out air (exhale), your alveoli shrink and force carbon dioxide out of your body.
Think of your lungs as bubble wrap. The alveoli are like individual bubbles in bubble wrap. If you have emphysema, your alveoli eventually break. Instead of many tiny bubble wrap bubbles, you develop a large air pocket, like a big shipping air pillow. This damage causes your lungs’ overall surface area to shrink, and it makes it hard to get fresh air in and out of your lungs. This makes your breathing difficult and makes you short of breath.
Emphysema usually develops after many years of smoking. However, emphysema has other causes. These include:
Many people don’t notice emphysema symptoms until the disease has destroyed 50% or more of their lung tissue. Until then, the first signs include gradual shortness of breath and tiredness (fatigue).
Other emphysema symptoms include:
Long-term coughing (smoker’s cough).
Wheezing.
Shortness of breath, especially during light exercise like climbing steps.
Constant feeling of not being able to get enough air.
If you have emphysema, you also have an increased risk of pneumonia, bronchitis and other lung infections.
What is the main cause of emphysema?
Smoking is the main cause of emphysema.
Cigarette smoke destroys your lung tissue, and it also irritates your airways. Cigarette smoke causes inflammation and damages your cilia. Irritation and damaged cilia cause swollen airways, mucus production and difficulty clearing your airways. All of these changes can cause shortness of breath.
Though smoking is the main cause of emphysema, there are other causes. These include:
No, emphysema isn’t contagious. If you have emphysema, you can’t give it to another person.
Can your lungs heal from emphysema?
No, your lungs can’t heal from emphysema. However, treatments can help reduce your symptoms and improve your quality of life. Other interventions can help prevent further damage from occurring.
How is emphysema treated?
Emphysema can worsen over time, so treatment focuses on slowing emphysema down and maximizing the function of your remaining healthy lung. The type of treatment depends on the severity of your emphysema.
Treatment options may include:
Quitting smoking. If you smoke, the best way to slow down emphysema is to quit. It’s the most important step you can take to protect your lungs. You and your healthcare provider can work together to find the best, most effective methods to quit smoking.
Bronchodilators. These medicines relax the muscles around your airways. When these muscles relax, more air comes in and out of your lungs. They’re faster and more effective than oral medications. Bronchodilators also help treat asthma and other lung conditions.
Inhaled corticosteroids. Inhaled corticosteroids reduce swelling in your airways and mucus production. You may have to take inhaled corticosteroids every day to help prevent emphysema symptoms.
Oral corticosteroids. A provider often prescribes short courses of oral corticosteroids when you’re having an exacerbation or “flare” of your emphysema.
Antibiotics. Antibiotics help treat bacterial infections, including pneumonia, bronchitis and other lung infections.
Anti-inflammatory medications. Anti-inflammatories reduce inflammation in your airways.
Oxygen therapy. If your lungs aren’t getting enough oxygen to your blood (hypoxemia), oxygen therapy can help. A machine will deliver more oxygen to you through a nasal catheter or a facemask. A nasal catheter (nasal cannula) is a flexible tube that your healthcare provider will clip to your nose.
Lung volume reduction surgery (LVRS). During LVRS, your healthcare provider removes a portion of your diseased lung tissue and joins the remaining tissue together. Removing the damaged tissue may relieve pressure on your breathing muscles and help improve your lungs’ ability to stretch. LVRS results are usually promising. However, not all people with emphysema are candidates for this surgery.
Bronchoscopic lung volume reduction. During bronchoscopic lung volume reduction, a provider places a one-way valve into your airways. The valve allows air to leave those sections of your lungs, but not enter. This helps decrease the amount of “trapped” air that’s in your lungs and makes it easier to breathe. Not all people with emphysema are candidates for this procedure.
Lung transplant. If you have severe emphysema and your lungs don’t respond to other treatment options, a lung transplant replaces your damaged lungs with a donor’s healthy lungs.
What tests will be done to diagnose emphysema?
Your healthcare provider may order the following tests to diagnose emphysema:
Chest X-ray. Your healthcare provider will take X-rays of your chest to look at your lungs. They’ll compare your lungs to X-rays of healthy lungs. X-rays are usually not helpful in detecting the early stages of emphysema. They’re more useful in diagnosing moderate or severe emphysema.
CT scan. A CT scan creates a 3D image of your lungs. It provides more detailed images than an X-ray.
Pulmonary function testing. Pulmonary function tests measure how well your lungs inhale and exhale air. Testing may include spirometry. Spirometry uses a spirometer machine to measure the flow of air through your lungs. It also estimates the amount of air in your lungs.
Arterial blood gas (ABG). An ABG measures the amount of oxygen and carbon dioxide in the blood from an artery (arterial blood). An artery is a tube that carries blood away from your heart. Your healthcare provider may order an ABG if your emphysema gets worse. It can help determine if you need extra oxygen.
Electrocardiogram (EKG). An EKG checks your heart function. Your healthcare provider may order an EKG to rule out heart disease as a cause of shortness of breath.
Blood tests and genetic tests. Your healthcare provider may order blood tests and genetic tests to confirm alpha-1 antitrypsin deficiency as a cause of emphysema.