Emphysema

Causes

Damage to the air sacs may be caused by:

• Smoking
• Breathing toxins or other irritants
• Alpha1-antitrypsin deficiency (A1AD)—a genetic problem that can cause emphysema at an early age

Risk Factors

Emphysema is more common in people over 40 years old. Other things that may raise the risk are:

• Smoking
• Being around smoke
• Exposure to irritants at work
• Having alpha-1 antitrypsin deficiency
• Indoor air pollution

Symptoms

Early symptoms include:

• Problems breathing
• Coughing
• Coughing up mucus

Later symptoms may be:

• Breathing problems that worsen
• A choking feeling when lying flat
• Tiredness
• Problems focusing
• An enlarged chest
• Coughing up bloody mucus
• Weight loss

Diagnosis

The doctor will ask about symptoms and past health. A physical exam will be done.

The doctor will want to test how well the lungs are working. This may be done with:

• Pulmonary function tests, such as spirometry—to test the force of a person's breath
• Arterial blood gas test—to test oxygen and carbon dioxide levels in the blood

Images may be taken of the lungs to confirm the diagnosis. They may include:

• Chest x-ray
• CT scan

Treatment

There is no cure. The doctor will focus on helping the person manage symptoms and improve quality of life.

Treatment may include:

• Quitting smoking—to slow the disease
• Avoiding lung irritants, such as smoke, dust, smog, extreme heat or cold, and high altitudes
• Medicines taken by mouth or inhaled, such as:
• Bronchodilators to open and relax airways
• Corticosteroids to ease swelling
• Antibiotics to treat lung infections
• Vaccines for illnesses that can make breathing worse, such as:
• Flu
• Pneumonia
• COVID-19

Oxygen therapy may help if oxygen levels in the blood are too low. It can help the person breathe and improve energy levels. It may only be needed for certain activities or it may be given throughout the day.

Other treatments may include:

• Exercises to strengthen chest muscles and make it easier to breathe
• Regular physical activity
• Breathing and coughing methods—to improve breathing and help clear mucus
• Weight management, which may include:
• Weight loss—to help improve breathing if a person has excess weight
• Weight gain—if a person has lost too much weight from breathing problems
• Counseling and relaxation methods—to help the person cope with the stress of emphysema

A small number of people may benefit from surgery. Part of the lung may be removed. This will let healthier areas open.

Alung transplant may be an option. A healthy, donor lung will be placed. It will require lifelong medicine.

Prevention

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