Emphysema is a type of chronic obstructive pulmonary disease (COPD). In this condition, the air sacs in the lungs become damaged and stretched. This results in a chronic cough and difficulty breathing.
The key symptoms of emphysema include:
Shortness of breath, or dyspnea
A chronic cough that produces mucus
Wheezing and a whistling or squeaky sound when breathing
Tightness in the chest At first, a person may notice these symptoms during physical exertion. However, as the condition progresses, they can also start to happen during rest.
Emphysema and COPD develop over a number of years.
In the later stages, a person may have:
Frequent lung infections and flare-ups
Worsening symptoms, including shortness of breath, mucus production, and wheezing
Weight loss and reduced appetite
Fatigue and a loss of energy
Blue-tinged lips or fingernail beds, or cyanosis, due to a lack of oxygen
Anxiety and depression
In most cases, emphysema and COPD result from cigarette smoking. However, up to 25% of people with COPD have never smoked.
Other causes appear to be genetic factors, such as an alpha-1 antitrypsin deficiency, and exposure to environmental irritants, including secondhand smoke, workplace pollutants, air pollution, and biomass fuels.
In addition, not all people who smoke develop emphysema. It may be that genetic factors make some people more susceptible to the condition.
Emphysema is not contagious. One person cannot catch it from another.
Based on FEV1, the stages are as follows:
Very mild, or stage 1: FEV1 is about 80% of normal.
Moderate, or stage 2: FEV1 is 50–80% of normal.
Severe, or stage 3: FEV1 is 30–50% of normal.
Very severe, or stage 4: FEV1 is less than 30% of normal.
The main medications for emphysema are inhaled bronchodilators, which can help relieve symptoms. They relax and open the airways, making it easier for a person to breathe.
The inhaler delivers the following bronchodilators:
beta-agonists, which relax bronchial smooth muscle and help clear mucus
anticholinergics, or antimuscarinics, such as albuterol (Ventolin), which relax bronchial smooth muscle
inhaled steroids, such as fluticasone, which help reduce inflammation
If a person uses them regularly, these options can improve lung function and increase exercise capacity.
There are short-acting and long-acting drugs, and people can combine them. Treatment may also change over time and as the condition progresses.
People can take steps to manage their symptoms, improve their quality of life, and slow the progression of emphysema. The sooner a person takes these steps, the more helpful they will be.
Some things to try include:
Quitting or avoiding smoking
Avoiding places where there are air pollutants, if possible
Following or developing an exercise program
Consuming a healthful diet
Drinking plenty of water, to loosen mucus and help keep the airways open
Breathing through the nose in cold weather or using a face covering to keep out cold air
Practicing diaphragmatic breathing, pursed-lip breathing, and deep breathing
Pulmonary rehabilitation is a program of care that encourages people with emphysema to learn about and manage their condition. There is a focus on developing and maintaining healthful lifestyle choices.
Making these changes may not alter the overall course of the condition, but it can help people manage the symptoms, improve their exercise capacity, and boost their quality of life.
People should also ensure that they meet with their healthcare provider regularly and receive their routine vaccinations, including those for flu and pneumonia.
In time, breathing can become more difficult, and a person may need oxygen therapy some or all of the time. Some people use oxygen overnight, for example.
Various devices are available, including large tanks for home use and portable oxygen kits for traveling.
People should discuss the most suitable options with their healthcare provider.
People with severe emphysema may sometimes need to undergo surgery to remove damaged lung tissue and reduce large spaces that develop in the lungs due to the condition.
Transplantation of one or both lungs can improve a person’s quality of life. However, there are some risks involved, such as the chance of infection.
A healthcare provider will help the person decide whether or not surgery is a good idea for them.
Other treatment options can help during a flare-up or if complications arise. These options may include:
Oxygen therapy, to relieve worsening symptoms
Antibiotics, to treat a bacterial infection
Corticosteroid drugs, to reduce inflammation
Other medications, to relieve severe coughing and pain