Emphysema

The primary cause of emphysema is exposure to airborne irritants over a long period of time. These irritants include:

• Tobacco smoke

• Marijuana smoke

• Chemical fumes/dust

• Air pollution

While rare, emphysema can also be caused by a lack of the alpha-1 antitrypsin protein. This protein deficiency is genetic, and it is known as alpha-1 antitrypsin deficiency — or AATD. 

A person’s primary risk factor for developing emphysema is smoking. This disease is most likely to develop in cigarette smokers, but people who smoke cigars, pipes, or marijuana are also at risk. 

Other risk factors for developing emphysema include:

• Secondhand smoke exposure

• Occupational exposure to dust/fumes/chemicals

• Age – most people begin experiencing the symptoms of emphysema between the ages of 40 and 60

• Indoor/outdoor pollution exposure

Though research is still continuing, it’s thought that people with emphysema and other forms of COPD are more susceptible to developing complications and getting severely ill with COVID-19. 

Emphysema symptoms typically come on gradually. Many people have emphysema for years without noticing significant symptoms. Shortness of breath is the primary symptom of emphysema, and it gradually gets worse until you can find yourself short of breath even without activity. Other symptoms of emphysema include:

• Chest tightness

• Wheezing

• Coughing

• Increased mucus production

These symptoms can be signs of many other respiratory ailments. If you develop these symptoms and you are a current or former smoker, it’s important to promptly see your doctor . Seek immediate medical attention if you:

• Are not alert mentally

• Are experiencing graying lips/fingernails with exercise or exertion

• Are so short of breath you cannot climb stairs or perform normal activities

Diagnosing emphysema begins with an examination where your doctor will ask about your medical history and perform a physical exam. From there, you may be scheduled for further tests. Some of the tests performed in diagnosing emphysema include:

• Lab tests

• Imaging: Chest x-ray or Computerized tomography (CT) scan

• Lung function (spirometry)

As a progressive lung disease, emphysema cannot be cured — but there are treatments available to help relieve symptoms and slow the progression. The most impactful way you can help yourself is to quit smoking. Emphysema treatments include: 

Medication

Depending on your condition’s severity, your doctor may suggest:

• Bronchodilators (these are drugs that relax constricted airways)

• Inhaled steroids (these reduce inflammation and help relieve shortness of breath)

• Antibiotics (these are only helpful if you have a bacterial infection such as acute bronchitis or bacterial pneumonia)

Therapies

Several therapies are available to help manage the symptoms of emphysema including:

• Nutrition therapy (depending on the stage of emphysema, weight loss or weight gain can be beneficial)

• Supplemental oxygen (if your oxygen levels are low, using at-home oxygen regularly can help)

• Pulmonary rehabilitation (you’ll learn breathing exercises to help reduce breathlessness and improve your exercise ability)

• Spiration Valve System treatment

Surgery

In more severe or advanced stages of emphysema, surgery might be appropriate. Your doctor might suggest the following surgeries:

• Lung volume reduction surgery (during this surgery, surgeons remove small wedges of damaged lung tissue)

• Lung transplantation