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Patient Information: Adult Illnesses |
What You Should Know About
Emphysema
In the normal lung, the bronchial tubes are kept open by a network of elastic tissue that attaches to their outer surface. Without these elastic fibers, the bronchi will close, especially during expiration. Emphysema is a disease in which much of the elastic network is destroyed. The destruction occurs because the wall of the tiny air sacs that make up most of the lung tissue are broken up by the effects of inflammation and irritants, such as tobacco smoke. As the walls of the air sacs (alveoli) are destroyed, the sacs become larger and larger, and they no longer provide tissue for the elastic fibers. As stated above, without intact elastic fibers, the bronchi become narrow and often collapse during expiration. Air is trapped in the lungs and they become too large for the space that is available inside the thorax. The amount of work that is required to move the thorax is increased, and shortness of breath is the main symptom of emphysema.
Currently there are there are 1.8 million Americans with emphysema, most of whom are either smokers or ex-smokers. Emphysema ranks 15th among chronic conditions that contribute to activity limitations - almost 44 percent of individuals with emphysema report that the disease has limited their daily activities. Many of the people with emphysema are older men, but the condition is rapidly increasing among women. In 1994, males outnumbered females by more than 54 percent. Within 2 years the % difference between males and females decreased to 10%. While emphysema can and does exist alone, it occurs most commonly in association with chronic bronchitis in a disease known as COPD.
In addition to the emphysema that is caused by smoking and inhalant irritants, it is estimated that 50,000 to 100,000 Americans living today were born with a deficiency of a protein known as alpha 1-antitrypsin (AAT) which can lead to an inherited form of emphysema called alpha 1-antitrypsin (AAT) deficiency-related emphysema. |
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Treatment
Because it is a disease that destroys the structure of the lungs, there are no medications that can reverse that process. However, doctors can help persons with emphysema live more comfortably with their disease. The goal of treatment is to provide relief of symptoms and prevent progression of the disease with a minimum of side effects. The doctor's advice and treatment may include:
- Quitting smoking, which is 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 by nebulizer.
- 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. This is best done in circumstances where oxygen levels can be measured, to assure that adequate levels are maintained
- 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. This is a major procedure, which has been carried out on a limited number of patients. It is too early to tell if this is a viable form of treatment for this disease.
Prevention Tips
- Quit smoking, which may prevent the occurrence and decrease the progression of emphysema. The majority of those who get emphysema are smokers. Continued smoking makes emphysema worse, especially for those who have AAT deficiency, the inherited form of emphysema.
- Maintain overall good health habits, which include proper nutrition, adequate sleep, and regular exercise to build up stamina and resistance to infections.
- Reduce your exposure to air pollution, which may aggravate symptoms of emphysema. Refer to radio or television weather reports or your local newspaper for information about air quality. On days when the ozone (smog) level is unhealthy, restrict activity to early morning or evening. When pollution levels are dangerous, remain indoors and stay as comfortable as possible.
- Although not truly a preventive treatment for emphysema, all patients with this disease should have annual flu shots, and every six years, a pneumonia vaccine shot.
Clinical Trials at the Arizona Respiratory Center
Individuals over 40 years of age with a diagnosis of emphysema or chronic bronchitis, who are otherwise in good health, are welcome to participate in a clinical trial. Extensive pulmonary testing is included as part of the trial and compensation is provided. For more information, call (520) 626-7091.
Where to Get More Information
For more information, try these online resources.
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