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Fitango EducationHealth Topics
Emphysema
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Overview
Emphysema is a type of chronic obstructive pulmonary disease (COPD) involving damage to the air sacs (alveoli) in
the lungs. As a result, your body does not get the oxygen it needs. Emphysema
makes it hard to catch your breath. You may also have a chronic cough and have
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Overview
trouble breathing during exercise.
The most common cause is cigarette smoking.
If you smoke, quitting can
help prevent you from getting the disease. If you already have emphysema, not smoking
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Overview
might keep it from getting worse. Treatment is based on whether your symptoms
are mild, moderate or severe. Treatments include inhalers, oxygen, medications
and sometimes surgery to relieve symptoms and prevent complications.
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Symptoms
At first, COPD may cause no symptoms or only mild symptoms. As the
disease gets worse, symptoms usually become more severe. Common signs
and symptoms of COPD include:
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Symptoms
-- An ongoing cough or a cough that produces a lot of mucus (often called "smoker's cough")
-- Shortness of breath, especially with physical activity
-- Wheezing (a whistling or squeaky sound when you breathe)
-- Chest tightness
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Symptoms
If you have COPD, you also may have colds or the flu (influenza) often.
Not
everyone who has the symptoms above has COPD. Likewise, not everyone
who has COPD has these symptoms. Some of the symptoms of COPD are
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Symptoms
similar to the symptoms of other diseases and conditions. Your doctor
can find out whether you have COPD.
If your symptoms are mild, you
may not notice them, or you may adjust your lifestyle to make breathing
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Symptoms
easier. For example, you may take the elevator instead of the stairs.
Over time, symptoms may become severe enough to see a doctor. For example, you may get short of breath during physical exertion.
The
severity of your symptoms will depend on how much lung damage you have.
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Symptoms
If you keep smoking, the damage will occur faster than if you stop
smoking.
Severe COPD can cause other symptoms, such as swelling in your ankles, feet, or legs; weight loss; and lower muscle endurance.
Some
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Symptoms
severe symptoms may require treatment in a hospital. You—with the help
of family members or friends, if you're unable—should seek emergency
care if:
-- You're having a hard time catching your breath or talking.
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Symptoms
-- Your lips or fingernails turn blue or gray. (This is a sign of a low oxygen level in your blood.)
-- You're not mentally alert.
-- Your heartbeat is very fast.
-- The recommended treatment for symptoms that are getting worse isn't working.
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Diagnosis
Your doctor will diagnose COPD based on your signs and symptoms, your medical and family histories, and test results.
Your
doctor may ask whether you smoke or have had contact with lung
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Diagnosis
irritants, such as secondhand smoke, air pollution, chemical fumes, or
dust.
If you have an ongoing cough,
let your doctor know how long you've had it, how much you cough, and
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Diagnosis
how much mucus comes up when you cough. Also, let your doctor know
whether you have a family history of COPD.
Your doctor will
examine you and use a stethoscope to listen for wheezing or other
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Diagnosis
abnormal chest sounds. He or she also may recommend one or more tests to
diagnose COPD.
Lung Function TestsLung function tests
measure how much air you can breathe in and out, how fast you can
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Diagnosis
breathe air out, and how well your lungs deliver oxygen to your blood.
The
main test for COPD is spirometry (spi-ROM-eh-tre). Other lung function
tests, such as a lung diffusion capacity test, also might be used. (For
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Diagnosis
more information, go to the Health Topics Lung Function Tests article.)
SpirometryDuring
this painless test, a technician will ask you to take a deep breath in.
Then, you'll blow as hard as you can into a tube connected to a small
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Diagnosis
machine. The machine is called a spirometer.
The machine measures how much air you breathe out. It also measures how fast you can blow air out.
Other TestsYour doctor may recommend other tests, such as:
-- A chest x ray or chest CT scan.
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Diagnosis
These tests create pictures of the structures inside your chest, such
as your heart, lungs, and blood vessels. The pictures can show signs of
COPD. They also may show whether another condition, such as heart
failure, is causing your symptoms.
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Diagnosis
-- An arterial blood gas test.
This blood test measures the oxygen level in your blood using a sample
of blood taken from an artery. The results from this test can show how
severe your COPD is and whether you need oxygen therapy.
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Treatment
COPD has no cure yet. However, lifestyle changes and treatments can
help you feel better, stay more active, and slow the progress of the
disease.
The goals of COPD treatment include:
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Treatment
-- Relieving your symptoms
-- Slowing the progress of the disease
-- Improving your exercise tolerance (your ability to stay active)
-- Preventing and treating complications
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Treatment
-- Improving your overall health
To
assist with your treatment, your family doctor may advise you to see a
pulmonologist. This is a doctor who specializes in treating lung
disorders.
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Treatment
Lifestyle ChangesQuit Smoking and Avoid Lung IrritantsQuitting
smoking is the most important step you can take to treat COPD. Talk
with your doctor about programs and products that can help you quit.
If
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Treatment
you have trouble quitting smoking on your own, consider joining a
support group. Many hospitals, workplaces, and community groups offer
classes to help people quit smoking. Ask your family members and friends
to support you in your efforts to quit.
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Treatment
Also, try to avoid secondhand smoke and places with dust, fumes, or other toxic substances that you may inhale.
For more information about how to quit smoking, go to the Health Topics Smoking and Your Heart article and the National Heart, Lung, and Blood Institute's "Your Guide to a Healthy Heart." Although these resources focus on heart health, they include basic information about how to quit smoking.
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Treatment
Other Lifestyle ChangesIf
you have COPD, you may have trouble eating enough because of your
symptoms, such as shortness of breath and fatigue. (This issue is more
common with severe disease.)
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Treatment
As a result, you may not get all of
the calories and nutrients you need, which can worsen your symptoms and
raise your risk for infections.
Talk with your doctor about
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Treatment
following an eating plan that will meet your nutritional needs. Your
doctor may suggest eating smaller, more frequent meals; resting before
eating; and taking vitamins or nutritional supplements.
Also, talk
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Treatment
with your doctor about what types of activity are safe for you. You may
find it hard to be active with your symptoms. However, physical
activity can strengthen the muscles that help you breathe and improve
your overall wellness.
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Treatment
MedicinesBronchodilatorsBronchodilators relax the muscles around your airways. This helps open your airways and makes breathing easier.
Depending
on the severity of your COPD, your doctor may prescribe short-acting or
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Treatment
long-acting bronchodilators. Short-acting bronchodilators last about
4–6 hours and should be used only when needed. Long-acting
bronchodilators last about 12 hours or more and are used every day.
Most
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Treatment
bronchodilators are taken using a device called an inhaler. This device
allows the medicine to go straight to your lungs. Not all inhalers are
used the same way. Ask your health care team to show you the correct way
to use your inhaler.
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Treatment
If your COPD is mild, your doctor may only
prescribe a short-acting inhaled bronchodilator. In this case, you may
use the medicine only when symptoms occur.
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Treatment
If your COPD is moderate or severe, your doctor may prescribe regular treatment with short- and long-acting bronchodilators.
Inhaled Glucocorticosteroids (Steroids)Doctors
use inhaled steroids to treat people whose COPD symptoms flare up or
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Treatment
worsen. These medicines help reduce airway inflammation.
Your
doctor may ask you to try inhaled steroids for a trial period of 6 weeks
to 3 months to see whether the medicine helps relieve your breathing
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Treatment
problems.
VaccinesFlu ShotsThe flu (influenza)
can cause serious problems for people who have COPD. Flu shots can
reduce your risk of getting the flu. Talk with your doctor about getting
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Treatment
a yearly flu shot.
Pneumococcal VaccineThis vaccine lowers your risk for pneumococcal pneumonia
(NU-mo-KOK-al nu-MO-ne-ah) and its complications. People who have COPD
are at higher risk for pneumonia than people who don't have COPD. Talk
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Treatment
with your doctor about whether you should get this vaccine.
Pulmonary RehabilitationPulmonary rehabilitation (rehab) is a broad program that helps improve the well-being of people who have chronic (ongoing) breathing problems.
Rehab
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Treatment
may include an exercise program, disease management training, and
nutritional and psychological counseling. The program's goal is to help
you stay active and carry out your daily activities.
Your rehab
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Treatment
team may include doctors, nurses, physical therapists, respiratory
therapists, exercise specialists, and dietitians. These health
professionals will create a program that meets your needs.
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Treatment
Oxygen TherapyIf you have severe COPD and low levels of oxygen in your blood, oxygen therapy can help you breathe better. For this treatment, you're given oxygen through nasal prongs or a mask.
You
may need extra oxygen all the time or only at certain times. For some
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Treatment
people who have severe COPD, using extra oxygen for most of the day can
help them:
-- Do tasks or activities, while having fewer symptoms
-- Protect their hearts and other organs from damage
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Treatment
-- Sleep more during the night and improve alertness during the day
-- Live longer
SurgerySurgery
may benefit some people who have COPD. Surgery usually is a last resort
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Treatment
for people who have severe symptoms that have not improved from taking
medicines.
Surgeries for people who have COPD that's mainly related to emphysema include bullectomy (bul-EK-toe-me) and lung volume reduction surgery (LVRS). A lung transplant might be an option for people who have very severe COPD.
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Treatment
BullectomyWhen
the walls of the air sacs are destroyed, larger air spaces called
bullae (BUL-e) form. These air spaces can become so large that they
interfere with breathing. In a bullectomy, doctors remove one or more
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Treatment
very large bullae from the lungs.
Lung Volume Reduction SurgeryIn
LVRS, surgeons remove damaged tissue from the lungs. This helps the
lungs work better. In carefully selected patients, LVRS can improve
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Treatment
breathing and quality of life.
Lung TransplantDuring a lung transplant, your damaged lung is removed and replaced with a healthy lung from a deceased donor.
A
lung transplant can improve your lung function and quality of life.
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Treatment
However, lung transplants have many risks, such as infections. The
surgery can cause death if the body rejects the transplanted lung.
If
you have very severe COPD, talk with your doctor about whether a lung
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Treatment
transplant is an option. Ask your doctor about the benefits and risks of
this type of surgery.
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Causes
Long-term exposure to lung irritants that damage the lungs and the airways usually is the cause of COPD.
In
the United States, the most common irritant that causes COPD is
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Causes
cigarette smoke. Pipe, cigar, and other types of tobacco smoke also can
cause COPD, especially if the smoke is inhaled.
Breathing in
secondhand smoke, air pollution, or chemical fumes or dust from the
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Causes
environment or workplace also can contribute to COPD. (Secondhand smoke
is smoke in the air from other people smoking.)
Rarely, a genetic condition called alpha-1 antitrypsin deficiency
may play a role in causing COPD. People who have this condition have
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Causes
low levels of alpha-1 antitrypsin (AAT)—a protein made in the liver.
Having
a low level of the AAT protein can lead to lung damage and COPD if
you're exposed to smoke or other lung irritants. If you have this
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Causes
condition and smoke, COPD can worsen very quickly.
Although uncommon, some people who have asthma
can develop COPD. Asthma is a chronic (long-term) lung disease that
inflames and narrows the airways. Treatment usually can reverse the
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Causes
inflammation and narrowing. However, if not, COPD can develop.
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Prevention
You can take steps to prevent COPD before it starts. If you already
have COPD, you can take steps to prevent complications and slow the
progress of the disease.
Prevent COPD Before It StartsThe
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Prevention
best way to prevent COPD is to not start smoking or to quit smoking.
Smoking is the leading cause of COPD. If you smoke, talk with your
doctor about programs and products that can help you quit.
If you
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Prevention
have trouble quitting smoking on your own, consider joining a support
group. Many hospitals, workplaces, and community groups offer classes to
help people quit smoking. Ask your family members and friends to
support you in your efforts to quit.
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Prevention
Also, try to avoid lung
irritants that can contribute to COPD. Examples include secondhand
smoke, air pollution, chemical fumes, and dust. (Secondhand smoke is
smoke in the air from other people smoking.)
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Prevention
For more information about how to quit smoking, go to the Health Topics Smoking and Your Heart article and the National Heart, Lung, and Blood Institute's "Your Guide to a Healthy Heart." Although these resources focus on heart health, they include basic information about how to quit smoking.
Prevent Complications and Slow the Progress of COPDIf
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Prevention
you have COPD, the most important step you can take is to quit smoking.
Quitting can help prevent complications and slow the progress of the
disease. You also should avoid exposure to the lung irritants mentioned
above.
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Prevention
Follow your treatments for COPD exactly as your doctor
prescribes. They can help you breathe easier, stay more active, and
avoid or manage severe symptoms.
Talk with your doctor about whether and when you should get flu (influenza) and
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Prevention
vaccines. These vaccines can lower your chances of getting these
illnesses, which are major health risks for people who have COPD.