What exactly is Emphysema?
The purpose of the lungs is to make the exchange of oxygen and carbon dioxide possible between our blood and the air that we breathe. Inside of the lungs are small clusters of alveoli (pictured right). These are tiny air sacs that are separated and divided by membranes. Inside the membranes are capillaries that allow blood and air to interact and perform their necessary task. The alveoli expand as we breathe in and allow for oxygen to reach the capillaries. Once oxygen has attached to the red blood cells, carbon dioxide joins the alveoli to be exhaled. As we breathe out, the alveoli get squeezed against the membranes and air is released.
Emphysema is the destruction of these membranes and the capillaries that are inside. This reduces the area when blood and air meet and as a result limiting the oxygen/carbon dioxide exchange. In early cases of emphysema there is a swelling of the airways that limits the amount of air the alveoli can receive. In more severe cases, the membranes loose their elasticity and instead of acting like a catapult for the carbon dioxide, they instead collapse. This makes it harder for air to leave the lungs and even harder for air to enter them. As the severity of this condition increases, the lungs will try and compensate by increasing the rate of breathing to maintain oxygen levels in the blood stream. The heart has to work harder to push blood into the narrowing areas. Over time, this can cause the size of the heart to increase.
What are the causes?
The main cause of emphysema is cigarette smoking. Smoking will agitate cells and cause them to inflame in the lungs. This activates enzymes that will destroy the alveoli membranes and reduce the exchange of oxygen and carbon dioxide. Another cause of emphysema is age. The elasticity of the lungs decrease with age and this can result in a decrease of the lungs efficiency. Less common causes include inhalation of toxic air pollutants and the use of intravenous drugs. Some illegal drugs can contain cornstarch that will damage the tissue of the lungs.
What are the symptoms?
The most common symptoms of emphysema are wheezing and a shortness of breath. In early stages this shortness of breath and wheezing will occur after activity, but emphysema is a progressive disease and eventually, these symptoms will be present even when the person is resting.
What are the treatments?
Although emphysema is not curable, there are treatments that will aim to prevent any further deterioration. The first and most important treatment is to stop smoking. If the patient continues to inhale cigarette smoke, the enzymes that destroy the alveoli membranes will continue to grow and the condition will become much more aggressive. A bronchodilator can be used. This is commonly known as an inhaler. The inhaler will dilate breathing tubes and allow more air to flow to and from the lungs. There are two main types of inhaler, and it is important that a person be aware of which one they are using. There are both short acting and long acting inhalers. Short acting inhalers are used when the condition suddenly worsens, where as long term inhalers are used as part of long term therapy. If conditions suddenly decrease, a long-term bronchodilator cannot be used to help the problem. Your doctor will talk you through the difference between the two. Antibiotics may also be prescribed if the person is at risk from infections such as pneumonia. They may also be necessary if the person is weak from a fever or shows sign of an infection. Pulmonary rehabilitation is essential emphysema treatment. This will involve learning proper breathing techniques as well as supervised physical exercise. With the appropriate education and exercise, the person can experience increased mobility and an improvement in the quality of their life.