Emphysema is not curable, but it can be treated. Those who have it can be helped to live with it. It is a destructive disease for many people and their families. Over 1100 people die of it as a major cause each year.

Something can be done about emphysema today.

Who gets Emphysema?

Persons with emphysema are, for the most part, males between 50 and 70 years old. Women get emphysema, too, but so far, not as often as men. However these statistics are changing as women are starting to smoke more, and at an earlier age. A very high percentage of the people who have emphysema smoke cigarettes and have been heavy smokers for many years. Frequently, they live in areas where air pollution is a constant problem.

Some people are born with a lack of a substance called alpha-1 antitrypsin. This makes them more likely than others to get emphysema and at an earlier age.

How it Attacks

A person with emphysema doesn’t develop the disease suddenly. It comes on gradually. He or she has probably had several very bad colds each winter for the past few years, each accompanied by a heavy cough, and often with chronic bronchitis. The cough often persists between colds and becomes chronic.

The thing that usually brings the patient to the doctor is that he or she has begun to feel short of breath on exertion in morning or evening or both. The patient may think he or she has asthma or heart disease.

Causes of Emphysema

It is believed that emphysema often is a late effect of chronic infection or irritation of the bronchial tubes. These tubes, the bronchi, connect the windpipe with the lungs. The bronchi look like branches of a tree, with the branches becoming smaller and smaller until each one ends in a cluster of tiny air spaces in the lung. From these tiny spaces (alveoli) oxygen enters the blood when air is breathed in, and waste gas (carbon dioxide) is removed from the lungs by breathing out.

When the bronchi become irritated, some of the airways may be obstructed, trapping air in the lung beyond them. Or the walls of the tiny air spaces may tear, for various reasons. The small blood vessels in the walls disappear. Less contact between blood and air results.

If infection or irritation continues or is repeated for a long time and the stretching and destruction of the walls of the air spaces goes on, the lungs as a whole may become enlarged, at the same time becoming less efficient in exchanging oxygen for carbon dioxide. Enlarged lungs is what gives the disease its name, emphysema (which is a Greek word meaning "Inflation").

Cigarette smoking contributes to the destructive processes that end up as emphysema.

Effects of Emphysema

Emphysema may begin with only a slight morning and evening inconvenience in breathing. Next, a short walk may be enough to bring on an attack of breathlessness. It may reach a point where every breath requires a major effort.

The changes of emphysema also interfere with the passage of blood through the small blood vessels of the lung. As interference grows, the heart must work harder to pump blood. The heart may enlarge under the strain and eventually give out. This type of heart failure is often an end result of emphysema.

Treatment

The emphysematous patient must stop smoking to retard progression of the disease. Doctors may prescribe various bronchial dilating medications to treat an asthmatic component that often co-exists with emphysema. Antibiotics are helpful for acute chest infections. Some patients benefit from oxygen therapy, either when exercising or on a nearly continuous basis.

For the few patients suffering alpha-1 antitrypsin deficiency, weekly infusions of alpha-1 antitrypsin are available. These infusions are very expensive and it is not yet known if progress of this rare form of emphysema can be reduced by using this therapy. Physicians may emphasize the importance of regular exercise to maintain physical fitness and even refer a patient with emphysema to a respiratory rehabilitation program.

Prevention

At this time, doctors do not know how to prevent emphysema. Continuing research is being conducted to find answers to many questions about this disease. But they do know that cigarette smoking is a definite cause, and that cutting out smoking can avoid damage for many who would otherwise develop the disease. Controlling air pollution can also help.

Modern medicine can usually slow down the progress of emphysema if patients are treated early. It is always the doctor’s immediate concern to clear up any infection or irritation of a patient’s respiratory system, because these things set up a possible starting place for emphysema.

If Emphysema concerns you, you should know:

1. Emphysema can be a serious disease. It damages your lungs. It can damage your heart. You can’t treat it yourself. See your doctor at first symptoms.
   
2. DON’T SMOKE. A high percentage of those who develop emphysema are heavy smokers. Continued smoking definitely makes emphysema worse.
   
3. Some people with emphysema also have a tendency to develop stomach trouble. If you have any digestive difficulty, be sure to discuss it with your doctor.
   
4. Keeping fit not only helps prevent emphysema and other diseases, it also speeds recovery if you do get sick. Set up a good health routine – and stick to it.
   
5. Avoid polluted air. This is advice that is easier to give than to follow since air pollution is a serious problem in almost every part of the country. However, do not expose yourself unnecessarily to dust or fumes of any kind.
   
6. See your doctor at the start of any cold or other respiratory infection.