Emphysema

Emphysema is a long-term (chronic) lung disease. In emphysema, the tiny air sacs (alveoli) at the end of the airways in the lungs are damaged and lose their stretch. When the air sacs are damaged or destroyed, the inner walls break down and the sacs become larger. These larger air sacs move less oxygen into the blood. This causes difficulty breathing or shortness of breath that often gets worse over time. After air sacs are destroyed, they cannot be replaced.

Emphysema is a type of COPD (chronic obstructive pulmonary disease). Emphysema is usually caused by smoking. Air pollution can also cause emphysema. Other things that may lead to it include breathing chemical fumes, factory dust, soot, or secondhand smoke over a long period of time. Some people get emphysema because they have a disorder that runs in families, called alpha-1 antitrypsin deficiency.

The main symptoms of emphysema are:

• A cough that will not go away.
• Mucus that comes up when you cough.
• Shortness of breath that gets worse when you are active.

Sometimes your symptoms may get worse over a short time and stay bad. This is called an exacerbation (say "ig-ZAS-ur-BAY-shun") or flare-up. A flare-up can be dangerous, so it's important to know what to do and take action. Your doctor can help you make a plan to manage flare-ups.

Symptoms of a flare-up include:

• More shortness of breath than usual.
• Coughing more than usual.
• A change in the amount, color, or thickness of mucus.

Your doctor will do a physical exam and ask questions about your health. You may have blood tests. You may also get a chest X-ray to look at your lungs. And you may have breathing tests to find out how well your lungs work.

Emphysema is treated with medicines and oxygen. You also can take steps to stay as healthy as possible. Treatment can help you feel better and prevent flare-ups. Some treatments may also slow the disease and help you live longer.

Medicines and oxygen therapy

• Medicines called bronchodilators are used to open or relax your airways. They can help you breathe easier and prevent breathing problems.
• Other medicines, such as corticosteroids, may be used to help you feel better and prevent or treat flare-ups.
• Take your medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine.
• Ask your doctor, pharmacist, or respiratory therapist how to use each of your inhalers correctly. With correct use, the medicine is more likely to get to your lungs.
• Oxygen therapy boosts the amount of oxygen in your blood and helps you breathe easier. Use the flow rate your doctor has recommended, and do not change it without talking to your doctor first.

Other care

• If you smoke, quit or cut back as much as you can. Not smoking is the most important thing you can do to keep emphysema from getting worse. It is never too late to stop. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.
• If your doctor has not set you up with a pulmonary rehabilitation program, ask your doctor if rehab is right for you. Rehab includes exercise programs, education about your disease and how to manage it, help with diet and other changes, and emotional support.
• You may choose palliative care to help improve your shortness of breath and quality of life.
• You can also plan ahead for what kind of care you want if you become very ill. This is called advance care planning.
• Surgery or certain procedures may be an option for some people. Examples include lung volume reduction and placing an endobronchial valve (EBV).

There are many things you can do to help manage emphysema. They may help slow the disease, help you feel better, and help prevent flare-ups.

• If you smoke, quit or cut back as much as you can. If you need help quitting, talk to your doctor about stop-smoking programs and medicines.
• Take your medicines as prescribed. Learn how to use each of your inhalers correctly.
• Try to avoid things that can irritate your lungs. These things include secondhand smoke, chemical fumes, factory dust, soot, and air pollution.
• Stay as active as possible. Try to do activities that build muscle strength and help your heart.
• Try to eat healthy. Tell your doctor if you are losing weight without trying.
• Learn and practice breathing methods. They may help when you are more short of breath than normal.
• Avoid infections such as COVID-19, colds, and the flu. Wash your hands often. You may want to wear a mask when you go to public indoor places. Try to avoid sick people. Get a flu vaccine every year. Stay up to date on your COVID-19 vaccines. Get the pneumococcal, whooping cough, and shingles vaccines. Ask your doctor if the RSV vaccine is right for you.