Emphysema is an illness which is included in the broader diagnosis of chronic obstructive pulmonary disease or COPD. It progressively destroys the tissue of the alveoli or small air sacs found in the lungs that hold air. As the illness progresses, these small air sacs converge into one larger sac. This decreases the overall surface area of the lungs, and prevents them from absorbing oxygen rich air to be distributed by the body, according to the Mayo Clinic.
Who Gets Emphysema?
Emphysema primarily affects users of tobacco products like cigarettes and cigars. Secondhand smoke may also be a cause. Rarely, other environmental contaminants may damage the lungs severely enough to cause emphysema, even in non-smokers. It is estimated that between 80 and 90 percent of all emphysema and COPD cases are directly related to smoking, according to The American Lung Association.
It is estimated that up to 24 million people may be living with emphysema or COPD, but only 11 million of them have been diagnosed. One cause of this discrepancy is due to delays in diagnosis. Because emphysema has symptoms in common with less severe illnesses, such as influenza or the common cold, sufferers may not immediately seek medical care.
Most individuals with emphysema are over the age of 35, with people 50 and older being the most commonly diagnosed.
What are the Symptoms of Emphysema?
Early symptoms of emphysema may include a lingering cough or shortness of breath during physical activity. As the illness progresses, sufferers may also experience fatigue, excessive phlegm, blue nail beds and lips, severe cough, and trouble breathing.
The symptoms of emphysema include the following:
- Shortness of breath
- Chest tightness or pain
The First Symptoms
As the lung sacs start to overfill and burst, they create shortness of breath. It becomes harder to do the things you are used to doing, and your endurance takes a major hit. Because you are constantly out of breath, you will feel like you can’t keep going after a short jog or minor exercise.
This shortness of breath is caused indirectly by the problem with the lungs. The direct cause is that the muscles have to work harder. As the lungs have difficulty in maintaining oxygenation, the muscles have to work extra hard to do much of anything. They are not receiving the proper oxygen, so they are not as fluid and not as easy to move.
Breathing itself also becomes harder. Air, instead of entering and exiting the lungs normally, is often trapped inside the lungs, in the open pockets. This makes it difficult to breathe properly, and it becomes even more troublesome if you exert yourself and make your body require more oxygen.
Shortness of breath is the most common symptom that people experience who have emphysema. But there are other symptoms that can come as a part of the initial problem. Not everyone will experience them, but they are still fairly common.
These include wheezing, coughing and chest tightness. As the lungs work harder to do the same work they used to do, they create secondary symptoms. The more you exert yourself and overwork your lungs and muscles, the more prevalent these other symptoms become. They are typically developed by people who have demanding jobs or who live very physical lives. The overexertion begins to take its toll and cause them numerous health problems.
It is not uncommon to have persistent chest pain or chronic coughing that simply does not go away after taking rest. These become almost permanent symptoms in some cases, and they can make it hard for you to live your life the way you used to or to be physically active at all.
Advanced Symptoms of Emphysema
Emphysema only becomes worse over time. It cannot be cured, only treated to slow down its inevitable progression. If a smoker stops smoking and receives treatment, it can slow the progression down to a crawl. But if a smoker with emphysema continues to smoke regularly, they will aggravate their condition and cause it to rapidly deteriorate.
Other factors beyond just smoking contribute to emphysema’s worsening. These are genetic factors, and they are not entirely understood. It is simply known that some people will suffer the more serious effects of emphysema sooner than others simply because of their genetic makeup rather than because of anything they are doing to themselves.
But the symptoms will worsen over time, no matter what you do to try to stop it. Eventually, this leads to lung failure, and the body is no longer able to breathe on its own. In some cases, the lungs can be assisted by machines, but that would be all that is keeping the body alive. Once the lungs have failed, only medical machinery can continue to breathe for the patient.
Before that happens, the lungs will develop massive scar tissue. This can cause lung cancer, which is often created from the continuous creation of scar tissue. As the lungs heal, the alveoli sacs continued to burst and deteriorate, creating more scar tissue. This creates an ideal environment for cancer to form.
Unfortunately, many patients do not experience symptoms until the condition is in its later stages. Some patients also assume the symptoms are due to less severe health issues and delay seeking medical advice. Those who are at risk for emphysema should see a health care professional immediately if these symptoms occur to ensure earlier diagnosis. Smokers over the age of 35 are most at risk.
Stages of Emphysema
Emphysema is a progressive disease that always gets worse. However, there are stages of the disease, which correlate to how much lung damage is present. The Global Initiative for Chronic Obstructive Lung Disease, or GOLD, uses FEV1 measurements to evaluate and determine the extent of lung damage and progression of the disease. FEV stands for Forced Expiratory Volume, which measures the amount of air you can exhale after holding air in your lungs for a short period. A lower FEV1 level is a sign of worse health because it means that your lungs cannot hold as much air.
Stage 1: mild disease, with FEV1 levels greater than 80 percent
Stage 2: moderate disease, FEV1 levels greater than 50 percent but less than 80 percent
Stage 3: severe disease, FEV1 levels between 30 percent and 50 percent
Stage 4: very severe disease, FEV1 levels less than 30 percent or less than 50 percent with accompanying chronic respiratory failure.
How is Emphysema Diagnosed?
If emphysema is suspected, doctors will generally have patients perform one or several pulmonary function tests, or PFTs. This helps determine how much airflow a patient can emit from their lungs, and it is performed by blowing into a meter. Lowered lung function indicates airway obstruction.
Chest X-rays may also be performed to view the lungs directly.
Most cases of emphysema are treated with inhaler medications and nebulizers. These medications are breathed directly into the lungs to open airways and prevent obstruction. Those with more severe illnesses may also require oxygen to help them breathe easier. Oxygen may be delivered continuously, or as needed. In some very severe cases, patients may require surgery.
Emphysema: how serious is it?
There is no cure for emphysema. Those who catch the illness early may live many years, while those with more advanced stages will typically have a much shorter life expectancy. According to WebMD, no widespread studies have been done to determine expected lifespans of those with emphysema, so predicting how the disease will progress in any given patient is impossible to do. Life expectancy will depend, in part, on overall health, age, whether the person has access to medical care, and whether the person is a smoker.
Because emphysema is progressive, that means that it doesn’t ever get better once you have it. One of the worst aspects of emphysema is that it gradually destroys the tissue inside your lungs, and not surprisingly that makes it harder to breathe. When more lung tissue is destroyed, the amount of oxygen in your bloodstream becomes less concentrated, which means that the problem affects far more than just your lungs. Your body tries to compensate for this lower oxygen concentration by breathing faster. Your skin can even start to turn blue – also called cyanotic – because you’re not getting enough oxygen in your blood.
Eventually as this process continues, the arteries in your lungs will get narrower and your heart will have to beat harder to pump more blood through them. The longer your heart has to work harder to pump more blood, the greater it increases your risk of heart failure. As you can probably see, emphysema isn’t just a problem with your lungs; eventually it can create major problems with your heart, too.
Despite treatment options, COPD-related illnesses are the fourth leading cause of death in the US.
What can be done to prevent Emphysema
Since most cases of emphysema and other COPD-related diseases are caused by smoking, the best means of prevention is to avoid smoking. This includes all tobacco related products. Those who do smoke should quit immediately. Quitting could prevent the occurrence of tobacco-related diseases, or slow down progression in those who are already sufferers.
Quit Smoking Anyway
Once you have emphysema, it’s not curable. However, you may be able to prevent it from getting worse after you start to show symptoms. It’s never too late to quit smoking, even when you have emphysema. Even if your emphysema is at an incurable point, quitting smoking can still improve your quality of life.
Most people with emphysema do not die from the disease directly but from other causes of organ failure caused by the lack of oxygen associated with emphysema.