Emphysema

What is emphysema?

Emphysema is a long-term, progressive lung disease that causes shortness of breath due to the enlargement of the alveoli. The disease is characterized by the fact that the lung tissue, which participates in the exchange of gases – oxygen and carbon dioxide, is damaged or completely destroyed.

The disease is in the group of diseases known as Chronic Obstructive Pulmonary Disease /COPD/. The disease is included in this group because the airflow during exhalation is slowed or stopped due to enlarged alveoli that do not exchange gases when the affected person inhales.

The disease changes the anatomy of the lung in several ways. This is due in part to the destruction of the lung tissue around the small airways. This tissue normally keeps these small airways, called bronchioles, open, allowing air to leave the lungs when you exhale. When this tissue is damaged, it becomes difficult to release air and it is blocked in the alveoli.

What are the symptoms of emphysema?

Shortness of breath is the most common symptom. Sometimes coughing, due to increased mucus production, and wheezing can also be among the manifestations of the disease. With the passage of time, it is observed that the opportunities for physical exertion decrease.

The disease usually progresses slowly. The rule is that the patient’s condition deteriorates very slowly and therefore may go unnoticed. Especially if the patient is a smoker or has other diseases, in which physical exertion is contraindicated.

One of the characteristic signs of the disease is that the patient exhales with a half-closed mouth in an attempt to exhale completely and release the air blocked in the alveoli. When exhaling, the patient sticks his lips together, leaving a very small opening.

Then, when you exhale, your lips block the flow of air. This increases the pressure of the trapped air in the airways and their opening allows the blocked air to be released due to the high pressure.

What are the causes?

Smoking is the most common reason for the development of the disease, but also the most preventable. Other risk factors include a deficiency of an enzyme called alpha-1-antitrypsin, air pollution and age.

Alpha-1-antrypsin, also known as alpha-1-antiprotease, is a substance that blocks the action of the lung-destroying enzyme trypsin, or protease. Trypsin is a digestive enzyme that helps digest food. It is also released by immune cells, helping to destroy bacteria and other foreign bodies.

Men are at greater risk of developing the disease than women. The exact cause is unknown, but differences between male and female sex hormones are suspected.

Advanced age is a risk factor for the disease. Lung function weakens with age.

Treatment of emphysema

• Quit smoking – although it is not a cure, most people make this recommendation to people with this disease. Quitting smoking can stop the development of the disease and improve lung function to some extent.
• Bronchodilators – drugs that widen the airways and provide better gas exchange in the respiratory system. These are usually the first drugs that doctors prescribe to treat emphysema. In very mild cases, bronchodilators are used only as needed when the patient feels short of breath. The most widely used drug in this class is albuterol. It is fast acting and one dose provides relief for 4-6 hours. Another drug used is eipratropium bromide, which, unlike albuterol, is given at regular intervals, not just as a “rescue.”