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What is "emphysema"?


Richard Sheldon (Medical Advisor to the CA State Respiratory Care Board) gives expert video advice on: What are the treatments for emphysema?; Can emphysema be cured? and more...

What is "emphysema"?

Emphysema is a disorder where the lung loses its elasticity. We have muscles that will allow us to inhale, but we have no muscles that will allow us to exhale. When you develop emphysema you can pull the air in OK but you can't get rid of it. So you lungs get bigger and bigger and bigger and then they lose their elasticity and then along with that the airways collapse much sooner through expiration, trapping old dirty air in your lungs, and then the alveolar sacks begin to collapse together. So where you used to have a thousand little tiny ones with lots of surface area you now have one big one that has a mere fraction of the surface area available to it in order to exchange oxygen with carbon dioxide. And one might happily, if i can be so forward to say that, be willing to die of lung cancer if they could avoid year after year after year of slowly getting more and more short of breath. It is a terrible disease and its terribly debilitating and its very, very difficult to keep the patient comfortable and productive as year after year they get more and more short of breath.

Are there causes for emphysema besides smoking?

Yes, there are. Like I say, there's an inherited form and there are other inhaled substances that can cause a form of emphysema, but they make up a very small fraction of the total patients with emphysema when compared with the number of patients who develop emphysema from smoking.

What are the symptoms of emphysema?

Signs and symptoms of emphysema are progressive shortness of breath especially with exercise. You can start to develop Carpal Manali where the right heart starts to fail because it has to pump blood into the lungs under increasing pressure. So, you get ankle swelling, you can get some chest pain associated with that, but by in large the most difficult problem that an emphysema encounters early on is the fact that he can't walk across the room like he use to without being short of breath. He can't go outside and throw a baseball for his grandkids. He can't go out and pull weeds. Bending over to tie his shoes is so difficult because it presents for shortness of breath.

How is emphysema diagnosed?

Emphysema can be diagnosed with pulmonary function testing, a chest x-ray will become abnormal early on, and blood gasses will help you with that diagnosis. But primarily, pulmonary function testing, blood gasses, and chest x-rays.

What are the treatments for emphysema?

Treatment for emphysema includes oxygen, yearly flu shots, bronchodilators, the inhaled medications. Pulmonary rehab can be very effective in helping these people in their quality of life. Sometimes the use of inhaled steroids can be of help to these patients.

Can emphysema be cured?

Emphysema cannot be cured. Once you have emphysema you are stuck with it. What you can do is you can slow down the effects of emphysema, the bad effects, and the sooner you stop smoking the sooner you're going to get a chance to turn some of this around. Emphysema is a slow progression towards dying.