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Emphysema - A Useful Guide

• Written by Josh

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Emphysema is one type of chronic obstructive pulmonary disease (COPD). This is a group of lung conditions that damage the organ and make it difficult to breath. The other main condition is chronic bronchitis, which you can learn more about in our in-depth guide.

Today's post will focus on Emphysema; the symptoms, causes, treatment and ways to prevent it.

What is Emphysema?

As we've discussed, emphysema is a COPD. It targets the air sacs of the lungs, damaging the walls and causing enlargement. Your breathing tubes are also affected, with the attachments that hold them open being destroyed. This results in the collapse of the breathing tubes when you breathe out.

Causes

The main cause of lung conditions such as emphysema is smoking. The chance of being diagnosed increases the more and longer you smoke. In fact, according to Chest Foundation, around one in five people who smoke at least a pack or more of cigarettes each day for at least 10 years will develop a COPD.

The harmful chemicals can damage the lining of your lungs and airways, consequently causing them to become inflamed, damaged and narrowed. Smoking is thought to be responsible for around nine in every 10 cases.

Other causes include second-hand smoke, as well as dust and other fumes from certain working environments. Substances that have been linked include:

  • Coal dust.
  • Welding fumes.
  • Grain and flour dust.
  • Isocyanates.
  • Cadmium dust and fumes.
  • Silica dust.

Another cause is the alpha-1 antitrypsin deficiency. The alpha-1 protein protects the lung from damage, so when you have low levels or a deficient protein, the effects of smoking or inhaling dusts and chemicals damages the lungs more than usual. This is in the case in around one in 100 people with COPD. People who have an alpha-1-antitrypsin deficiency usually develop COPD at a younger age, often under 35.

You're more likely to develop COPD if you smoke and have a close relative with the condition.

 

Symptoms

The damage caused by emphysema often occurs at a slow pace, meaning that you may not be aware in the early stages. The main symptom is that it will become much harder for you to breathe. This is because the condition causes your breathing tubes to collapse when you breathe out, preventing the air in the lungs from being emptied. The trapped air is pushed down the diaphragm, making it less effective.

It will be harder for the oxygen in your body to pass into the blood vessels of the lungs, reducing the overall body level. As a result, your body will breathe more in order to compensate for the lack of oxygen. Other symptoms include:

  • Frequent chest infections.
  • Wheezing.
  • A chesty cough that doesn't seem to go away.
  • Feeling out of breath.
  • Weight loss.
  • Tiredness.
  • Swollen Ankles from a build-up of fluid.

Each case of emphysema is different; therefore the level of damage varies from mild to very severe. Some people may only notice symptoms through exercise, whilst others can struggle to even walk around their home without being out of breath.

Symptoms can gradually get worse over time and as a result can have a huge impact on your everyday life. In some cases, you may go through flare-ups where your symptoms worsen for a certain period of time.

Diagnosis

You should visit your doctor as soon as possible if you believe you may have the symptoms mentioned above. Your doctor will carry out a series of medical tests in order to determine diagnosis. These include:

  • Examining your chest and breathing with a stethoscope.
  • A spirometry test. This shows how well your lungs are working. It takes two measurements; the volume of air you can breathe out in one second, and the total amount of air you breathe out.
  • Chest X-Ray. This can show any problems in the lungs that can cause similar symptoms, such as an infection and lung cancer.
  • Blood Test. This can also pick up other conditions that have similar symptoms, such as anaemia and polycythaemia. This test may also be used to see if you have alpha-1-antitrypsin deficiency.

 

Treatment

Unfortunately, the damage to your lungs is irreversible. However, there are treatments and lifestyle changes that can be made in order to prevent the damage from increasing in severity.

The main lifestyle change is to stop smoking. This is the most effective way of preventing emphysema, and bronchitis, from getting any worse. In the early stages of COPD, this may be the only treatment that is needed. However, even in later stages there may be some positives from quitting.

Treatment is intended to help improve your breathing. This is done via an inhaler. The three main types of inhaler that will be prescribed are: short-acting bronchodilator, long-acting bronchodilator, and steroid.

Most people will receive the short-acting device. There are two available (beta-2 agonist inhalers and antimuscarinic inhalers) and can be used up to four times a day when you feel out of breath.

If you suffer regularly throughout the day, you will be given a long-acting inhaler. Each dose lasts 12 hours, so they only need to be used once or twice a day. Again, there are two types available, whilst some new versions contain a mixture of both beta-2 agonist and antimuscarinic.

If you have regular flare-ups and the long-acting inhaler isn't effective, your doctor may suggest a steroid inhaler. These contain corticosteroid medication which can reduce the inflammation in your airways. They are usually prescribed as part of a combination inhaler that also includes one of the long-acting medications mentioned above.

Pulmonary Rehabilitation Programme

This is a specialist programme consisting of exercise and education. The aim is to improve how much exercise you're able to do before you feel out of breath, and to work on your symptoms, self-confidence and emotional well-being.

They usually last around six weeks, including two or more group sessions per week. According to the NHS, a typical programme includes:

  • Physical exercise tailored to your condition. Exercises may include walking, cycling, and strength training.
  • Education about the condition for you and your loved ones.
  • Dietary advice.
  • Psychological and emotional support.

A range of healthcare professionals will host each class, such as dietitians and physiotherapists.

Further Options

Other treatment includes:

  • Medication - Medication can be prescribed to help relax and open your airways, clear up chesty coughs, and reduce inflammation.
  • Surgery - This is only suitable for a small number of people with severe Emphysema. Symptoms cannot be controlled with medication. Options include a lung transplant, a bullectomy (removal of a pocket of air from the lungs) and lung volume reduction (removal of a badly damaged section of the lung).

VAT Exemption and Personal Alarms

Emphysema is one of many long-term medical conditions that qualify for VAT Exemption. As a result, you will pay no VAT when you purchase a personal alarm, something that we believe is a good idea if you suffer from COPD.

Having an alarm means that you can find help fast if you're struggling with your breathing at home. Simply push a button around your wrist or neck and our Response Team will respond and organise help quickly. Most importantly, our service is available 24/7, so you can always find help.

For more information send an email at info@lifeline24.co.uk or speak to one of our friendly advisers on 0800 999 0400. Alternatively, complete our contact us form and we will get back to you as soon as possible.

 

Editor's Note: This article was updated on 23rd September 2021 to reflect current information.

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