Emphysema - The Facts
Copyright 2006 Anne Wolski
Anyone suffering from a disease of the lungs knows how
distressing the shortness of breath can be. Emphysema is a
particularly acute lung disease in which the damage is permanent
so it is important to take all steps possible to avoid these
conditions in the first place.
Inside the respiratory system, there are very small sacs of air
called alveoli and the passages that lead to these sacs of air
are called bronchioles. In pulmonary emphysema, the bronchioles
become permanently distended with air. This condition reduces
the number of blood vessels because of the loss of elasticity in
the lung tissues. Consequently, the ability of the lungs to
provide oxygen continues to decrease and the person becomes
breathless very easily.
The condition is more common in men and usually appears after
the age of forty. It is thought that women may be protected by a
hormonal factor but this has not actually been proven. This
condition can cause disability and eventually death. The main
cause of emphysema is cigarette smoking. However, exposure to
pollution and dust on an ongoing basis can also bring on the
disease. This becomes a risk factor in some industries where
there are large amounts of dust. Also, people who suffer from
chronic bronchitis may also suffer from emphysema. If these
people are also smokers, it makes the condition even worse.
Not all smokers contract emphysema and it also occurs in non
smokers. Some feel that the white cells in the lungs produce a
substance called elastase. Smoke or dust interferes with the
cells causing them to release this elastase. If this happens, it
may attack the lung tissue.
When a person suffers from chronic bronchitis, the airways
become blocked with mucous because of irritation by smoke, dust
and other pollutants. This makes it difficult to breathe as the
person must overcome the resistance of the mucous. Inspiration
of air then results in distension of the alveoli. The elasticity
of the lung tissue may also be weakened by bacterial infections
which are common in chronic bronchitis.
Subcutaneous emphysema can also result from a broken rib that
punctures the lung or from whooping cough.
The most recognized symptom of emphysema is breathlessness. This
can be accompanied by a cough that can be brought on by the
smallest amount of action. Simply laughing or talking can make
the person breathless. There may also be discomfort after a meal
because the lungs have expanded. Sometimes this can result in
loss of appetite and resultant weight loss.
Some patients become cyanosed due to a lack of oxygen in the
blood. This bluish discolouration is most noticeable on the lips
and under the fingernails.
Emphysema can also affect the heart. The lungs become resistant
to the flow of blood as the alveolar walls thicken. This means
the heart has to work harder to force blood through the lungs,
putting extra strain on the heart.
The progress of pulmonary emphysema may be slowed with treatment
but it cannot be cured. Some bronchodilator drugs give relief,
particularly if the patient also has chronic bronchitis.
Breathing pure oxygen from a cylinder allows enough gas to enter
the blood stream.
Surgery to reduce lung volume is a new, experimental treatment
in which parts of both lungs are removed, decreasing the
hyperinflation of the chest and improving breathing.
Emphysema can sometimes be slowed but lung damage cannot be
repaired, so it is better not to begin smoking.