Emphysema

2021-07-24 12:06 PM

Shortness of breath, wheezing, chest tightness, decreased physical activity, chronic cough, poor appetite, and thinness, fatigue

Define

Emphysema is a factor in the progression of chronic obstructive pulmonary disease (COPD), a problem that restricts the flow of air during expiration. Emphysema occurs when the alveoli at the end of the smallest air passages (bronchioles) are slowly being destroyed. Smoking is the leading cause of emphysema.

More severe emphysema causes the alveoli to become spherules - cluster-like, irregular alveolar sacs with holes in its inner wall. This reduces the number of alveoli and limits oxygen from the lungs to the blood. In addition, the elastic fibers to keep open the small airways leading to the alveolar sacs gradually being destroyed, collapsing on expiration.
 
Airway obstruction, a symptom of COPD that contributes to emphysema. The combination of emphysema and an obstructed airway makes breathing increasingly difficult. Treatment often slows disease progression but does not reverse it.

Symptoms

Symptoms of emphysema begin mildly with the disease steadily progressing to worsen. The main symptoms of emphysema are:

Shortness of breath.

Wheeze.

Chest tightness.

Reduced physical activity.

Chronic cough, which can also indicate chronic bronchitis.

Loss of appetite and weight loss.

Tired.

See a doctor

Get tired quickly, or may not be able to do things easily.

Unable to breathe when the level of performance is even moderate.

Shortness of breath when cold.

Blue or gray lips or fingernails indicate low blood oxygen.

Frequent coughing up yellow or green sputum.

Bending down to tie your shoes makes breathing difficult.

Weight loss.

These signs and symptoms do not necessarily mean there is edema, but they do indicate that the lungs are not working properly and should be evaluated by a doctor as soon as possible.

Causes

Causes of emphysema include:

Smoking

Smoking is the most common cause of emphysema. There are more than 4,000 chemicals in cigarette smoke. These chemical irritants slowly destroy small peripheral airways, air sacs - elastic and supportive of elastic fibers.

Protein deficiency

About 1 to 2 percent of people with emphysema have an inherited genetic deficiency of a protein called AAT, which protects the elastic structures in the lungs. Without this protein, enzymes can cause progressive lung damage, eventually leading to emphysema. If you smoke with AAT deficiency, emphysema can begin in your 30s and 40s. The progression and severity of this disease are very rapid due to smoking.

Risk factors

Risk factors for emphysema include:

Smoking

Emphysema is most likely to develop in cigarette and cigar smokers, also the risk for all smokers increases with the number of years and number of cigarettes smoked.

Age

Although the lung damage that occurs with emphysema develops gradually, most people with tobacco-related emphysema begin to have symptoms between the ages of 40 and 60.

Exposure to secondhand smoke

Secondhand smoke, also called secondhand smoke, is not smoking that is accidentally inhaled from other people, cigarettes or cigars. Ambient smoke increases the risk of emphysema.

Occupations exposed to smoke and dust

If you breathe in fumes from certain chemicals, dust from grains, wood, cotton, or mining products, you are more likely to develop emphysema. This risk is even greater if you smoke.

Exposure to indoor and outdoor pollution

Breathing indoor pollutants, such as emissions from heating fuels, as well as outdoor pollutants, such as car exhaust, increase the risk of emphysema.

HIV infection

Smokers living with HIV have a greater risk of emphysema than smokers without HIV.

Connective tissue disorders

A number of problems that affect the connective tissues - the fibers that provide the framework and support to the body - are associated with emphysema. These conditions include laxa-dermal, a rare disease that causes premature aging, and Marfan syndrome, a disorder that affects many different organs, especially the heart, eyes, bones, and lungs.

Complications

Emphysema can increase the severity of other chronic conditions, like diabetes and heart failure. If you have emphysema, air pollution or a respiratory infection can lead to a COPD exacerbation, with increased shortness of breath and dangerously low oxygen levels. It may be necessary to enter intensive care and temporary support from an artificial ventilator until the infection is cleared.

Tests and diagnostics

To determine, your doctor may recommend certain tests, including:

Spirometry and pulmonary function tests (PFTs)

Noninvasive tests can detect emphysema before symptoms appear. Assess the air the lungs can hold and the flow of air in and out of the lungs. It is also possible to measure how well the lungs supply oxygen to the blood.

In spirometry, blowing into a spirometer is usually required. PFTs can be done before and after using the inhaler to check for a response to it. If you're a smoker or former smoker, ask your doctor about participating in these trials, even if you don't have symptoms of emphysema or COPD.

Arterial blood air analysis

Blood tests measure how well the lungs move oxygen into the blood and remove carbon dioxide.

Oxygen pulse measurement method

This test involves the use of a small device attached to the finger. Blood oxygen measurement is otherwise measured by blood gas analysis. To help determine if supplemental oxygen is needed, testing may be done at rest, during exercise, and overnight.

X-ray

X-rays can help confirm the diagnosis of emphysema and rule out other causes of dyspnea, but radiographs are not sufficient to make an accurate diagnosis.

Sputum test

Analysis of sputum cells can help determine the cause of some lung problems.

Computed tomography (CT scan). A CT scan can allow your doctor to see internal organs where features or blisters are caused by emphysema.

Treatments and drugs

The most important step in any treatment plan for a smoker with emphysema is to stop smoking, which is the only way to prevent the damage to the lungs from getting worse. But quitting is never easy, and people often need the help of a comprehensive smoking cessation plan, which may include:

Target date to quit smoking.

Prevention and control of addiction.

Tips for healthy lifestyle changes.

Social support system.

Medicines, nicotine or alternative gum, and prescription drugs hydrochloride, bupropion, and varenicline.

Other treatments for emphysema focus on helping you feel better, get back to being more active and slow the progression of emphysema. These include:

Bronchodilators

These drugs can help relieve cough and shortness of breath by relaxing narrowed airways, but they are not as effective in treating emphysema as they are in treating asthma or chronic bronchitis.

Inhale steroids

Inhaled corticosteroids such as aerosol sprays can relieve symptoms of emphysema associated with asthma and bronchitis. Although inhaled steroids have fewer side effects than oral steroids, long-term use can weaken bones and increase the risk of hypertension, cataracts, and diabetes.

Treatment of GERD

Gastroesophageal reflux disease (GERD) symptoms worsen airway problems in many people, so your doctor may recommend medication as well as lifestyle changes to treat it.

Additional oxygen

If you have severe emphysema with low blood oxygen levels, using oxygen regularly at home and with exercise may provide some relief. Many people use oxygen 24 hours a day. Many forms of oxygen are available as well as different devices to deliver oxygen to the lungs.

Pulmonary rehabilitation program

An important part of treatment includes a pulmonary rehabilitation program, which combines education, training, exercise, and behavioral interventions to help return to activity and improve health and quality of life. living.

Help with smoking cessation and nutritional needs

Special breathing techniques and ways to conserve energy can be learned. Because exercise can help slow the decline in lung function.

Antibiotics

If you develop a bacterial infection such as bronchitis or pneumonia.

Vaccination against flu and pneumonia

If you have emphysema or other forms of COPD, experts recommend yearly flu (flu) and pneumonia prevention every five years.

Surgery

In an experimental procedure called lung volume reduction surgery (LVRS), surgeons remove small damaged lung tissue. Removing diseased tissue helps the lungs work more efficiently and improves breathing.

In another surgery, called a bullectomy, doctors remove one or more of the balloons that have formed when the small air sacs are destroyed. This procedure can improve breathing.

Implant

A lung transplant is an option if there is severe emphysema and other options have failed.

Lifestyle and remedies

Some simple exercises can improve breathing if you have emphysema or another chronic disorder. They help control the lungs by using the abdominal muscles 2 - 4 times a day.

Diaphragm breathing

To perform the breathing pattern, follow these steps:

Lie on your back with your head supported by pillows. Start by breathing in and out slowly and gently in a rhythmic pattern - relax.

Place your fingers on your belly, just below your rib cage. As you inhale slowly, you should feel your diaphragm lift your hand.