Emphysema Causes and Treatment

All of us have been short of breath at some time - most commonly after strenuous exercise or during a bout of coughing. You gasp for air, and wonder where the next breath is coming from, but then the problem slowly passes. But try and imagine the way you would feel if the shortness of breath did not go away. Imagine constantly gasping for breath - even while resting in front of the television - even while trying to sleep! This is the way patients with emphysema feel. Emphysema is an incurable disease that is frequently caused by smoking or exposure to other noxious gases. Recurrent attacks of bronchitis or pneumonia may also be responsible for it.

The lung is made from millions of tiny bubbles (called alveoli), rather like the foam that detergent makes while you are washing the dishes. These tiny bubbles are all interconnected by fine tubes that join together into successively larger tubes (called bronchi) to eventually form the windpipe (trachea). Air enters and leaves the lungs through the tubes, and essential oxygen is absorbed into the bloodstream through the walls of the tiny bubbles. With constant exposure to noxious gases, or repeated lung infections, these bubbles start to break down into larger cavities. If you watch detergent foam in the sink, this too will gradually merge into fewer larger bubbles in much the same way as a lung affected by emphysema. These larger cavities have less surface area to absorb oxygen, and there is a great deal of scar tissue also affecting their function. Oxygen is essential for the function of the body, and when it is lacking, signals are sent to make you breathe faster and deeper. With emphysema, these signals go unanswered because the lungs are already working to their full capacity.

Emphysema is most common in the elderly, and in addition to their constant shortness of breath, sufferers have a constant cough, a barrel shaped chest and excessive sputum. Because of their constant exertion to breathe, they are wasted and emaciated. This worsens as the disease progresses.

The disease is diagnosed by X-rays, and by breathing into machines (e.g. spirometers, peak flow meters) that can analyze the lung function. There may be changes found in blood tests and electrocardiograms (ECG) indicating chronic oxygen starvation. Once diagnosed, it is essential to avoid any further deterioration as the damage is permanent.

Treatment is aimed at trying to control the situation. It involves physiotherapy to make the damaged lung work as effectively as possible, drugs by tablet or spray to open up the lungs to their maximum capacity, and antibiotics to treat infection at the earliest possible stage. In severe cases, steroids by inhalation or tablet, are given to reduce any inflammation in the lungs, and as a last resort oxygen may be given to make more effective what breathing can be managed. Oxygen can be provided by cylinders of compressed gas or, more efficiently in chronic cases, by a machine that concentrates oxygen from the atmosphere.

Complications of emphysema include recurrent attacks of bronchitis and pneumonia, heart failure and pneumothorax. It is these complications that eventually cause death in emphysemic patients. Vaccination against influenza with annual flu shots, and the use of Broncostat to prevent bronchitis may prevent a fatal illness.

The best form of treatment is prevention. Emphysema is a terrible and distressing disease, and if you smoke you have a reasonable chance of developing it.

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