Diseases & Conditions
At Boston Medical Center we pride ourselves on the ability to diagnose and treat a wide variety of thoracic conditions and symptoms, including emphysema. We do so in an environment of caring and compassion, where our priority is the well-being of you and your family.
What is Emphysema?
Emphysema is a progressive lung disease in which the small air sacs and airways in the lungs become damaged. More specifically, the walls between these air sacs (alveoli) lose their ability to stretch, which causes weakening and breakage. This gradual damage obstructs air flow so that exhaling air is difficult; breathing becomes a frustrating and painful process. Emphysema is more common in men than women, and occurs more frequently in people older than age 45.
Symptoms may include:
- Shortness of breath
- Chronic cough
- Limited ability to exercise comfortably
The most common cause of emphysema is smoking, particularly cigarette smoking. Tobacco can paralyze the tiny hairs (called cilia) that line bronchial tubes and usually sweep irritants and germs out of airways.
Other risk factors include:
- Deficiency in the alpha-1 atritrypsin (AAt) protein, which protects lung structures. Some people carry a single defective AAt gene and some people carry two. Symptoms in either of these two types may begin between 32 and 41 years of age.
- Exposure to secondhand smoke
- Age, since emphysema most often develops between the ages of 50 and 60 years
- Frequent exposure to chemicals, such as car exhaust
- HIV infection
- Some rare connective tissue disorders
One or more of the following tools may be used to diagnose emphysema:
- Chest X-rays provide an image of the heart, lungs, airways, blood vessels and bones in the spine and chest area.
- Computed tomography (CT) scans use X-rays to create two-dimensional images of the body, including lymph nodes. If contrast dye is used to improve the computer image, you may need to avoid eating or drinking for four to six hours before the test. Be sure to tell your doctor before the test if you have any allergies or if you have kidney problems.
- Arterial blood gas analysis measures how well your lungs transfer oxygen from the blood and how well the lungs remove carbon dioxide.
- Pulse oximetry measures the amount of oxygen in the blood using a small device that attaches to your fingertip.
Treatment methods vary based on your unique situation, but the most important treatment typically is quitting smoking. Using a combination of cessation techniques—such as support groups, nicotine patches or replacement drugs, counseling and relapse prevention—usually brings about the most positive results.
Other treatments include:
- Bronchodilators, a class of drugs that are either inhaled as a spray or taken as a pill, help open airways and allow for easier breathing
- Steroids to relieve symptoms
- Oxygen supplementation therapy
- Infusions of AAt
- Surgery may involve removing small parts of damaged lung tissue or, in the most severe cases, lung transplantation
- Bronchial valves decrease the size of overly inflated lungs
Pulmonary rehabilitation is often a key part of treatment, too. It includes education, exercise training and behavioral intervention to help restore you to a better level of function and comfort.