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Emphysema

Emphysema is a progressive lung disease in which the small air sacs and airways in the lungs become damaged, making breathing a frustrating and painful process.

Symptoms

Symptoms may include:

  • Shortness of breath
  • Chronic cough
  • Limited ability to exercise comfortably
  • Fatigue

Causes

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 age 50-60
  • Frequent exposure to chemicals, such as car exhaust
  • HIV infection
  • Some rare connective tissue disorders

Diagnosis

One or more of the following tools may be used to diagnose emphysema:

  • Chest X-ray

    Chest x-rays provide an image of the heart, lungs, airways, blood vessels and bones in the spine and chest area. They can be used to look for broken bones, diseases like pneumonia, abnormalities, or cancer.

  • Computed Tomography (CT) Scan

    CT scans use x-ray equipment and computer processing to produce 2-dimensional images of the body. The patient lies on a table and passes through a machine that looks like a large, squared-off donut. Doctors order CT scans when they want to see a two-dimensional image of the body to look for tumors and examine lymph nodes and bone abnormalities. If contrast dye is used to improve the computer image, the patient may need to avoid eating or drinking for 4 to 6 hours before the test. Patients should tell their provider before the test if they have any allergies or kidney problems.

  • Arterial blood gas analysis

    To measure how well your lungs transfer oxygen from the blood and how well the lungs remove carbon dioxide

  • Pulse Oximetry

    A pulse oximetry measures the amount of oxygen in the blood using a small device that attaches to the patient’s fingertip.

Treatment

Treatment methods vary based on the 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.

  • Oxygen supplementation therapy

    Oxygen supplementation therapy means providing a patient with additional oxygen, through a machine, to help them breathe more easily.

  • Infusions of Alpha-1 Antitrypsin

    This may be given to patients whose bodies do not produce enough of it on their own.

  • Medications
  • Surgery may involve removing small parts of damaged lung tissue or, in the most severe cases, lung transplantation

Pulmonary rehabilitation is often a key part of treatment, too. It includes education, exercise training, and behavioral intervention to help restore a better level of function and comfort.

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