Emphysema is a chronic and progressive lung condition that usually causes alveoli enlargement, making it more difficult to breathe. Progressive means there is a chance for the disease to progressively worsen with age. Does this mean that it always worsens over time?
What is emphysema?
It is chronic lung disease that can cause irreversible destruction of the lungs, especially for alveoli (located at the end of bronchial tubes). The damaged alveoli can significantly impair with the lungs function, because there will be less space for gas exchange between oxygen and carbon dioxide.
Alveoli are essential part of your lung where oxygen begins entering the blood and carbon dioxide begins leaving the circulation. If they get damaged, this can make breathing more difficult and the supply of oxygen to the body will be affected.
Emphysema belongs to a group of diseases called chronic obstructive pulmonary disease (COPD). Even it is one of the main types of COPD.
Cigarette smoking is the leading cause of the disease. It’s associated with about 80-90 percent of deaths due to emphysema. Interestingly, many smokers don’t develop the disease. But it’s still thought that the best way to prevent the disease is not to smoke. Avoiding secondhand smoke is important, too.
Quitting is also worth a try if you’re already diagnosed with the disease. It can help prevent the disease from getting worse and preserve the lungs functions as much as possible.
In a few cases, the disease is linked to alpha-1-antitrypsin deficiency, a genetic abnormality. Exposure to other airborne irritants, such as manufacturing fumes and air pollution, sometimes also has a role to cause the disease.
It is not easy to catch the disease at early stages, because many times it doesn’t have early symptoms. If you have it, you may not know it for many years. On the other hand, it’s most treatable if caught early.
Shortness of breath (typically on exertion) is the most common symptom. But as the disease becomes advanced, breathlessness may also flare up even at rest. Other symptoms include persistent cough and sometimes wheezing.
If your doctors think that your symptoms are associated with COPD, there are usually several tests you need to follow.
- Physical examination, including interview to ask any respiratory symptom that you have.
- Lung function test, such as spirometry. It is used to help diagnose emphysema by measuring the capacity of your lung, as well as to determine the stage of the disease.
- Imaging tests, such as X-rays and CT-scan. These can help relieve how far changes in the lung have occurred. CT-scan is more effective than X-rays. Early changes of emphysema may show up on CT-scan.
Does emphysema always get worse?
Although it can be progressive and cause permanent damage in the lung, this doesn’t mean that it always worsens. The symptoms can come and go, chronic. This means that there is also a time for remission to occur.
Remission doesn’t mean that the disease is cured. It means that the symptoms disappear for a while. But as long as the disease is controlled as well, there should be nothing to worry – especially true if the disease has not become advanced.
The damaged alveoli due to emphysema is currently irreversible, there is still no cure. But the disease is controllable.
However, in fact again it is a progressive lung disease. This means it develops gradually and tends to get worse over time, as noted before. For example, typically it takes years for emphysema associated with smoking to destroy tiny air sacs in the lungs. Once the damage is done, it’s irreversible.
Therefore, it’s important for people with this respiratory disease to clearly understand what they should do to control and prevent it from worsening. Some effective treatments are available to avoid the complications of the disease.
Depending on the severity of the disease, appropriate treatments and lifestyle changes can help preserve the lung function and the patient should still be able to have a good or even normal quality of life. Appropriate treatment and management also have been shown to improve the symptoms and help patients stay out of hospital.
The prognosis and outlook (life expectancy) for people with emphysema can vary. Each case is also different. There is no any formula that can tell you exactly what will happen. But in general, the prognosis of the disease is dependent on the following factors:
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- The stage of the disease, how far it has caused damage to the lung.
- How well the lungs are functioning.
- And how well the patient responds to and follows the treatment plan.
For more information about the prognosis and life expectancy of emphysema, see in here!
Treatment options
Again, the damaged alveoli due to emphysema are permanent (irreversible). But the treatment can help control the disease and prevent the complications.
The treatment can involve medications or just with some lifestyle measures, depending on the severity of the disease. In more severe case, surgery may be required.
The single most important thing to remember is to stop and avoid tobacco smoke. Quitting smoking (if you’re a smoker), can significantly slow the progression of the disease and improve the symptoms.
Although shortness of breath usually worsens on exertion, especially when the disease flares up, but this doesn’t mean that you can skip your exercise. However, exercise is important to strengthen the breathing muscles and improve the overall health of your lung. When you think ready for exercise, do it regularly!
To help relieve shortness of breath, medications such as inhalers may be required to help open the airways and relax the lung. If you have a sudden worsening with increased breathlessness, anti-inflammatory steroids may be prescribed.
Surgery is rarely used for emphysema treatment. But sometimes it’s suggested when the doctor think that removing the damaged areas of the lung can help relieve shortness of breath or other symptoms of the disease, and make it easier for breathing. One of procedures for this goal is called lung volume reduction surgery. In this procedure, specialist will remove the most severely damaged portion of the lung.
In a few cases, lung transplantation is also suggested. This is particularly true if other treatments fail to work.