Elasticity of the lung tissue is lost, causing air to be trapped in the air sacs and impairing the exchange of oxygen and carbon dioxide. The result is that the small airways collapse during expiration, leading to an obstructive form of lung disease . Cigarette
Signs and symptoms
The two most common symptoms of emphysema are shortness of breath and a reduced capacity for physical activity. As the disease progresses both of these symptoms are becoming worse.
Other signs and symptoms of emphysema include:
- Chronic, mild cough which sometimes may produce sputum or phlegm.
- Loss of appetite and weight loss. Emphysema can make eating more difficult because the act of eating can leave you out of breath. The result is that you simply may not feel like eating much of the time.
- Fatigue. The patients with emphysema are feeling tired all the time because it's more difficult to breathe and because your body is getting less oxygen.
Emphysema and chronic bronchitis frequently co-exist together to comprise chronic obstructive pulmonary disease.
Pathophysiology of the condition
When someone inhales, air travels to lungs through two major airways called bronchi. The bronchi divide into million smaller airways that finally end in clusters of tiny air sacs called alveoli. What happens in emphysema? In emphysema, inflammation destroys these fragile walls of the air sacs, causing them to lose their elasticity.
The result is clear- the bronchioles collapse, and air becomes trapped in the air sacs, causing them to overstretch. With time, this overstretching may cause several air sacs to rupture, forming one larger air space instead of many small ones.
Usually when someone is diagnosed with emphysema, many of those elastic fibers located in the lungs have already been destroyed, so the forced exhalation compresses many of the small airways, making expelling air even more difficult.
Possible causes of emphysema
Tobacco smoke
The fact is that cigarette smoke is by far the most common cause of emphysema. The damage begins when tobacco smoke temporarily paralyzes the microscopic hairs called cilia that line bronchial air ways. What is the purpose of these hairs? Normally, these hairs sweep irritants and germs out of your airways, but when smoke interferes with this sweeping movement, irritants remain in your bronchial tubes and infiltrate the alveoli, inflaming the tissue and eventually breaking down elastic fibers. Oxidants present in the smoke itself or those generated by inflammatory cells in response to the particulate phase of the smoke, inactivate proteinase inhibitors and the increased inflammatory cells produce and release additional proteinases.
Protein deficiency
It is also proven that emphysema could results from low levels of a protein called alpha-1-antitrypsin. The purpose of this protein is to protect the elastic structures in lungs from the destructive effects of certain enzymes. It is easy to understand that a lack of this protein can lead to progressive lung damage which eventually results in emphysema. This deficiency is a hereditary condition that occurs when you inherit two defective genes, one from each parent. When will the first symptoms occur? People with two defective genes have a high likelihood of developing emphysema, usually between the ages of 30 and 40.
Risk factors for developing emphysema – SMOKING
The single greatest risk factor for emphysema is tobacco smoking. Emphysema is most likely to develop in cigarette smokers, but cigar and pipe smokers are also susceptible, and the risk for all types of smokers increases with the number of years and the amount of tobacco smoked.
Other risk factors include:
Age
The lung damage that occurs in emphysema develops gradually and most people with emphysema begin to experience the symptoms between the ages of 50 and 60. This means that the age is also one of the very important risk factors.
Exposure to secondhand smoke
Although not too many people pay attention to it, secondhand smoke is a very important risk factor too. What exactly is the secondhand smoke? Also known as passive or environmental tobacco smoke, secondhand smoke is smoke that you inhale from someone else's cigarette, pipe or cigar. Despite the negative effects that involuntarily inhaled tobacco smoke can have on the lung, no experimental model of the passive smoker has been proposed.
Exposure to chemical fumes
If someone breathes fumes from certain chemicals or dust from grain, cotton, wood or mining products, she or he is definitely more likely to develop emphysema. The risk is even greater if that person smokes.
Exposure to indoor and outdoor pollution
Breathing indoor pollutants such as fumes from heating fuel as well as outdoor pollutants , car exhaust, for instance, increases the risk of emphysema significantly.
Heredity
It is proven that rare, inherited deficiency of the protein, alpha-1-antitrypsin can cause emphysema.
HIV infection
Smokers living with HIV are at greater risk of emphysema. In most cases these people develop the disease at a relatively young age.
Connective tissue disorders
Some conditions that affect connective tissue are associated with emphysema.
These conditions include:
- Cutis laxa, a rare disease that causes premature aging, and
- Marfan syndrome, a disorder that affects many different organs, especially the heart, eyes, skeleton and lungs.
Diagnosis of emphysema
To determine whether you have emphysema, your doctor is likely to recommend certain tests, including:
Pulmonary function tests
These are very helpful diagnostic tools because they are noninvasive and can detect emphysema before a person has any symptoms. These tests measure how much air lungs can hold and the flow of air in and out of lungs. They can also measure the amount of gases exchanged across the membrane between your alveolar wall and capillary membrane.
Chest X-ray
A chest X-ray is usually used to help rule out other lung problems rather than to diagnose emphysema.
Arterial blood gases analysis
These blood tests measure how well lungs transfer oxygen to your bloodstream and how effectively they remove carbon dioxide from the blood.
Pulse oximetry test
This test involves use of a small device that is beeing attached to your fingertip. The device is called oximetar. It measures the amount of oxygen in blood differently from the way it's measured in blood gas analysis.
Sputum examination
Analysis of cells in sputum can help determine the cause of some lung problems.
Computerized tomography scan
A CT scan allows a doctor to see organs in two-dimensional images. It is done by a computer. Split-second computer processing creates images as a series of very thin X-ray beams are passed through your body. A CT scan can detect emphysema sooner than an X-ray can.
What can tobacco do to your health?
It is proven that smoking at an early age can cause lung cancer. When you smoke you lower your level of lung function. Smoking also causes several other respiratory damages, shortness of breath and reduces the rate of lung growth.
What are the kinds of illnesses that you can get from smoking tobacco?
You can get lung cancer, trachea, or throat cancer. Smoking also causes emphysema, or blackened tarnished lungs. Smoking irritates lung cells causing them to produce a layer of mucus, which makes it harder to breath. Tobacco smoke eats away at lung cells. Smoking can also stain your teeth because tar residue from the smoke builds up on them. Trying to brush or use mouthwash won't help. Smoking also leaves a foul scent on you which is also hard to get rid of. Smoking weakens teeth causing them to break.
Treatment of emphysema
The most essential step in any treatment plan for smokers with emphysema is to stop smoking; it's the only way to prevent the damage to your lungs from becoming worse.
Other treatments, which focus on relieving symptoms and preventing complications, include:
- Bronchodilators- drugs that can help relieve coughing, shortness of breath and trouble breathing by opening constricted airways.
- Corticosteroid drugs inhaled as aerosol sprays may relieve symptoms of emphysema associated with asthma and bronchitis, although inhaled steroids have several side effects
- Supplemental oxygen may provide some relief. Various forms of oxygen are available as well as different devices to deliver them to your lungs.
- Protein therapy. Infusions of the alpha-1-antitrypsin protein may help slow lung damage in people with an inherited deficiency of that protein.
- Respiratory infections such as acute bronchitis, pneumonia and influenza are a leading complication of emphysema which can be cured with different antibiotics!
- Surgery. In a procedure called lung volume reduction surgery, surgeons remove small wedges of damaged lung tissue. Lung transplantation is also an option if you have a severe emphysema and other options have failed.