EMPHYSEMA

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Emphysema is a lung condition that causes shortness of breath. In people with emphysema, the air sacs in the lungs (alveoli) are damaged. Over time, the inner walls of the air sacs weaken and rupture — creating larger air spaces instead of many small ones. This reduces the surface area of the lungs and, in turn, the amount of oxygen that reaches your bloodstream.

Symptoms

You can have emphysema for many years without noticing any signs or symptoms. The main symptom of emphysema is shortness of breath, which usually begins gradually.

You may start avoiding activities that cause you to be short of breath, so the symptom doesn’t become a problem until it starts interfering with daily tasks. Emphysema eventually causes shortness of breath even while you’re at rest.

When to see a doctor

See your doctor if you’ve had unexplained shortness of breath for several months, especially if it’s getting worse or it’s interfering with your daily activities. Don’t ignore it by telling yourself it’s because you’re aging or out of shape. Seek immediate medical attention if:

  • You’re so short of breath, you can’t climb stairs
  • Your lips or fingernails turn blue or gray with exertion
  • You’re not mentally alert

Causes

The main cause of emphysema is long-term exposure to airborne irritants, including:

  • Tobacco smoke
  • Marijuana smoke
  • Air pollution
  • Chemical fumes and dust

Rarely, emphysema is caused by an inherited deficiency of a protein that protects the elastic structures in the lungs. It’s called alpha-1-antitrypsin deficiency emphysema.

Risk factors

Factors that increase your risk of developing emphysema include:

  • Smoking. Emphysema is most likely to develop in cigarette smokers, but cigar and pipe smokers also are susceptible. The risk for all types of smokers increases with the number of years and amount of tobacco smoked.
  • Age. Although the lung damage that occurs in emphysema develops gradually, most people with tobacco-related emphysema begin to experience symptoms of the disease between the ages of 40 and 60.
  • Exposure to secondhand smoke.Secondhand smoke, also known as passive or environmental tobacco smoke, is smoke that you inadvertently inhale from someone else’s cigarette, pipe or cigar. Being around secondhand smoke increases your risk of emphysema.
  • Occupational exposure to fumes or dust.If you breathe fumes from certain chemicals or dust from grain, cotton, wood or mining products, you’re more likely to develop emphysema. This risk is even greater if you smoke.
  • 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 your risk of emphysema.

Complications

People who have emphysema are also more likely to develop:

  • Collapsed lung (pneumothorax). A collapsed lung can be life-threatening in people who have severe emphysema, because the function of their lungs is already so compromised. This is uncommon but serious when it occurs.
  • Heart problems. Emphysema can increase the pressure in the arteries that connect the heart and lungs. This can cause a condition called cor pulmonale, in which a section of the heart expands and weakens.
  • Large holes in the lungs (bullae). Some people with emphysema develop empty spaces in the lungs called bullae. They can be as large as half the lung. In addition to reducing the amount of space available for the lung to expand, giant bullae can increase your risk of pneumothorax.

Treatment

-Mild physical activity.
-Avoid pulmonary irritants, i.e. smoking, exposure
to dust, humid or cold air.
-Control of bronchial secretion—Mucous liquification by giving plenty of fluids, Bromhexine and facilitation of expectoration by giving expectorants.

-Control of respiratory infection by giving the appropriate antibiotic. When mixed organisms are likely, long course of Tetracycline is preferable.
-Relief of respiratory obstruction by use of broncho- dilators, preferably in the aerosol form. Salbutamol or Ventolin are preferred.
-Breathing exercises to improve alveolar ventilation,i.e.
a. To exhale through closed lips gradually and as
completely as possible.
b. Rapid inhalation.
c. To contract abdominal muscles gently during expiration.
-Intermittent positive pressure breathing for patients of advanced respiratory acidosis.
-Corticosteroids in lowest doses especially to
patients of chronic bronchitis.Phlebotomy especially if polycythemia is trouble some.

Treatments include:

  • Lifestyle changes, such as
    • Quitting smoking if you are a smoker. This is the most important step you can take to treat emphysema.
    • Avoiding secondhand smoke and places where you might breathe in other lung irritants
    • Ask your health care provider for an eating plan that will meet your nutritional needs. Also ask about how much physical activity you can do. Physical activity can strengthen the muscles that help you breathe and improve your overall wellness.
  • Medicines, such as
    • Bronchodilators, which relax the muscles around your airways. This helps open your airways and makes breathing easier. Most bronchodilators are taken through an inhaler. In more severe cases, the inhaler may also contain steroids to reduce inflammation.
    • Vaccines for the flu and pneumococcal pneumonia, since people with emphysema are at higher risk for serious problems from these diseases
    • Antibiotics if you get a bacterial or viral lung infection
  • Oxygen therapy , if you have severe emphysema and low levels of oxygen in your blood. Oxygen therapy can help you breathe better. You may need extra oxygen all the time or only at certain times.
  • Pulmonary rehabilitation , which is a program that helps improve the well-being of people who have chronic breathing problems. It may include
    • An exercise program
    • Disease management training
    • Nutritional counseling
    • Psychological counseling
  • Surgery, usually as a last resort for people who have severe symptoms that have not gotten better with medicines. There are surgeries to
    • Remove damaged lung tissue
    • Remove large air spaces (bullae) that can form when air sacs are destroyed. The bullae can interfere with breathing.
    • Do a lung transplants . This is might be an option if you have very severe emphysema.

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