A B C D E F G H I J K L M N O P R S T U V W

EMPHYSEMA

How does Emphysema occur ?

COPD is the result of increased production of mucus in the lining of the bronchi. The bronchi are series of branching tubes which carry air from the main windpipe (trachea) to the lung tissues. The mucus builds up in the bronchi, and can easily become infected. This leads to narrowing of the bronchi, and the symptoms of cough, sputum and shortness of breath. In emphysema, the thin walls of the air spaces (alveoli) are destroyed. This means that there is less space available for oxygen to get absorbed, causing breathlessness. One of the less common causes of emphysema is a hereditary lack of a chemical, or enzyme, that protects the alveoli against damage. This condition is called alpha-1-antitrypsin deficiency.

Why does Emphysema occur ?

Although as stated above, some people are born with a tendency to COPD or emphysema, the conditions usually result from the harmful effects of the environment in particular from cigarette smoking. Cigarette smoking is the biggest single cause of preventable death and disease. Although fewer people are smoking now, the harmful effects of cigarettes on COPD will be present for many years yet. Sulphur dioxide is another potent cause of lung damage. People who spend much of their lives in polluted environments, particularly great industrial centres, are much more likely to suffer from COPD. Certain occupations are high risk, especially coal mining, where a special sort of COPD called pneumoconiosis used to be common. With better medical supervision now available, this problem occurs less than it used to.

Treatment Involved for Emphysema

Wherever possible, the best sort of treatment for COPD is to avoid the conditions that brought it about. This means living in a smoke-free and pollution-free environment something that may be easier said than done. Continuing to smoke will certainly worsen both COPD and emphysema. General fitness measures and exercise are very important, since they help to maintain the function of the lungs at their best possible level. Antibiotics do not play a major part in the regular management of COPD but they may be required quite often for episodes of acute bronchitis, because people with COPD are much more prone to these. For these episodes they are very effective but probably do not have much impact on the underlying problem. Doctors may advise that the patient keeps antibiotics on hand so that they may be started at the first sign of an acute infection (such as a cold, or a change in colour of the sputum). Other drugs, known as bronchodilators, are prescribed when the airways obstruction is partially reversible (as shown by breathing tests).. They improve breathing by opening up the narrowed bronchi. Generally though, they are not as helpful in COPD as in asthma, where they are prescribed much more. Oxygen is given for relief of breathlessness, when the condition is severe, or sometimes during an acute infection if symptoms are distressing. If the condition is advanced, long term oxygen therapy may be provided at home, for the patient to breathe for prolonged periods of up to 15 hours per day. This is provided through a facemask or tubes (cannula) placed in the nose. It makes it possible for people to live at home who might otherwisehave been hospitalized permanently. Oxygen concentrators are now available. These are machines which can extract oxygen from room air, and they have made large oxygen cylinders unnecessary. Physiotherapy to the chest can be very helpful, particularly during acute infections.

After Treatment for Emphysema

The treatment of COPD and emphysema is lifelong, in terms of avoiding causes and maintaining good health. In this sense there is no after treatment phase. After acute infections, though, there is always a chance of relapse in the early weeks and so careful attention to symptoms will help to spot this.

If Emphysema is Left Untreated

A gradual worsening of lung function would be expected, particularly if the main causative factors could not be avoided or reduced.

Effects on Family of Emphysema

Support and understanding, as with all problems, will help to make the quality of life better. Physiotherapy can be learnt by your relatives or friends and given at home to help in clearing phlegm from the chest. When oxygen is needed in the home, the family should learn how to maintain the equipment.