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Emphysema

Emphysema is a chronic lung disease. It is often caused by exposure to toxic chemicals or long-term exposure to tobacco smoke.

Signs and symptoms

Emphysema symptoms are characterised by loss of elasticity of the lung tissue; destruction of structures supporting the alveoli; and destruction of capillaries feeding the alveoli. The result is that the small airways collapse early during expiration, leading to an obstructive form of lung disease (air is trapped in the lungs in obstructive lung diseases).

Feature symptoms of emphesyma are: shortness of breath on exertion--particularly when climbing stairs or inclines (and later at rest), hyperventilation and an expanded chest. As emphysema progresses, clubbing of the fingers may be observed, a feature of longstanding hypoxia.

Emphysema patients are sometimes referred to as "pink puffers". This is because emphysema sufferers may hyperventilate to maintain adequate blood oxygen levels. Hyperventilation explains why emphysema patients do not appear cyanotic as chronic bronchitis (another COPD disorder) sufferers often do; hence they are "pink" puffers (adequate oxygen levels in the blood) and not "blue" bloaters (cyanosis; inadequate oxygen in the blood).

diagnosis of emphysema

Diagnosis is by spirometry (lung function testing), including diffusion testing. Other investigations might include X-rays, high resolution spiral chest CT-scan, bronchoscopy (when other lung disease is suspected, including malignancy), blood tests, pulse oximetry and arterial blood gas sampling.

prognosis and treatment of emphysema

Emphysema is an irreversible degenerative condition. The most important measure that can be taken to slow the progression of emphysema is for the patient to stop smoking and avoid all exposure to cigarette smoke and lung irritants. Pulmonary rehabilitation can be very helpful to optimize the patients quality of life and teach the patient how to actively manage his or her care. It is treated by supporting the breathing with anticholinergics, bronchodilators and (inhaled or oral) steroid medication, and supplemental oxygen as required. Treating patient's other conditions including gastric reflux and allergies may also help the patient's lung function. Supplemental oxygen used as prescribed (20+ hours/day) is the only non-surgical treatment which has been shown to prolong life in emphysema patients. Other medications are being researched. There are lightweight portable oxygen systems which allow patients increasing mobility. Patients fly, cruise, and work while using supplemental oxygen.

Lung volume reduction surgery (LVRS) can improve the quality of life for carefully selected patients. It can be done by several different methods, some of which are minimally invasive. The only 'cure' for emphysema is a lung transplant, although not many patients are strong enough physically to survive the surgery. The combination of patient's age, oxygen deprivation and the side-effects of the medications used to treat emphysema cause damage to the kidneys, heart and other bodily organs. Transplants also require the patient to take a anti-rejection drug regimen which suppresses immunities and creates new medical issues.

Posted by Staff at May 20, 2005 4:35 AM

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