Emphysema

Emphysema – understanding the respiratory disease

Emphysema is a type of COPD or Chronic Obstructive Pulmonary Disease. As the name suggests, it is caused by obstructions in the respiratory tract which mainly causes difficulty in breathing. By nature, this is a long-term condition where the symptoms worsen over time. As the disease progresses, the irreversible damage to the lungs could lead to severe disability and even death in many patients.

Emphysema affects the lungs and massively changes its anatomy. Lungs are responsible for the vital exchange of gases between the human body and external surrounding. The lung tissues are made up of bronchioles which are tiny air pathways. Due to over-inflation of the air sacs or alveoli, these tissues get irreversibly damaged. Owing to this damage, the bronchioles are unable to release air out of the lungs, severely limiting the individual’s capacity to breathe.

Under normal conditions, human lungs resemble a sponge, both in appearance and function.

The primary function of lungs is to absorb oxygen and exhale carbon dioxide.

This function is made possible by the coordinated working of millions of airways stretching and relaxing to make way for thegaseous exchange.

Upon the onset of emphysema, the “spongy-ness” of the lungs is significantly reduced which leads to air being trapped in it.In addition to the bronchiole damage, emphysema also leads to poor blood flow to the lungs which further hinders normal breathing.This condition usually occurs in tandem with chronic bronchitis (inflammation of bronchioles). Hence the umbrella term COPD is used to refer to these ailments. COPD is one of the leading causes of deaths in the USA.

Emphysema – causes and risk factors

The two causes which primarily lead to the onset of emphysema are Smoking and AAT deficiency.

Cigarette smoking is one of the most significant factors linked to the occurrence of emphysema.

Tobacco and nicotine intake through smoking render severe lung damage in two distinct ways.

Firstly, smoking largely reduces the lung’s ability to clear mucous-related secretions through cilia.

This inevitably leads to large mucous deposition in the lungs which restricts airflow.

Secondly, due to smoking, the immunity of lungs is primarily compromised and hence they are not able to get rid of infections. These infections give rise to inflammation of the lung tissues which further add to the severity of the condition.The deficiency of the protein AAT (Alpha-1 Antitrypsin) causes depletion of WBCs (white blood cells). In the absence of AAT, the lung is unable to fight against infections caused by the enzyme trypsin. The after-effects are akin to that of smoking as the lungs progressively degenerate rendering normal breathing impossible. This is a genetic predisposition.

Other factors which may cause emphysema may include exposure to polluted air, passive smoking, and hazardous working conditions which may expose an individual to noxious fumes and chemicals.The risk factors for emphysema are smoking, old age, working in mining/cotton/wood factories and frequent exposure to automotive exhaust.

What are the major symptoms of emphysema?

• The onset of emphysema is indicated by shortness of breath which worsens over time.
• Usual physical activities such as walking or jogging will cause more than usual difficulty in breathing.
• As the condition progresses, even during times of rest the person will experience troubled breathing.
• Gradually the person starts developing frequent coughs and wheezing accompanied by a large production of mucous.
• The person will also suffer from chronic bronchitis and/or asthma.
• Those who have AAT deficiency caused emphysema will observe these symptoms to develop at earlier ages as compared to chain smokers.
• Emphysema patients gradually develop the habit of “pursed-lip breathing” (breathing through the mouth) and even “barrel chest” condition (decrease in the distance between chest and back).

How is emphysema detected?

The first diagnostic method in detecting emphysema will include the physician to check for the extent of breathing and wheezing and also for the barrel-chest symptom.

• Imagining tests such as X-rays and CT-scans are useful in identifying the correct reason for lung obstruction. Since trouble in breathing could be caused by many other conditions, it is important to rule out the presence of a tumour or any other factor that might be restricting the air-flow. These also indicate the presence of over-inflated lungs and the extent of lung damage.
• Pulmonary Function Tests (PFTs) are non-invasive in nature and are useful in measuring the amount of airflow occurring within the lungs. These are accurate in determining the severity of emphysema.
• Blood tests which check for RBC and WBC count also help doctors gauge the onset of emphysema. The arterial blood gas test sheds light on the levels of oxygen and carbon dioxide present in the patient’s blood.

Treatment methods for emphysema

The treatment protocol adopted for treating emphysema depends upon the magnitude of symptoms surfacing on the patient. The level of damage caused within the lung tissues is strictly irreversible. Hence, the treatment focuses on slowing the progress of the disease and enabling the patient to  manage the symptoms:

• Medications – The kind of medications which help manage emphysema are bronchodilators, steroids, and antibiotics. Bronchodilators such as albuterol and ipratropium are responsible for clearing the constricted airways. Antibiotics are helpful for those who have chronic shortness of breath. This is due to increased inflammation and infections in the lungs such as pneumonia or bronchitis. Steroids are mostly taken in the inhaled form such as aerosol sprays which provide immediate relief from breathlessness.
• Pulmonary Therapies – In addition to the medications, a series of effective therapies such as pulmonary rehabilitation therapy, nutrition therapy, or supplemental oxygen have shown positive results. These aim to teach proper breathing exercises and diet plans which can help control the progression of the disease.
• Surgery – The last resort for treating emphysema is surgery. The most widely used surgical procedures include lung volume reduction surgery and lung transplant. In lung volume reduction, the emphysema affected portion of the lung is carefully removed to facilitate normal lung functioning. Lung transplant is usually employed in the very rare case where the lung damage is beyond control and no other treatment method is yielding results.

Preventive measures

• The biggest preventive measure against emphysema is quitting smoking. Smoking exacerbates lung conditions. Similarly, one must completely avoid passive smoking as well.
• Staying away from toxic fumes such as automotive exhaust and paints helps prevent the onset. Protective face masks must be used at all times in such situations.
• Doing exercises regularly will help increase the lung capacity.

Emphysema Home Remedies

The symptoms of emphysema can be controlled by having the following things in your regular diet:

• Flaxseeds: Flaxseeds are rich sources of omega-3 fats. This kind of fat is beneficial for your body as it reduces bodily inflammation. Consume flaxseeds every day in order to manage the symptoms of emphysema, bronchitis, and other chronic lung infections.
• Citrus fruits: Citrus fruits especially the ones which are rich in polyphenols and antioxidants protect lung tissues from further damage. Oranges, pears, grapefruits, and cantaloupes are proven to decrease the risk of mortality associated with COPD (Chronic Obstructive Pulmonary Disease).
• Fatty fish: Salmon, mackerel, tuna, herring, and sardines – these fatty fish are abundant in omega-3 fats which, as mentioned above, have anti-inflammatory properties.
• Eucalyptus: Eucalyptus is an effective treatment for emphysema when used in diluted form. Eucalyptus when inhaled with steam can help in opening up air pathways and facilitate easy breathing. This shouldn’t be inhaled in concentrated form as it can irritate your lungs.
• Ginseng: Panax ginseng or P. Ginseng is studied as an effect treatment for emphysema and other related lung conditions. It improves lung function and is helpful in pulmonary rehabilitation.

TL;DR?

References