This is a common lung disease among long-time smokers.  Chronic exposure to cigarette smoke causes inflammation in the lungs that leads to destruction of the lung tissue.  Over time, this leads to numerous holes in the lungs.  As the disease progresses, the lungs lose their ability to exchange gas effectively and breathing gets harder.  Although cigarette smoking is the most common cause of emphysema, occasionally non-smokers can be affected.  There is a rare genetic (familial) disease that can cause emphysema.  Also, chronic exposure to dust and use of certain injection street drugs can cause emphysema.

The term emphysema is often used interchangeably with COPD.  Emphysema is a type of COPD.  The most common symptoms of emphysema are shortness of breath and coughing.  Wheezing, fatigue and leg swelling are also common as the disease progresses.

Emphysema is diagnosed by taking a history, physical exam, breathing tests and chest XRays or CT scan.  Once the diagnosis is confirmed, your doctor with create a treatment plant.  The first and most important step in treating emphysema is to stop smoking immediately.  In addition, there are many medications that can help reduce symptoms, decrease the frequency of exacerbations and improve your exercise capacity.  First line medications are usually inhalers.  Exacerbations are often treated with antibiotics, steroids and increased frequency of breathing treatments.  If you are so short of breath that you are unable to speak a full sentence without gasping for air, it is an emergency and you need to be get medical attention immediately. 

In addition to medications for emphysema, several other treatments are very important.  If your oxygen saturations (levels) are low, you will need to use oxygen.  This is the only intervention that has been proven to improve your survival.  Additionally, your doctor may want you to participate in Pulmonary Rehabilitation (supervised exercise and lung education).  There are also two surgical options for very carefully selected patients.  Lung Volume Reduction Surgery (LVRS) and lung transplantation—these two surgeries are only appropriate for a small percentage of patients.  Your doctor will discuss these options if your disease is very severe and you are an appropriate candidate. 

Annual influenza vaccination and pneumonia vaccination every five years are generally encouraged. 

The lung doctors at Arizona Pulmonary Specialists are experts in the diagnosis and treatment of emphysema.   Our team of doctors, nurses and respiratory therapists will work with you to ensure that you understand your medications and other treatments. 

At Arizona Pulmonary Specialists, we are actively involved in many research studies.  We often have studies of new medications for emphysema.  Ask your doctor if you are interested.