Emphysema is a disease of the lungs that usually develops after many years of smoking. Both chronic bronchitis and emphysema belong to a group of lung diseases known as chronic obstructive pulmonary disease (COPD). Once it develops, emphysema can’t be reversed. This is why not smoking or stopping smoking is very important.
Emphysema is a condition that involves damage to the walls of the air sacs (alveoli) of the lung. Alveoli are small, thin-walled, very fragile air sacs located in clusters at the end of the bronchial tubes deep inside the lungs. There are about 300 million alveoli in normal lungs. As you breathe in air, the alveoli stretch, drawing oxygen in and transporting it to the blood. When you exhale, the alveoli shrink, forcing carbon dioxide out of the body.
When emphysema develops, the alveoli and lung tissue are destroyed. With this damage, the alveoli cannot support the bronchial tubes. The tubes collapse and cause an “obstruction”(a blockage), which traps air inside the lungs. Too much air trapped in the lungs can give some patients a barrel-chested appearance. Also, less oxygen will be able to move into the bloodstream because of fewer alveoli.
It is known from scientific research that the normal lung has a remarkable balance between two classes of chemicals with opposing action. The lung also has a system of elastic fibers. The fibers allow the lungs to expand and contract. When the chemical balance is altered, the lungs lose the ability to protect themselves against the destruction of these elastic fibers. This is what happens in emphysema.
There are a number of reasons this chemical imbalance occurs. Smoking is responsible for 82% of chronic lung disease, including emphysema. Exposure to air pollution is one suspected cause. Irritating fumes and dusts on the job also are thought to be a factor. A small number of people with emphysema have a rare inherited form of the disease called alpha I-antitrypsin (AAT) deficiency-related emphysema, or early onset emphysema. This form of disease is caused by an inherited lack of a protective protein called alpha I-antitrypsin (AAT).
Emphysema doesn’t develop suddenly, it comes on very slowly. Years of exposure to the irritation of cigarette smoke usually precede the development of emphysema. A person may initially visit the doctor because they start to feel short of breath during activity or exercise. As the disease progresses, a short walk can be enough to bring on breathing difficulty. Some people may have chronic bronchitis before developing emphysema.
Once the diagnosis of chronic obstructive pulmonary disease (COPD) is established, the patient should be educated about the disease and should be encouraged to participate actively in therapy. The goal of therapy is to relieve symptoms, prevent disease progression, improve exercise tolerance and health status, prevent and treat complications and exacerbations, and reduce mortality. Treatments should be added in a stepwise fashion to reach these goals. Smoking cessation is the single most effective therapy for most COPD patients. Studies have shown that a less than 10-minute discussion by a physician can motivate a patient to quit smoking. A smoking cessation plan is an essential part of a comprehensive treatment plan. Although many believe that the success rates for smoking cessation are low because of the addictive potential of nicotine, it is the conditioned response to smoking-associated stimuli, including oral fixation, habit, psycho-social stress, and forceful promotional campaigns by the tobacco industry, which are more dominant players. The process of smoking cessation must involve multiple interventions. Quitting “cold turkey” has been shown to have the greatest success rate over all other quitting aids.
Posted on May 18, 2023