Emphysema is a chronic or long-term disease caused by damage to the alveoli, the tiny air sacs in the lungs.This condition can cause shortness of breath or difficulty breathing.
Alveoli function as a place of exchange of oxygen and carbon dioxide when breathing. In patients with emphysema, the alveoli are damaged and ruptured, forming a large air pocket.
The formation of these air pockets causes the surface area of the lungs to decrease and the level of oxygen reaching the bloodstream decreases.
In addition, the destruction of the alveoli will also interfere with the process of expelling carbon dioxide-filled air from the lungs. As a result, the lungs can slowly expand because air is trapped and builds up in the air sacs.
Emphysema is one of the most common types of chronic obstructive pulmonary disease (COPD). This type of disease will develop into more severe over time. Treatment of emphysema can slow the progression of the disease, but cannot restore damaged alveoli.
Causes of Emphysema
The main cause of emphysema is long-term exposure to substances that can irritate the lungs, such as:
- Cigarette smoke
- Air pollution
- Chemical fumes or dust from the environment
Although rare, emphysema can also be caused by a genetic disorder, namely alpha-1 antitrypsin deficiency. This condition occurs due to a deficiency of alpha-1 antitrypsin protein, which is a protein that functions to protect the elastic tissue in the lungs.
Emphysema risk factors
Emphysema can happen to anyone. However, the following conditions can increase a person's risk of developing emphysema:
- Have a smoking habit or are often exposed to secondhand smoke (passive smoking)
- Living or working in an environment that is easily exposed to air pollution, such as a factory or industrial environment
- 40 years and over
- Have a family history of alpha-1 antitrypsin deficiency or obstructive pulmonary disease (COPD).
Symptoms of Emphysema
In the early stages, usually emphysema does not cause special symptoms. However, emphysema develops slowly and can cause a variety of symptoms, as the damage becomes more severe.
The following are some of the common symptoms experienced by people with emphysema:
- Shortness of breath, especially when exercising
- Persistent cough and phlegm
- Wheezing
- Tightness or pain in the chest
If the emphysema is getting worse, the symptoms that can be caused are:
- Decreased appetite leading to weight loss
- Recurrent lung infections
- Tired easily
- Headache in the morning
- Heart beat
- Lips and nails turn blue
- Swelling of the legs
- Difficulty in having sex
- Sleep disturbance
- Depression
When to go to the doctor
Check with your doctor if you experience shortness of breath for no reason that occurs in the long term, especially if it interferes with daily activities or if you are at risk of developing emphysema. Early examination can prevent more serious conditions.
Go to the doctor or the emergency room immediately if you experience symptoms that indicate emphysema has progressed to more severe, such as lips and nails turning blue due to disturbed breathing and decreased consciousness (drowsiness or confusion).
Emphysema Diagnosis
To diagnose emphysema, the doctor will ask questions about the symptoms and complaints experienced by the patient, the patient's and family's medical history, and the patient's habits, especially smoking habits and environmental conditions at home or work.
Next, the doctor will perform a physical examination, especially the condition of the lungs. To confirm the diagnosis, the doctor will also perform several supporting examinations, such as:
- Chest X-ray, to detect changes in the lungs that indicate the condition of emphysema
- CT Scan, to detect changes in the lungs in more detail
- Pulmonary function tests or spirometry, to measure the capacity of the lungs to breathe
In certain cases, the doctor may also perform some of the following examinations:
- Blood gas analysis test, to check the amount of oxygen and carbon dioxide in the bloodstream
- Electrocardiogram, if the shortness of breath is suspected also from a heart problem or if the emphysema is severe and is suspected of reducing heart function
Emphysema Treatment
Emphysema cannot be completely treated. However, some treatments can relieve symptoms, slow disease progression, and improve the patient's ability to function normally. Some of these treatments are:
Lifestyle changes
Generally, doctors will advise patients to make lifestyle changes as an initial treatment for emphysema. Lifestyle changes in question can be in the form of:
- Stop smoking, if the patient is an active smoker
- Avoid cigarette smoke or other air pollution that can irritate the lungs
- Eat a balanced diet
- Exercise regularly, which has been adapted to the patient's health condition
Administration of drugs
The drug given will be adjusted according to the severity of the condition. The following are some of the drugs commonly used by doctors to treat emphysema:
- Bronchodilators (breathing medications), such as tiotropium in inhaled form, to relieve symptoms of shortness of breath
- Corticosteroids, to reduce inflammation and relieve symptoms
- Antibiotics, for patients with emphysema who have bacterial infections
Therapy
The doctor may suggest the following types of therapy to relieve symptoms and improve the patient's ability to function normally:
- Pulmonary rehabilitation or chest physical therapy
- Nutrition consultation
- Oxygen therapy, for patients with emphysema who experience a lack of oxygen in the lungs (hypoxemia)
Operation
The type of surgery performed will be adjusted to the severity of the patient's condition. For people with severe emphysema, surgical removal of the lung can be performed to remove the damaged lung tissue, so that the undamaged tissue can work more effectively.
In addition to these surgeries, lung transplants can also be performed on patients with severe lung damage. However, this measure is not yet available in Indonesia.
Emphysema Complications
Emphysema that is not treated properly can lead to several complications, namely:
- Pneumothorax
- Pneumonia
- Pulmonary hypertension
- Disorders of the heart
In addition, because it is a type of chronic obstructive pulmonary disease, emphysema can also increase the risk of sufferers from getting COVID-19 with more severe symptoms and can be fatal.
Emphysema Prevention
The best step that can be taken to prevent emphysema is to stop smoking or avoid secondhand smoke. In addition, other fumes, such as vehicle fumes, should be avoided as much as possible.
Wear a mask to reduce exposure to substances in the air that can irritate the lungs, especially if you work or live in an environment where there is a risk of long-term exposure to these substances.