Emphysema is a chronic, progressive disease of the lungs primarily causing shortness of breath. Considered one of the Chronic Obstructive Pulmonary Diseases (COPD), emphysema affects the walls between the alveoli (air sacs), causing their ability to stretch and recoil to break down. As a result, the sac is weakened and eventually breaks. The elasticity of the lung is lost, which allows air to become trapped in those sacs, which impedes the lung to exchange carbon dioxide for oxygen. This creates an obstruction of airflow.

By far, the most common cause of emphysema is cigarette smoking. In fact, cigarette smoking is responsible for 80 – 90% of deaths due to COPD, including emphysema. Cigarettes not only damage the cilia (microscopic) hairs that line the bronchial tubes, protecting them from bacteria and other foreign matter, they also leave irritants in your bronchial tubes, infiltrating your alveoli, causing them to become inflamed and weakened. Cigarette smoking can cause emphysema in two ways – first, by destroying lung tissue which causes the obstruction and second, by irritating the airways which causes the disease to progress more rapidly.

Additionally, about 100,000 Americans were born with a lung protector protein deficiency, alpha 1-antitrypsin deficiency (A1AD). People with this deficiency are unable to fight off the negative effects of a digestive enzyme called trypsin. Once its released in the lungs, the destruction caused by the trypsin is similar to that of cigarettes, slowly decreasing the lungs’ ability to perform properly.

Other causes of emphysema are:

  • air pollution,
  • genetics,
  • problems with airway activity, such as bronchial asthma,
  • gender (Note – men are more likely to develop emphysema than women),
  • and age (advanced age increases your risk of getting emphysema).

The most common symptom of emphysema is shortness of breath. There is also a reduced capacity for physical activity. Both of these symptoms will worsen as the disease progresses. As time passes, you will have trouble breathing even when you lay down. It may become harder and harder to breathe during and after certain respiratory infections, like a cold or the flu.

Coughing and wheezing may also be indicative of emphysema. However, one of the difficulties with this disease is that it is chronic and progressive. Emphysema develops slowly. Usually, the cough is mild and unproductive. That means it doesn’t bring up phlegm, or mucus. Of course, a chronic and unproductive cough may or may not be a symptom of another condition such as chronic bronchitis. People with emphysema may also notice that they have a low appetite or trouble eating. As a result, they tend to lose weight easily and rapidly without really trying to.

People with emphysema also may become ‘barrel-chested’, meaning that the distance from the chest to the back becomes more pronounced. Another symptom of emphysema, one which may be considered specific to the condition, is ‘purse-lipped breathing.’ The person struggles to exhale complete because the airways close when the chest wall collapses during expiration. As a result, they purse their lips and leave a small opening when they exhale to get a little extra out of it.


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