Emphysema is a serious lung condition that affects the small air sacs in the lungs (alveoli). This gradual damage to the lungs makes it very hard for you to breath. Emphysema is a common condition in smokers and cannot be cured.

What causes emphysema and who can get it?

Emphysema usually affects older people. It is caused by damage to your lungs over a long period of time, such as from a lifetime of smoking. Smoking is the main cause of emphysema in the UK.

Working in industries, such as mining, where you inhale a lot of smoke or dust can also increase your risk of getting emphysema. Very rarely emphysema is a genetic condition caused by a lack of protein.

It is quite common for someone with emphysema to suffer from chronic bronchitis as well. This is because the lungs are not able work properly. They can’t clear mucus, which then sits in your lungs and becomes infected.

This combination is called Chronic Obstructive Pulmonary Disease (COPD)  and is a common cause of death in heavy smokers.

What happens to your lungs?

We all breathe in oxygen and breathe out carbon dioxide. This is an essential function of our bodies.

After air has been inhaled into your lungs, it travels through the bronchial tubes and into your alveoli. The alveoli are small 'balloon-like' structures that are located at the ends of your bronchial tubes.

It is here, at the alveoli, that oxygen is passed into the blood and carbon dioxide passes back out.

Emphysema causes the walls of the alveoli to break down so the total surface area available for this gas exchange in your lungs is greatly reduced.

This means that less oxygen gets into your blood and to your muscles and organs. Also, more of your waste gas (carbon dioxide) stays in your blood because it can’t get into the alveoli to be exhaled.

What are the signs and symptoms of emphysema?

The two main symptoms of emphysema are:

• Coughing (especially coughing up a lot of mucus and phlegm)
• Shortness of breath

If you have a persistent cough, you should go to see your doctor. If you are a smoker, you may think that your cough is 'normal' but it could be a sign that you are damaging your lungs.

Other symptoms of emphysema include:

• Weight loss
• Tiredness
• Weak bones that break easily
• Swollen ankles

People with emphysema often experience ‘attacks’ of the condition. This is when their symptoms suddenly get worse. They will find it harder to breathe and cough a lot more. They will also bring up mucus which is thicker than usual and yellow or greenish in colour.

Emphysema can get progressively worse if damage to lungs continues.

In bad cases of emphysema breathing will worsen considerably. With less oxygen getting around your body, your energy levels will slump and your skin may turn a blue colour (cyanosis).

In really extreme cases patients have to breathe in oxygen through a mask to get enough oxygen.

The worst cases of emphysema can cause death.

How is it normally diagnosed and treated?

Lung function tests and chest x-rays http://www.childrenfirst.nhs.uk/teens/hospital/treatment/x-ray.html can diagnose emphysema.

Unfortunately, once damage to your lungs has been found it can’t be cured or reversed. It can only be slowed down.

Most patients try to control their symptoms with bronchodilators - the same type of inhaler that asthmatics use. These help relax your airways and help oxygen get to your lungs.

In very bad cases surgeons can give lung transplants.  Another technique called lung volume reduction surgery is also used. This cuts away the most diseased parts of your lungs, leaving the remaining parts to work better.

Can it be prevented?

For emphysema, prevention is the best form of cure. The best thing you can do is to give up smoking and avoid other people’s smoke. The more you smoke, the more likely you are to develop bronchitis and emphysema.

What’s going to help?

Exercising as much as you can helps to keep the lungs (and heart) strong.
For patients with emphysema, physiotherapy can help to clear mucus from their lungs. A physiotherapist can teach exercises to do every day to help them feel better.

For more help and information

If you would like to know more about emphysema, please ask your doctor.

The British lung foundation can help. Visit them at www.britishlungfoundation.org.uk

Last reviewed by Great Ormond Street Hospital: 5 October 2007

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