Emphysema

A long term progressive disease of the lung, emphysema occurs when the alveolar walls of the lungs are destroyed. This reduces the total area within the lung where blood and air can come together thus limiting the possibility of oxygen and carbon dioxide transfer. Emphysema is grouped under COPD because this condition can destroy the lung tissue around the bronchioles (tiny airways) thus preventing them from holding on to their functional shape upon exhalation. This will cause permanent damage to the tiny air sacs.

Emphysema is common in people aged 50 and older. A few, with inherited emphysema may develop the condition in their early thirties or forties. Men are more susceptible to emphysema than women but recent times have seen an increase in female cases as the number of female smokers has gone up considerably. Smoking and Alpha-1 Antitrypsin Deficiency are the main causes for emphysema.

• Lungs do not contract to fullest extent because they lose their elasticity. This in turn stops the alveoli from deflating completely thereby making exhalation difficult.
  
  
• As complete exhalation has not happened, the next breath starts off with more air in the lungs.
  
  
• The entrapped old air takes up space. This prevents the alveoli from taking in enough fresh air as required so as to supply the required oxygen to the body.
  
  
• Shortness in breath while exerting a lot is reported commonly by patients with emphysema. People with advanced emphysema feel shortness in breath even while at rest.
  
  

Emphysema symptoms

• Shortness of breath while at rest
  
• Coughing
  
• Wheezing
  
• Difficulty to breath
  
• Skin turns bluish
  
• Excess mucus production
  

• Studying medical history of patient
  
• Physical/clinical examination
  
• Chest x-ray
  
• Medical imaging like CT scan of the chest
  
• Laboratory tests (blood)
  
• Lung function test
  

There is no permanent cure for emphysema. Treatment aims at slowing the development of the disease condition and reduce the symptoms. Medications are prescribed for relieving symptomatic conditions. Patients suffering this condition must stop smoking.

Chronic Obstructive Pulmonary Disease

Chronic Obstructive Pulmonary Disease (COPD)encompasses a group of lung disorders that include chronic bronchitis, emphysema, chronic obstructive airways disease and chronic asthma. COPD affects millions of people worldwide and this disease is mostly attributed to smoking. Air pollution, working in an environment with harmful effluents and passive smoking are also likely causes for Chronic Obstructive Pulmonary Disease. Sometimes a patient may suffer an inherited form of emphysema due to a deficiency of alpha-1-antitrypsin. With chronic bronchitis, the air passages and mucus glands are enlarged thereby leading to severe cough. Over time, the enlargement can lead to reduced oxygen supply to the lungs. Elevated blood pressure is noticed. This condition is more predominant in those who smoke or have a history of respiratory illness. While some patients develop wheezing and shortness of breath, others notice mucus while coughing. Chronic bronchitis is noticed with symptoms such as continuous cough, rapid breathing and cyanosis (bluish tint to the lips and nails). Morning headaches may be noticed on account of inability to remove carbon dioxide from the blood. Patients with severe case of COPD may face hemoptysis (alternatively haemoptysis) (blood while coughing). Emphysema occurs when the tiny alveoli in the lungs are destroyed thereby hampering efficiency of the lungs. It leads to labored breathing and the patient often feels out of breath. Other symptoms are loss of weight, disturbed sleep and tight constriction in the chest.

Diagnostic tests for COPD include blood tests and pulmonary function test. The pulmonary function test is an indicator of the extent of blockage of the lungs. Chest x-rays help in identifying damaged areas of the lungs and areas of fluid collection as well as any masses in the lungs. Sputum culture can identify any respiratory infection. A spirometry test measures the amount of air a person can blow in a second. Arterial blood gas analysis indicates how efficiently the lungs bring oxygen into the blood and remove carbon dioxide.

Antibiotics can help in tackling the bacterial infections in the lungs. Bronchodilators open up the air passages in the lungs thereby alleviating some of the symptoms of Chronic Obstructive Pulmonary Disease. Inhaled corticosteroids will reduce airway inflammation. In severe cases, oxygen is administered. In addition, some lifestyle changes must be followed:

• Avoid smoking
  
• Avoid exposure to secondhand tobacco smoke
  
• Adopt physical fitness regime to maintain good lung health
  
• As far as possible, avoid environmental irritants, hazardous inhaled substances such as paints, chemicals and cleaning agents
  
• Balanced diet
  
• Plenty of water and fluids
  
• Steam inhalation
  

Chest x ray

Chest x-ray is a regular diagnostic test that throws light on the condition of the lungs, heart and chest wall. Chest x-ray reveals possible lung cancer, emphysema, heart failure and pneumonia. Heart irregularities and CHF may be visible on a chest X ray. Any pleural effusions may be detected through a chest x-ray. The patient must wear loose fitting gown and remove any metal objects from clothing. In most cases, chest x-ray of frontal or posteroanterior view is taken. The patient has to take a deep breath so as to ensure a good quality chest x-ray image. There is no discomfort. Pregnant women must not undergo chest x-ray. But some conditions may not be easily diagnosed with a chest Xray, such as pulmonary embolism or some cancers. In such cases, CT scan of chest is used for further clarification. Abnormal findings on chest X-rays can range from pneumonia and tuberculosis to lung tumor or collapsed lung. Osteoporosis or fracture of ribs or spine can be detected.