Emphysema is a disease resulting from long-term damage to the alveoli, which are the tiny air sacs in the lungs. This condition can cause shortness of breath or difficulty breathing. Alveoli function as a place for exchange of oxygen and carbon dioxide when breathing. In patients with emphysema, the alveoli are damaged and ruptured, forming a large air pocket.
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The formation of these air sacs causes the area of the lungs to decrease and the capacity of the lungs to inhale air decreases. As a result, the level of oxygen reaching the bloodstream decreases.
In addition, damage to the alveoli will also interfere with the process of exhaling air containing carbon dioxide from the lungs. This causes the lungs to slowly expand as air is trapped and builds up in the air sacs.
Emphysema is one of the most common types of chronic obstructive pulmonary disease (COPD). Emphysema will get worse with time. Although there are treatments to slow the progression of the disease, the damaged alveoli are irreversible.
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 called alpha-1 antitrypsin deficiency. This condition occurs due to a deficiency of the alpha-1 antitrypsin protein, which is a protein that functions to protect elastic tissue in the lungs.
Emphysema risk factors
Emphysema can happen to anyone. However, this disease is more common in people with the following factors:
- Have a smoking habit or are often exposed to cigarette smoke (passive smoking)
- Living or working in an environment that is easily exposed to air pollution, such as a factory or industrial environment
- Age 40 and over
- Have a family history of alpha-1 antitrypsin deficiency or obstructive pulmonary disease (COPD).
Emphysema Symptoms
In its early stages, emphysema usually doesn't cause any specific symptoms. However, the disease develops slowly and can cause a variety of symptoms as the damage to the alveoli gets worse.
The following are some of the common symptoms experienced by people with emphysema:
- Shortness of breath, especially on exertion
- Persistent coughing and producing phlegm
- Wheezing
- Tightness or pain in the chest
If emphysema gets worse, symptoms that can arise are:
- Decreased appetite resulting in weight loss
- Recurrent lung infections
- Easily tired
- Headache in the morning
- Heart beat
- Lips and fingernails turn blue
- Swelling in the legs
- Difficulty in having sex
- Sleep disorders
- Depression
When to see a doctor
Check with your doctor if you experience shortness of breath for no reason, especially if it occurs in the long term and has interfered with daily activities. You are also advised to see a doctor if you are at risk of suffering from emphysema. Early examination can prevent more serious conditions.
Immediately go to the hospital emergency room if you experience symptoms indicating that emphysema has worsened, such as lips and nails turning blue due to breathing problems.
Emphysema Diagnostics
To diagnose emphysema, the doctor will conduct questions and answers about the symptoms experienced by the patient, medical history of the patient and his family, as well as the patient's habits, especially smoking habits and the conditions of the home or work environment.
Next, the doctor will do a physical examination, especially the condition of the lungs. To confirm the diagnosis, the doctor will also carry out supporting examinations, such as:
- Chest X-ray, to detect changes in the lungs that indicate 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 the following examinations:
- Blood gas analysis test, to check the amount of oxygen and carbon dioxide in the bloodstream
- Electrocardiogram, if shortness of breath is also suspected of originating from a heart problem, or if the emphysema is severe and is suspected of reducing heart function
Emphysema Treatment
Emphysema cannot be completely cured. However, some treatments can relieve symptoms, slow disease progression, and improve the patient's ability to carry out normal activities. Some of these treatments are:
Lifestyle improvement
Generally, doctors will advise patients to improve their lifestyle as an initial treatment for emphysema. Lifestyle improvements in question can be in the form of:
- Quit smoking if the patient is an active smoker
- Avoiding cigarette smoke or other air pollution that can irritate the lungs
- Eat a balanced nutritious diet
- Exercising regularly, the type of which is adjusted to the patient's health condition
Administration of drugs
The medicine given will be adjusted to the severity of the condition. The following are some drugs that doctors commonly use to treat emphysema:
- Respiratory relievers (bronchodilators), such as tiotropium in inhaled form, to relieve shortness of breath symptoms
- Corticosteroids, to reduce inflammation and relieve symptoms
- Antibiotics, for people with emphysema who also have a bacterial infection
Therapy
Doctors can suggest the following types of therapy to relieve symptoms and improve the patient's ability to carry out normal activities:
- Pulmonary rehabilitation or chest physical therapy
- Nutrition consultation
- Oxygen therapy, for people 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 patients with severe emphysema, lung removal surgery is performed to remove damaged lung tissue so that undamaged tissue can work more effectively.
In addition to these operations, lung transplants can also be performed on patients with severe lung damage. However, this action is not yet available in Indonesia.
Emphysema complications
Emphysema that is not handled properly can cause several complications, namely:
- Pneumothorax
- Pneumonia
- Pulmonary hypertension
- Heart problems
Because it is a type of chronic obstructive pulmonary disease, emphysema can also increase the risk of sufferers getting COVID-19 with more severe symptoms and fatal results.
Emphysema Prevention
The best effort that can be done to prevent emphysema is to stop smoking or avoid exposure to secondhand smoke. Other fumes, such as vehicle fumes, should also be avoided as much as possible.
In addition, 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 exposure to these substances in the long term.
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