For Starters: Lung Facts

Inside the lungs, there is a branching system of progressively smaller tubes (called bronchial tubes), at the end of which are air sacs (called alveoli). The alveoli have very thin walls, and are surrounded by capillaries (the smallest blood vessels).

When you breathe in, oxygen and carbon dioxide travel through the bronchioles to the alveoli, and then pass through into the capillaries, where they are absorbed by red blood cells. This “oxygenated” blood travels to the heart, and then the rest of the body.

At the same time, carbon dioxide from the blood in the capillaries passes into the alveoli, to be passed out of the body when you exhale. This exchange of gases—oxygen in, carbon dioxide out—takes just fractions of a second. But emphysema symptoms can prevent it from happening in the way it should.

Understanding Emphysema Symptoms

The bronchi, bronchioles, and alveoli of the lungs are normally very elastic. They easily stretch and then return to their original size during the process of breathing. The alveoli fill up with air like tiny balloons when you breathe in, and then easily deflate with each exhalation. With emphysema, the walls between many of the alveoli are destroyed and the airway loses much of its normal shape.

As a result, the airways and alveoli are no longer able to bounce back to their original shape, especially during exhalation. Some of the airways collapse, and consequently some alveoli don’t properly deflate. This process can happen due to smoking (and exposure to secondhand smoke), long-term exposure to air pollution, factory dust, and chemical fumes, or because of genetics (people with a hereditary disorder called alpha-1 antitrypsin deficiency are at greater risk for emphysema symptoms, especially if they smoke).

Collapsed airways become narrow, which obstructs normal airflow. When airways collapse or alveoli are destroyed, air can get trapped in the lungs. This causes parts of the lung to become enlarged (hyperinflated). Destruction of the alveoli also hampers the exchange of oxygen and carbon dioxide. This leads to too little oxygen and too much carbon dioxide in the blood.

You may notice that you’re always tired and short of breath (this is one of the main emphysema symptoms, but it can occur so gradually you may not be aware of it), and that your lips and fingertips look bluish (this is due to lack of oxygen).

The chemicals in cigarette smoke degrade the walls within the alveolae, which compromises elasticity. Emphysema sufferers can’t completely expel air, which means they can’t completely take in air. The result is a slow loss of blood oxygenation and resulting fatigue.

What Is Emphysema? Treatment Options

Effective emphysema treatment is vital because emphysema symptoms can lead to complications that impact life expectancy—for example, a collapsed lung, and large cavities in the lungs (called bullae) that raise the risk for a collapsed lung. Emphysema symptoms also can weaken your heart function, which also can reduce emphysema life expectancy.

Unfortunately there is no such thing as an emphysema cure. But drugs called bronchodilators can help your breathing by expanding your airways. There are two main types of bronchodilators—beta-agonists and anticholinergics—and each is available in a short-acting and a long-acting formulation.

You also may be given steroids and antibiotics—find out more on our COPD medications list, and also check out some of the COPD home remedies that can help increase emphysema life expectancy. If you still smoke, it is vital to stop. Quitting smoking is recommended by COPD treatment guidelines, and can make a big difference when it comes to helping you avoid COPD complications.

If your emphysema symptoms are occurring because of alpha-1 antitrypsin deficiency, you may be given a concentrated form of this protein, which has been removed from donated blood and purified. This therapy cannot reverse damage that has already been done by your emphysema symptoms, but it may slow down the further decline of your lung function. Pulmonary rehabilitation, which consists of a series of educational and structured exercises, also can help, and is recommended by the GOLD COPD guidelines.

How Should You Handle Severe Symptoms?

For severe emphysema symptoms, supplemental oxygen may be prescribed, or your doctor may suggest lung volume reduction surgery to remove parts of your lung that are most heavily damaged by emphysema.

The surgery isn’t an emphysema cure, but it may help to relieve symptoms and may prolong emphysema life expectancy in some people.

Originally published in May 2016 and updated.

The post What Is Emphysema? appeared first on University Health News.

In order to know how COPD affects your lungs, it’s necessary to know some basic facts about lungs.

Inside your lungs, there’s a branching system of progressively smaller tubes (called bronchial tubes), at the end of which are air sacs (called alveoli). The alveoli have very thin walls, and are surrounded by capillaries (the smallest blood vessels). When you breathe in, oxygen and carbon dioxide travel through the bronchioles to the alveoli, and then pass through into the capillaries, where they are absorbed by red blood cells.

This “oxygenated” blood travels to the heart, and then the rest of the body. At the same time, carbon dioxide from the blood in the capillaries passes into the alveoli, to be passed out of the body when you exhale. But the conditions that underpin COPD can prevent this process from happening in the way it should.

What Is Emphysema?

Is COPD the same as emphysema? No—but emphysema can underpin COPD, and here’s why. The bronchioles and alveoli inside the lungs are normally very elastic, easily stretching and then returning to their original size as you breathe.

But with emphysema, the thin walls between many of the alveoli are destroyed, and they (and the bronchioles that lead to them) are no longer able to return to their original shape during exhalation. Some of the airways collapse entirely, and this means that some alveoli don’t properly deflate. When airways collapse and alveoli are destroyed, air gets trapped in the lungs. This causes parts of the lung to become enlarged.

Destruction of the alveoli also hampers the exchange of oxygen and carbon dioxide, and this leads to too little oxygen and too much carbon dioxide in the blood.

Chronic Bronchitis Symptoms

When you ask “What is COPD?” you also need to consider chronic bronchitis, another serious condition on the lung diseases list. It’s caused by inflammation in the airways, and an increase in the production of mucus.

Inhaled tobacco smoke and other noxious particles cause lung inflammation. In the airways, the presence of harmful substances also sparks the increased production of mucus to help move the substance out of the lungs.

Under normal circumstances, once the infection or foreign substance has been eliminated, any inflammation and excess mucus production subside. In people with COPD, the inflammation and excess mucus production persist.

In addition, inhaled tobacco smoke can damage cilia: the tiny hair-like projections that normally help to sweep mucus out of the lungs, and expel toxic substances. Constant inflammation in the airways, along with an overabundance of mucus, narrows the bronchioles. This can cause difficulty breathing, and a chronic cough.

What Causes COPD?

What is COPD’s typical cause? Generally, it occurs as a result of repeated exposure of the lungs and airways to irritants, most commonly smoke from cigarettes, cigars, and pipes. But other factors also may come into play, including genetics and air pollution.

Kicking the habit of smoking can significantly reduce your chances of getting COPD and other lung disease.

Smoking: COPD most often affects people over age 40, who have smoked a pack of cigarettes a day for 10 or more years. Pipe and cigar smoking also can decrease lung function, give you lung problem symptoms, and increase the chance of COPD, even in people who have never smoked cigarettes. Recent research suggests that e-cigarettes also may be harmful to the lungs.

Smokers who have a family history of COPD are at particularly high risk, and so are people who are often exposed to secondhand smoke. People who have quit smoking are still at increased risk of eventually being diagnosed with COPD. But stopping the habit of smoking significantly reduces the chances of getting COPD, as well as other serious lung and heart diseases. You may be wondering: how long can you live with COPD? If you are, keep in mind that while COPD can’t be cured, smokers with COPD who stop smoking can slow the progression of the disease.

Genetics: Is COPD hereditary? Well, not all smokers develop COPD—therefore, experts believe that some combination of smoking and genetic factors may be at work in those who do get the disease. With the exception of the alpha-1 antitrypsin gene (see below), the specific genes that may be involved in COPD are not known. However, researchers have begun to identify possible candidates.

Occupational exposures: Long-term exposure to various kinds of chemicals, fumes, and dust can also harm the lungs and cause COPD. For example, agricultural workers may be exposed to gases and organic dusts generated by cotton, flax, hay and grains, as well as fertilizers and pesticides. Cotton textile workers may inhale cotton dust. Flourmill workers and bakers may breathe in flour and other grain particles. Exposure to coal mine dust over a full working lifetime, even at federally mandated limits, produces a cumulative exposure that appears to increase the risk for COPD.

Air pollution is not our friend, contributing to pulmonary difficulties, experts believe, that can become serious. (Photo: Alexander Tolstykh | Dreamstime.com)

Air pollution: Whether outdoor air pollution from sources such as automobile, factory, and power plant emissions can cause COPD is uncertain, but there is some evidence that it damages lung function. A recent study found that people who lived near major roadways and were exposed over a long period of time to the tiny particles in automobile exhaust had an accelerated rate of decline in lung function.

In addition to fine particulate matter, another type of outdoor air pollution is ozone. In the upper atmosphere, ozone protects against harmful ultraviolet radiation. But when present at ground level, where it may form when exhaust from tailpipes, coal-fired power plants and other sources mixes with oxygen, ozone is a pollutant. One study found that increased levels of ground-level ozone correlated with an increased risk of dying from respiratory illnesses, including COPD. For people who already have COPD, exposure to high levels of outdoor air pollution can worsen their condition.

Indoor air pollution also can be a risk factor for COPD. Studies have found that exposure to wood smoke may increase COPD risk for smokers. In addition, people who already have COPD and are exposed to both types of smoke experience more frequent and severe symptoms.

Alpha-1 antitrypsin deficiency: In a small number of people, COPD is caused by a hereditary disorder called alpha-1 antitrypsin deficiency. Alpha-1 antitrypsin is a protein that prevents an enzyme called neutrophil elastase from damaging the alveoli. People with alpha-1 antitrypsin deficiency lack this protein, and about 75 percent of adults with the deficiency develop COPD. People with this deficiency who smoke are at particularly high risk of developing severe lung disease, often at a relatively young age.

Originally published in May 2016 and updated.

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