Emphysema is a long-term, progressive disease of the lungs that primarily causes shortness of breath. In people with emphysema, the tissues necessary to support the physical shape and function of the lungs are destroyed. It is included in a group of diseases called chronic obstructive pulmonary disease or COPD (pulmonary refers to the lungs). Emphysema is called an obstructive lung disease because the destruction of lung tissue around smaller sacs, called alveoli, makes these air sacs unable to hold their functional shape upon exhalation.

In early emphysema, there is associated inflammation of the small airways or bronchioles that limits the amount of air that can flow to the alveoli. In more severe emphysema, there is also loss of elasticity in the alveolar walls that have not been destroyed. When the patient breathes out, the alveoli and small airways collapse. This makes it hard for air to get out of the lungs and makes it even harder for new air to enter. With advanced emphysema the large air cysts develop where normal lung tissue used to be. Air is trapped in the lungs due to a lack of supportive tissue, which in-turn decreases blood oxygenation.

As it worsens, emphysema turns the air sacs -- clustered like bunches of grapes -- into large, irregular pockets with gaping holes in their inner walls. This reduces the number of air sacs and keeps some of the oxygen entering your lungs from reaching your bloodstream. In addition, the elastic fibers that hold open the small airways leading to the air sacs are slowly destroyed, so that they collapse when you breathe out, not letting the air in your lungs escape.

Lung transplantation is an option if you have severe emphysema and other options have failed. Usually just one lung is transplanted because the survival rate has proved to be higher for people with single-lung transplants than for people with double-lung transplants.

Causes

It is known from scientific research that the normal lung has a remarkable balance between two classes of chemicals with opposing action. The lung also has a system of elastic fibers. The fibers allow the lungs to expand and contract. When the chemical balance is altered, the lungs lose the ability to protect themselves against the destruction of these elastic fibers.

There are a number of reasons this chemical imbalance occurs. Smoking is responsible for 82% of chronic lung disease, including emphysema. Exposure to air pollution is one suspected cause. Irritating fumes and dusts on the job also are thought to be a factor.

A small number of people with emphysema have a rare inherited form of the disease called alpha I-antitrypsin (AAT) deficiency-related emphysema, or early onset emphysema. This form of disease is caused by an inherited lack of a protective protein called alpha I-antitrypsin (AAT).

Western Medicine Treatment

Doctors can help persons with emphysema live more comfortably with their disease. The goal of treatment is to provide relief of symptoms and prevent progression of the disease with a minimum of side effects. The doctors advice and treatment may include:

Quitting smoking - the single most important factor for maintaining healthy lungs.

Bronchodilator drugs (prescription drugs that relax and open up air passages in the lungs) - may be prescribed to treat emphysema if there is a tendency toward airway constriction or tightening. These drugs may be inhaled as aerosol sprays or taken orally.

Antibiotics-if you have a bacterial infection, such as pneumococcal pneumonia.

Exercise -including breathing exercises to strengthen the muscles used in breathing as part of a pulmonary (the term pulmonary refers to the lungs) rehabilitation program to condition the rest of the body.

Treatment-with Alpha I-Proteinase Inhibitor (ALPI) only if a person has AAT deficiency-related emphysema. AIPI is not recommended for those who develop emphysema as a result of cigarette smoking or other environmental factors.

Lung transplantation - The only known cure for emphysema is lung transplant, but few patients are strong enough physically to survive the surgery. The combination of a patients age, oxygen deprivation and the side-effects of the medications used to treat emphysema cause damage to the kidneys, heart and other organs. Surgical transplantation also requires the patient to take an anti-rejection drug regimen which suppresses the immune system, and can lead to microbial infection of the patient.

Adopted from Wei Laboratories, Inc.