Emphysema: A Brief Overview

There's been a lot of interest in the news of late regarding Amy Winehouse being diagnosed with Emphysema; it's drawn the disease into the public eye somewhat, and people are wanting to know more about the condition. As someone who's worked in pulmonary medicine for some time in the past, I thought I'd do a brief roundup of the relevant facts for those who might be interested.

What is Emphysema?

Emphysema is a form of Chronic Obstructive Pulmonary Disease (COPD), formerly known in the US as Chronic Obstructive Lung Disease (COLD), or in the UK as Chronic Obstructive Airways Disease (COPD). It occurs when there is a loss of elasticity in the lungs, following the destruction of the alveoli and the capilliaries feeding them. The alveoli are the 'pockets' in the lungs which transfer oxygen into the bloodstream, and damage to these can impede that flow; emphysema sufferer's alveoli tend to collapse, especially on exhalation. This cause the patient to have to work harder to absorb oxygen, which leads to an increase in the sheer amount of energy the person has to use to be able to breathe.

What are the symptoms?

Symptoms generally include breathlessness and general fatigue, loss of appetite and weight loss. There tends to be signs of cyanosis to the extremeties and lips, and the sufferer can develop a mild, nonproductive cough. Nail beds can become 'clubbed'.

What causes Emphysema?

Emphysema can have several underlying causes, the most common of which is smoking, be it tobacco products or other substances. The smoke irritates and paralyses the cilia (or hairs) in the alveoli, preventing them from removing any irritants or germs from your lungs. The tissues then become inflamed, and lead to the breakdown of their elastic fibres.

Emphysema also used to be a common form of industrial disease: Workers in textile mills, mines, foundries, and other work environments where there is a high level of fine particles in the air commonly developed the disease in later years.

How is Emphysema treated?

The primary method of treating Emphysema is firstly to remove the cause; patients are strongly encouraged to stop smoking so as to not worsen the disease, for instance. Emphysema is an irreversable condition; once the damage is done, it will not get better, hence the important in retarding the progression of it.

While Emphysema cannot be 'cured', it can be treated and managed. Sufferers are typically prescribed a combination of bronchodilators, which encourage the alveoli and bronchial passages to dilate, and steroids, which help reduce the inflammation of the tissues. These are generally taken in either inhaler or nebulised form. In severe cases, home oxygen therapy may also prove helpful.