Anyone suffering from a disease of the lungs knows how distressing the shortness of breath can be. Emphysema is a particularly acute lung disease in which the damage is permanent so it is important to take all steps possible to avoid these conditions in the first place.

Inside the respiratory system, there are very small sacs of air called alveoli and the passages that lead to these sacs of air are called bronchioles. In pulmonary emphysema, the bronchioles become permanently distended with air. This condition reduces the number of blood vessels because of the loss of elasticity in the lung tissues. Consequently, the ability of the lungs to provide oxygen continues to decrease and the person becomes breathless very easily.

The condition is more common in men and usually appears after the age of forty. It is thought that women may be protected by a hormonal factor but this has not actually been proven. This condition can cause disability and eventually death. The main cause of emphysema is cigarette smoking. However, exposure to pollution and dust on an ongoing basis can also bring on the disease. This becomes a risk factor in some industries where there are large amounts of dust. Also, people who suffer from chronic bronchitis may also suffer from emphysema. If these people are also smokers, it makes the condition even worse.

Not all smokers contract emphysema and it also occurs in non smokers. Some feel that the white cells in the lungs produce a substance called elastase. Smoke or dust interferes with the cells causing them to release this elastase. If this happens, it may attack the lung tissue.

When a person suffers from chronic bronchitis, the airways become blocked with mucous because of irritation by smoke, dust and other pollutants. This makes it difficult to breathe as the person must overcome the resistance of the mucous. Inspiration of air then results in distension of the alveoli. The elasticity of the lung tissue may also be weakened by bacterial infections which are common in chronic bronchitis.

Subcutaneous emphysema can also result from a broken rib that punctures the lung or from whooping cough.

The most recognized symptom of emphysema is breathlessness. This can be accompanied by a cough that can be brought on by the smallest amount of action. Simply laughing or talking can make the person breathless. There may also be discomfort after a meal because the lungs have expanded. Sometimes this can result in loss of appetite and resultant weight loss.

Some patients become cyanosed due to a lack of oxygen in the blood. This bluish discolouration is most noticeable on the lips and under the fingernails.

Emphysema can also affect the heart. The lungs become resistant to the flow of blood as the alveolar walls thicken. This means the heart has to work harder to force blood through the lungs, putting extra strain on the heart.

The progress of pulmonary emphysema may be slowed with treatment but it cannot be cured. Some bronchodilator drugs give relief, particularly if the patient also has chronic bronchitis. Breathing pure oxygen from a cylinder allows enough gas to enter the blood stream.

Surgery to reduce lung volume is a new, experimental treatment in which parts of both lungs are removed, decreasing the hyperinflation of the chest and improving breathing.

Emphysema can sometimes be slowed but lung damage cannot be repaired, so it is better not to begin smoking.