What is Emphysema? Understanding Emphysema

Emphysema is when your lung tissues break down. It’s a progressive disease that can make you feel short of breath over time.

What Causes Emphysema?

A rare cause is genetics. It’s called Alpha-1 Antitrypsin Deficiency Disorder. An abnormal gene creates a situation that causes the breakdown of lung tissue. When this happens, emphysema may be diagnosed before the age of 40.

The most common cause is exposure to noxious substances in the air you inhale. These include chemicals in cigarette smoke. They also include chemicals, gases, vapors, fumes, and dust in the air at your work.

These noxious substances are inhaled day after day after day, year after year after year. Cells in your lungs recognize them as harmful. They release chemicals to initiate an immune response to get these harmful substances out of your lungs.

A significant part of this response is to cause inflammation of lung tissue. This inflammation is meant to trap and kill pathogens. Once the pathogens are gone, this inflammation eventually goes away, and your lungs heal.

But, if you continue inhaling harmful substances, this inflammation does not go away. When this happens, it may eventually cause damage to lung tissue. Since this occurs gradually over a long period, emphysema is usually not diagnosed until after the age of 45.

What happens with emphysema?

When you inhale, air travels down your airways. These airways branch out and get smaller and smaller. The smallest airways are surrounded by grape-like structures called alveoli.

Each alveoli is a round, balloon-like structure. Like balloons, they have elastic walls. As you inhale, they expand as air enters them. When you exhale, they recoil to their natural shape as air leaves them. Recoiling to their natural shape helps keep airways open and patent when you are exhaling. This makes it so air can easily travel through airways again when you inhale.

It’s in your alveoli where gas exchange occurs. Oxygen in the air you inhale enters your blood. Waste products from your blood enter your alveoli. Oxygen travels to all the tissues of your body. Waste products are exhaled into room air.

Inhaling noxious substances may damage alveolar walls. They become inflamed. Over time, this inflammation is damaging to alveolar walls. They become stiff and lose their elasticity. When you inhale they expand. But, when you exhale they fail to fully recoil to their natural shape. Because they no longer go back to their natural shape, airways leading to them are prone to collapsing. (6-7, 10)

As the disease progresses, alveolar walls break apart. This causes large spaces inside your lungs where air is trapped. These spaces do not participate in gas exchange. So, over time, emphysema causes less room for freshly oxygenated air. This may eventually cause oxygen levels to drop.

All of these effects gradually progress over time. While air is trapped inside your lungs, it may feel as though you can’t get air in. This feeling of shortness of breath may be mild at first. It’s often brushed off to aging or being out of shape.

What can you do? At present, there is no way to reverse damage already done. But, the good news is there are ways to slow the progression and allay symptoms. This begins by seeing a doctor and getting a proper diagnosis. A doctor can help you develop a treatment regimen that works best for you.

The information on this page is not intended to be a substitute for professional medical advice, diagnosis, or treatment. For more information about emphysema, talk to your doctor or primary care provider.

Page last updated: November 8, 2018

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About John Bottrell: John Bottrell is a licensed respiratory therapist who also lives with allergic asthma. He has blogged about his profession at Respiratory Therapy Cave since 2007. John was born and raised in Manistee, Michigan, and has lived and worked in Ludington, Michigan since 1997. He is an avid Detroit Tiger, Lion and Pistons fan. He loves playing fantasy baseball and football. Most of all, he enjoys spending time with his wife and four kids, three of whom also have asthma and allergies.

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