Emphysema

Emphysema is a chronic disease of the lungs that prevents
adequate oxygen from reaching the blood. There is destruction of
the small air sacs in the lungs with over-inflation of the
lungs.

DESCRIPTION

Along with chronic bronchitis and asthma, Emphysema is part of
a condition known as chronic obstructive pulmonary disease or
C.O.P.D. It occurs when the alveoli (small air sacs in the lungs)
become overinflated and damaged. This causes a loss of elasticity
in the lungs, preventing gases from being properly exchanged. This
interferes with the levels of oxygen and carbon dioxide in the
blood. Emphysema is nearly always caused by smoking.

Emphysema occurs most often in smokers aged over 50 years. There is
no cure for the condition although careful management can improve
symptoms and prolong life expectancy. Eventually the disease will
progress to either right-sided heart failure or respiratory
failure.

A different type of Emphysema, called pulmonary interstitial
Emphysema, can occur in newborn babies. The air leaks out through
the alveoli into the surrounding space. It affects babies with poor
lung function, such as those on mechanical ventilators, premature
births and those with respiratory distress syndrome. The condition
usually resolves over days or weeks.

SIGNS AND SYMPTOMS

Symptoms do not appear until at least one-third of lung
function has been impaired. They include:

• Shortness of breath, beginning mildly but rapidly becoming
  severe.
• Cough or wheeze, which may be misdiagnosed as asthma.
• Barrel-shaped chest due to overexpansion of the lungs.
• Weight loss.
• Little or no mucus is produced when coughing (Mucus production
  is more likely to signal chronic bronchitis).

TREATMENT OPTIONS

There is no cure for Emphysema. Quitting smoking is the best
way to prevent it from developing. Even those people with existing
Emphysema will benefit from quitting. Smoking cessation is the only
treatment known to reduce the rapid decline in lung function in
patients with Emphysema. See the Smoking – Why Quit? topic on the
Healthpoint.

Emphysema requires ongoing monitoring and treatment by a medical
practitioner. Treatment is aimed at preventing chest infections and
inflammation in the lungs. This can include antibiotics and
anti-inflammatory drugs. As the condition progresses, it may be
necessary for the patient to have an oxygen mask at home. Oxygen
therapy is particularly necessary when sleeping, as oxygen loss and
hypoventilation is greater when lying down. Patients with severe
Emphysema will need home help, as their activity levels become
increasingly restricted.

Surgical treatment is rare but possible. Lung volume reduction
surgery involves removing the damaged portions of lung (usually
about 20-30% of each lung) to improve oxygen exchange and
elasticity. It is an option for severe cases in people under 75
years of age. Short-term results are good but temporary; after 2 or
3 years, lung function usually deteriorates again. For this reason
it is not often recommended.

Total lung transplantation will restore the lung function to
normal. However, the mortality rates following this surgery are
high (50% in 5 years) and due to the shortage of donor organs, it
would only be considered in a very young patient.

DIET HINTS

• A healthy diet is an important foundation for good health.
  Always follow the advice of your Doctor.
• Eat a variety of nutritious foods, including fruit, vegetables,
  wholegrains, legumes (beans, peas, lentils etc), lean meats and
  dairy products.
• Fresh fruit and vegetable juices are an excellent way to
  include a variety of nutrients in the diet.
• Drink plenty of water.
• Certain vegetables, especially onions and garlic, can help
  liquefy mucus and allow it to be coughed from the lungs.
• Drink alcohol in moderate amounts only. For men no more than 3
  standard drinks per day; for women no more than 2 standard drinks
  per day.
• Maintain a healthy weight by balancing food intake with
  activity levels.
• Eat cold water fish such as tuna, salmon or swordfish at least
  2-3 times per week. Fish oil (DHA) may be of benefit in inhibiting
  the progression of Emphysema.

VITAMINS/MINERALS/HERBS

• Vitamin C, vitamin A and echinacea may improve immune function
  if dietary intake is inadequate.
• Antioxidants such as vitamin E, grape seed extract and selenium
  may help with inflammation.
• Liquorice herb may help relieve cough.
• Garlic has antibacterial properties that may help prevent
  infection. Garlic and horseradish have traditionally been used to
  help resolve mucus.
• Omega-3 fatty acids may be of benefit.

ORGANISATIONS & SUPPORT GROUPS

See the Australian Cancer Society topic on the Healthpoint for
information about the Quit Programme.

PHARMACIST’S ADVICE

Ask your Pharmacist for advice.

1. Follow the Diet Hints.
2. Smoking should definitely be avoided. If you need help to stop
   smoking ask your Pharmacist for suggestions.
3. Have as much rest as possible, with light exercise. Regular
   exercise can help improve general health and resistance to
   infection.
4. Keep salt intake low to avoid heart problems.
5. If the diet is inadequate consider some nutritional
   supplements. See the Vitamins/Minerals/Herbs section in this topic
   and ask your Pharmacist for advice.