Emphysema

Under a Emphysema is to be understood as irreversible damage to the lungs. Since existing damage cannot be reversed, therapy for pulmonary emphysema can only slow down or prevent the progression of the disease.

What is emphysema?

At a Emphysema there is an overinflation of the small air-filled structures in the area of ​​the lungs. Inflammatory processes are caused in the lungs by harmful substances in the air we breathe or by the body's own reactions.

These also cause increased external pressure on the bronchioles, so that the pulmonary sacs, the so-called alveoli, expand until they burst.

This can cause large emphysema bubbles to develop in the case of emphysema. As these bubbles in the lungs have no function, breathing becomes difficult.

causes

A Emphysema can have different causes. Normally there is a balance between different enzymes within the lungs. The granulocytes are tissue-splitting enzymes and the alpha-1 proteinase inhibitors are protective enzymes that restore balance.

If there is a hereditary predisposition to a deficiency in this protective enzyme, pulmonary emphysema can develop. However, only the severe form of this disease inevitably leads to pulmonary emphysema. In the case of lighter forms, there is only a risk of emphysema in connection with the ingestion of harmful substances. Because pollutants that are absorbed with the breath can also lead to emphysema.

For example, [smoking smokers]] absorb substances with their smoke that lead to the inactivation of the important alpha-1 proteinase inhibitor. In addition, smokers have an increased risk of infection.

But chemical substances, such as aluminum or cadmium, and occupational dust exposure, such as in mines, animal feed or raw cotton, can be the cause of emphysema.

Symptoms, ailments & signs

The disease usually develops slowly. Signs of the onset of emphysema are a morning cough with sputum and shortness of breath during physical exertion. Some patients make noticeable rattling noises when breathing, which otherwise only occur with bronchitis. Outward signs are blue lips and fingers and noticeably curved fingernails.

The lack of oxygen can also lead to paleness and dark circles. In the late stages, the lungs become overdeveloped and the chest is deformed and eventually resembles a barrel. The patients are mostly physically and mentally weak, complaints such as listlessness and fatigue become noticeable. If left untreated, the lungs will continue to enlarge, reducing the mobility of the chest.

The result is breathing difficulties, especially breathing out is difficult. The increasing lack of oxygen also affects the functions of the organs and causes a multitude of complaints. Headache, indigestion, cardiac arrhythmias and jaundice are typical. The initial shortness of breath now occurs permanently.

In the long term, a right heart failure can develop, which in turn is associated with serious complaints. Pulmonary emphysema damages the entire body over time. If the disease progresses, it inevitably leads to the death of the patient.

Course of disease

A Emphysema leads to reduced performance and, in an advanced stage, even to severe shortness of breath. Since pulmonary emphysema leads to instability of the airways and the lungs, breathing out is particularly difficult. Overall, the exhalation phase is thereby extended.Therefore, many sufferers use the so-called lip brake to exhale. Here the breath is let out through the pursed lips. In more severe cases, there is a strong inflation of the chest.

As the disease progresses, emphysema can develop in two different directions. A distinction is made between “blue bloater” and “pink buffer”. The “blue bloater” tends to be overweight and has red-blue nails and lips due to the lack of oxygen. He suffers less from shortness of breath than the "pink puffer", but has an increased and expectorant cough.

This course of emphysema easily develops right heart failure. The “pink puffer”, ie the “pink pant”, has a rather lean appearance. He suffers from severe shortness of breath and occasional dry cough without sputum. Its oxygen content is lower, but the carbon dioxide content is normal. With this course of emphysema, breathing can suddenly stop.

Complications

Various complications can arise from emphysema. They can be both acute and chronic in nature. The development of a spontaneous pneumothorax is considered an acute sequela. Medical professionals speak of this complication when emphysema bubbles burst. Air escapes into the gap between the chest wall and the lungs.

Eventually the lungs partially or even completely collapse. The acute effects of pulmonary emphysema also include infections of the airways. They result in a deterioration in the patient's state of health, who suffers from increasing cough, shortness of breath and sputum. For this reason, he receives additional treatment with antibiotic preparations.

Chronic complications can also occur with emphysema. This includes the cor pulmonale. Due to the chronic lack of oxygen in the context of pulmonary emphysema, the pulmonary vessels narrow, which in turn increases the blood pressure in the pulmonary circulation. In addition, the right heart is stressed. In the further course there is a risk of right heart failure.

Another chronic sequela of emphysema is respiratory insufficiency. Partial insufficiency often turns into global insufficiency. Being underweight is also one of the effects of the disease. The heavy strain on the respiratory muscles results in a high consumption of calories, which can often lead to underweight. In addition, the patient experiences shortness of breath and a feeling of fullness when eating meals, so that he eats less.

When should you go to the doctor?

If the person concerned experiences coughing attacks immediately after waking up, this is a sign of an irregularity. A doctor should be visited if the symptoms persist for several days or weeks. A doctor is required in the event of a racing heart, disorders of the heart rhythm or irregular breathing.

If there is discoloration of the skin, poorly supplied blood to the lips, fingers or toes and a feeling of shortness of breath, a doctor's visit is necessary. Blue discoloration indicates a lack of oxygen in the organism and should therefore be clarified by a doctor as soon as possible. Without timely medical care, a life-threatening condition can arise, which must be prevented in good time.

Fatigue, fatigue, inner weakness or a general feeling of illness are indications that should be followed up. A visit to the doctor is necessary if the usual level of performance drops, everyday tasks can no longer be performed or insomnia occurs. Consult a doctor if you feel anxious or have behavior problems.

Since untreated emphysema can lead to premature death, it is advisable to see a doctor at the first signs and irregularities. If existing symptoms increase or if they spread further, a doctor should be consulted as soon as possible. Headaches, digestive disorders or a yellow complexion should also be examined and treated.

Treatment & Therapy

Since the changes in the lungs in a Emphysema are irreversible, the disease cannot be cured. All that can be done is to try to prevent the disease from progressing further.

First of all, contact with harmful substances such as cigarette smoke must be stopped immediately. Infections of the respiratory tract should be treated consistently and at an early stage to prevent further damage to the lungs.

Physiotherapeutic exercises can strengthen the respiratory muscles and thus make breathing easier. If there is a congenital enzyme deficiency, this deficiency should be compensated for with a weekly infusion of this enzyme. If there are already large emphysema bubbles, it may be necessary to remove them surgically.

If the pulmonary emphysema is already more advanced, an existing shortness of breath can be alleviated by administering oxygen. However, in particularly severe cases, emphysema may require a lung transplant.

Outlook & forecast

Pulmonary emphysema occurs noticeably often in smokers. But gases and dust can also cause the disease. According to scientific standards, the best way to alleviate the symptoms is to stop nicotine immediately. However, this does not result in a cure if other therapies are used. Patients have to live with sometimes difficult restrictions.

Future life expectancy sometimes depends on your willingness to cooperate. Old age and other underlying respiratory diseases make the outlook significantly worse. If the affected person already suffers from smoker's cough, a life expectancy of five to seven years results from consistent implementation of the therapy. In this forecast, upward and downward swings represent a common deviation.

Those who fail to receive treatment will sooner or later accept their death. There is a risk of lung failure. Patients also forego existing therapies such as operations, breathing exercises and oxygen supply. The destruction of the tissue proceeds irrevocably. Depending on the basic condition at diagnosis, life expectancy is a few months to a few years. Difficulties in everyday life and the typical symptoms of emphysema are increasing more and more.

prevention

To the emergence of a Emphysema To prevent this, inhalation of the harmful substances mentioned should be avoided in the first place. Infections of the respiratory tract should also be prevented as far as possible. This can be done on the one hand with flu and pneumococcal vaccinations, on the other hand this can also be achieved through respiratory therapy and exercise in the fresh air. If there is a congenital enzyme deficiency, the same points should be observed. Furthermore, the enzyme deficiency can be compensated for in order to prevent damage to the lungs and the development of pulmonary emphysema.

Aftercare

One of the goals of follow-up care is to keep the shortness of breath caused by emphysema under control as far as possible. This includes, among other things, the omission of stimulants such as smoking that irritate the lungs. Smoking in particular is the primary cause of obstruction or narrowing of the airways. It is scientifically proven that ending nicotine addiction contributes to healing insofar as consumption is actually responsible for the typical complaints.

In many other cases, too, preventive measures that the patient can take themselves are effective. Inhaling certain substances and baths with essential oils can possibly prevent illness. A doctor will provide information about suitable measures. Basically, immunity does not build up after a single illness. Those affected therefore have to constantly struggle with respiratory problems, which can vary depending on the severity of the underlying disease.

Aftercare is becoming an ongoing issue. Imaging procedures such as CT or X-rays provide information about the progress of the airway obstruction. Sick people get relief through certain inhalations or breathing techniques. The attending physician continuously prescribes medication or, if necessary, orders therapies. This prevents complications.

You can do that yourself

Pulmonary emphysema cannot be cured, but dealing actively with the disease can make a significant contribution to maintaining quality of life. Above all, this includes largely eliminating harmful influences: Immediately stopping smoking can slow the progression of the disease, and those affected should avoid staying in polluted air as far as possible. So that the sick lungs are not additionally burdened by infections, especially in the typical cold season, more attention must be paid to appropriate clothing and thorough hand washing. A preventive vaccination against flu and pneumococci is advisable.

Physical activity strengthens the lungs and cardiovascular system. Duration and intensity must be tailored to the severity of the disease and the individual resilience - ideally, a training plan is drawn up with the doctor in charge before starting any exercise training. In addition, breathing and physiotherapy can help improve the symptoms.

In the advanced stages of the disease, it is important to take into account the decline in performance in everyday work and at home: Even routine tasks can take up more time, regular breaks ensure the necessary recovery. In the household, aids facilitate many activities - but those affected should not be afraid to accept outside help if necessary. In order to process the illness psychologically, it can be helpful to share experiences in a self-help group.