Talking About Emphysema

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Having to sit, wait and struggle to breathe is frustrating. For this reason, people with lung disease need to be patient. One example of lung disease is emphysema- a condition in which your lung tissues get hardened, which makes gaseous exchange difficult. When we breathe, gas exchange occurs. Our lungs absorb oxygen and emit carbon dioxide. But in emphysema, breathing gets compromised.

There are two types of chronic obstructive pulmonary disease (COPD)

  1. Chronic bronchitis- It is characterized by clinical features.
  2. Emphysema- It is characterized by the structural changes in alveoli.

Both almost always co-exist as they have the same risk factors, like smoking. Their treatment would not reverse the condition. But it can slow down their progression.

How Does Emphysema Occur?

Emphysema involves inflammation or swelling of the alveoli. Alveoli are where oxygen and carbon dioxide exchange takes place.

Oxygen travels out of the alveoli into the blood. Carbon dioxide travels the other way.

When lung tissue receives an irritant, it triggers an inflammatory reaction. The lung tissue gets damaged in emphysema. That also affects alveolar gases. An example of such an irritant is cigarette smoke.

The inner wall of the alveoli weakens. It creates large air spaces instead of smaller air spaces. The surface area of the lungs decreases, and so does the amount of oxygen that reaches your blood. This process all happens in the acinus of the alveoli.

The acinus is the end of the airway where clusters of airways are present. Different types of emphysema affect acinus in different ways:

Centriacinar emphysema/ Centrilobular emphysema

It is the most common type of emphysema. It affects the proximal or central alveoli of the acinus. Most commonly, it occurs due to cigarette smoking. The irritants of cigarettes can not make their way up to the distal end of the alveoli. Therefore it affects the upper lobes of the lungs.

Panacinar emphysema

This type of emphysema affects the entire acinus. It is caused by the deficiency of Alpha-1 antitrypsin and affects the lower lobes of the lungs.

Paraseptal emphysema

This emphysema affects the distal alveoli. It affects the lung tissue near the interlobular septa. It can cause pneumothorax.

If you have emphysema, you must attend follow-up visits with your healthcare provider. Not doing that can worsen your health. Therefore be regular about it. To get an expert opinion, you can visit the Best Pulmonologist in Karachi.

What Are The Signs And Symptoms Of Emphysema?

The common signs and symptoms of emphysema are:

  • Dyspnea- Decrease gas exchange causes shortness of breath.
  • Exhaling slowly- Pursuing of lips causes slow exhalation. It increases pressure in the airways and keeps the airway from collapsing. Such people are called ‘pink puffers’.
  • Weight loss- Constant energy waste on breathing causes weight loss.
  • Hypoxemia- Also known as low oxygen in the blood. It happens over time in emphysema.
  • Cough- Happens with some sputum due to inflammation of small bronchioles. It leads to excess mucus production via goblet cells. Whereas in chronic bronchitis, there is lots of sputum.
  • Barrel-shaped chest- Air trapping and hyperventilation cause a barrel-shaped chest.

In chest X-rays of patients suffering having barrel-shaped chests, the findings are:

  • Increased lung-field lucency
  • Increased anterior-posterior diameter
  • Flattened diaphragm


Treatment is dependent on reducing risk factors and managing associated illnesses.

Quit Smoking

Since smoking plays a significant role in causing emphysema. Quitting it can cause a reduction in its progression. |You might find it hard to leave smoking. For that, you can seek professional help. The therapists can help you with that. It might seem an arduous task, but it is not impossible.

Supplemental oxygen

The healthcare providers put you on supplemental oxygen to cope with the oxygen demands of your body.


Common medications for emphysema include:

  • Bronchodilators
  • Inhaled steroids
  • Antibiotics


Your lung is where the exchange of gasses takes place. It is a vital mechanism of our body. Thus, you should pay serious attention to any lung disease. Also, you should consult a pulmonologist in case you see any sign or symptom of emphysema, as you have read above.

If you have emphysema, you must attend follow-up visits with the healthcare provider. To get an expert opinion, you can consult the South City Hospital.