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Overview

Emphysema: Treatment, Procedure, Cost and Side Effects

What is the treatment?

Emphysema is a type of chronic obstructive pulmonary disorder that causes air sacs in the lung to get enlarged and also causes them to lose elasticity. This can cause a person to get seriously ill by causing serious breathing problems. This condition causes the alveoli present at the end of the bronchioles to get enlarged. This happens due to the break-down of the walls of the alveoli or if the air-sacs get stretched, collapsed, narrowed or over-inflated. When a person has less number of healthy sacs, his/her body has a smaller area for the entry of oxygen into his/her blood and exit of carbon di-oxide from it. People suffering from emphysema also tend to suffer from chronic bronchitis. These two conditions together make up chronic obstructive pulmonary disease.

Emphysema occurs when a person is exposed for a long time to airborne irritants like tobacco smoke, air pollution, chemical fumes, dust and also marijuana smoke. The treatment may consist of medications like bronchodilators, antibiotics and inhaled steroids, other treatments like pulmonary rehabilitation, supplemental oxygen and nutrition therapy and even surgical procedures like lung transplant and lung volume reduction surgery.

It is not possible to treat emphysema permanently. Treatment can reduce the symptoms and help to stop the progression of the condition.

How is the treatment done?

The primary treatment should revolve around avoiding environmental irritants. A person should stop smoking and also avoid breathing secondhand smoke. It is also essential for a person who works with chemical fumes or dust to wear a mask to protect his/her lungs.

Different types of medications may be advised depending on the severity of the condition. Bronchodilators are medications that help a person to get relief from coughing, shortness of breath and from breathing problems in general by easing the constricted airways. Corticosteroids may be recommended to reduce inflammation and they also help to overcome breathing problems. Antibiotics are prescribed when a person suffers from any bacterial infection like bronchitis or pneumonia. Furthermore, pulmonary rehabilitation therapy teaches a person some breathing exercises and techniques that help a person to reduce his/her breathlessness. Maintaining a proper diet is essential for containing emphysema. People with early stage emphysema may need to lose weight while a person suffering from late-stage emphysema may need to gain weight. Supplemental oxygen may be needed to be provided to a person suffering from severe emphysema.

A person may be required to undergo a surgery if the condition requires so. In a lung volume reduction surgery, a surgeon removes small wedges of damaged lung tissue. This procedure helps to improve breathing by removing the dead tissue and thereby allowing the remainder of the lung tissues to expand to work more efficiently.

Who is eligible for the treatment? (When is the treatment done?)

A person is eligible for treatment after he/she has undergone a medical examination and has been diagnosed to be suffering from such. A person in the initial stage of this condition may suffer from shortness of breath or may get easily exerted. However, as the disease progresses, other serious symptoms may include: wheezing, fatigue, anxiety, depression, sleep problems, morning headaches due to lack of oxygen, lot of mucus and frequent lung infections. A person suffering from some or all of these symptoms is eligible for treatment.

Who is not eligible for the treatment?

A person will not be eligible for treatment if a doctor does not diagnose him/her to be suffering from such. However, some of the tests that may help a doctor to understand whether a person is actually suffering from emphysema or not are imaging tests including computerized tomography and noninvasive lung function tests. A person who has not been diagnosed to be suffering from emphysema even after undergoing these tests is not eligible with treatment.

Are there any side effects?

The side-effects of bronchodilators may include diarrhea, palpitation, rapid heartbeat, irregular heartbeat, headache, insomnia and nausea. Corticosteroids, when used for a fairly longer period, can cause hypertension, weight gain, diabetes, disorder of the eyes, bruising, thinning of the skin, osteoporosis and even cause a person to be easily susceptible to infections. Some of the side-effects of lung volume reduction surgery include pneumonia or infection, bleeding, stroke, air leakage from the lung tissue and in some extreme cases, it may also result in death.

What are the post-treatment guidelines?

A person who has undergone treatment for emphysema should adopt a few measures so as to avoid deterioration of the condition. One of the most important steps is to stop smoking as this measure can help to stop the progression of the condition. He/she should also avoid coming in contact with other respiratory irritants like fumes from paint, automobile exhaust and certain perfumes. Other measures include exercising regularly, protecting oneself from cold air, get required vaccinations and also should also avoid coming in contact with respiratory infections.

How long does it take to recover?

A person who has undergone treatment for emphysema should adopt a few measures so as to avoid deterioration of the condition. One of the most important steps is to stop smoking as this measure can help to stop the progression of the condition. He/she should also avoid coming in contact with other respiratory irritants like fumes from paint, automobile exhaust and certain perfumes. Other measures include exercising regularly, protecting oneself from cold air, get required vaccinations and also should also avoid coming in contact with respiratory infections.

What is the price of the treatment in India?

The cost of an intermittent updaft nebulization is Rs around Rs 750 for three treatments. Corticosteroid medications are available within a price range of Rs 300 – Rs 1000. Antibiotic tablets are available within a price range of Rs 25- Rs 500 per box. Lung volume reduction surgery is very expensive and may cost more than Rs 10 lakhs.

Are the results of the treatment permanent?

There is no permanent solution for emphysema. Treatment can stop the condition from deteriorating but total cure is not possible. A person who starts smoking again or if is exposed to even second-hand smoke has the risk of getting the condition deteriorated. People working in conditions which expose them to environmental pollutants also need to take precautions.

What are the alternatives to the treatment?

Staying hydrated can help to reduce the symptoms of emphysema. Water intake helps to clear the mucus which results in uncontrollable coughing. Cardio exercises help to strengthen respiratory muscles and thereby helps a person to quit smoking. Other things that may help to treat with emphysema is eucalyptus oil, ginseng and N-acetylcysteine.

Safety: Disease Effectiveness: High Timeliness: High Relative Risk: Medium Side Effects: Low Time For Recovery: Medium Price Range:

Rs 25 - Rs 10 lakhs

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Emphysema - Diagnosis and Management

MD, DNB, Diploma In Tuberculosis & Chest Diseases (DTCD), MBBS
Pulmonologist, Delhi
Emphysema - Diagnosis and Management

 

Emphysema is a breathing disorder that has no cure and worsens with time. The symptoms of emphysema - a feeling of tightness in the chest, persistent cough, wheezing and breathlessness – are caused due to destroyed or impaired functioning of lung tissue.

Diagnosing Emphysema
A thorough physical examination which would include weight and blood pressure checks would be performed. The doctor would also listen to the heartbeat to determine if it sounds strange or different.

In addition to checking for the signs and symptoms of emphysema, a physical examination would also help the doctor in determining the following:

  • Whether the fingertips are rounded. This condition is also known as “clubbing”.
  • Whether you have a rounded or “barrel chest” which is caused by lungs that are larger than normal.
  • If the lips have a blue tinge also known as cyanosis, which is a sign of low levels of oxygen in the blood.
  • Signs of malnutrition as in advanced cases of emphysema the muscles slowly waste away.

Tests For Emphysema
A doctor would recommend additional tests to confirm his diagnosis of this lung condition. Some of the tests are:

  • Pulmonary Function Tests or PFTs and spirometry tests would be advised to measure the volume and capacity of the lungs.
  • A chest X-ray is useful to diagnose advanced emphysema as the lungs appear larger than normal in patients with this condition.
  • A CT scan of the chest will show the air sacs or alveoli have been destroyed.
  • The blood test report of patients with emphysema would show a high amount of red blood cells. The production of red blood cells in the body increases due to the reduced levels of oxygen.
  • A pulse oximetry test also known as an oxygen saturation test could be done to measure the amount of oxygen in the blood. A monitor would be attached to the patient’s forehead, finger or earlobe to carry out this test.
  • An arterial blood gas test is usually performed on patients as their condition worsens. It measures the amount of oxygen and carbon dioxide in the blood.
  • An electrocardiogram or ECG might be advised to rule out condition such as heart disease as a cause of shortness of breath.

Management and Treatment
There is no known cure for emphysema and the condition can worsen with time. Treatment will slow the speed of decline and will depend on the severity of the condition when diagnosed. Some treatment options are:

  1. Quit smoking to protect your lungs.
  2. Bronchodilator medications used to treat asthma are useful in relaxing the muscles around the airways.
  3. Anti-inflammatory medications reduce inflammation around the airways.
  4. Oxygen therapy is recommended to patients when they are not able to breathe enough oxygen from the air.
  5. In some severe cases, lung volume reduction surgery might be advised to relieve pressure on the muscles required for breathing and to improve the elasticity of the lungs.

Keeping your home clean and free of dust and pollutants will help to prevent respiratory infections and disorders such as emphysema. Consult an expert & get answers to your questions!

2742 people found this helpful

Emphysema - Know The Life Expectancy and Stages!

MD, MBBS
Pulmonologist, Delhi
Emphysema - Know The Life Expectancy and Stages!

If you are facing difficulties in breathing, especially in the process of exhaling, you are suffering from emphysema. Emphysema is a condition in which the air sacs of the lungs are damaged and enlarged, causing breathlessness. It occurs as a result of several triggers, smoking being the most common one. Emphysema is a type of chronic obstructive pulmonary disease. People with this condition struggle to exhale, which implies that there is some obstruction in the air flow. This disease has no permanent cure but by quitting smoking, you can stop it from getting worse.

Stages
The progression and severity of emphysema occurs with the staging systems. The staging of the condition can help in developing a prognosis.

The Gold emphysema staging system
Gold is a major emphysema staging system created by a group known as the Global Initiative for Chronic Obstructive Lung Disease. The amount of air a patient can exhale forcefully in one second is determined during this stage. It is also referred to as the forced expiratory volume or FEV1.

The staging is as follows:

  • Stage 1: Mild emphysema (FEV1 greater than 80% of normal)
  • Stage 2: Moderate emphysema (FEV less than 80%, but more than 50% normal)
  • Stage 3: Severe emphysema (FEV lesser than 50%, but more than 30% normal)
  • Stage 4: Extremely severe emphysema. (FEV lesser than 30% of normal or lesser than 50% normal, with low levels of oxygen in the blood.

The BODE emphysema staging system
The condition affects several abilities. The BODE index, an acronym for BMI (body mass index), obstruction, dyspnea (breathlessness), exercise capacity (health index) is another staging system for emphysema in which the emphysema’s impact on several areas of life are measured. They include the following:

  1. Body mass index (B)
  2. Airflow limitation or obstruction (O), which is measured by pulmonary function tests
  3. Breathless or dyspnea (D), which is assessed thoroughly via a questionnaire
  4. Exercise capacity (E), which is measured to check how long a person with emphysema can walk in a span of six minutes

Life expectancy
The prognosis of emphysema is impossible to be determined in any person individually. The staging system helps to identify the severity of the condition, but the future cannot be predicted. Not many studies have been undertaken for the determination of the effects of emphysema on life expectancy. The best research that has been carried out included around 100 people, which is very less. The condition varies largely among people, even if they are in the same stage.

The statistics available on emphysema are not reliable enough for individuals who wish to know their life expectancy. It is considered that if a patient falls in a higher stage, his/her long-term life expectancy is less. If you wish to discuss about any specific problem, you can consult a Pulmonologist.

3305 people found this helpful

Health Consequences of Smoking 3 Cigarettes A Day

Diploma in Tuberculosis and Chest Diseases (DTCD), Board Certified in Pulmonary Medicine, FCCP - Pulmonary Medicine
Pulmonologist, Nagpur
Health Consequences of Smoking 3 Cigarettes A Day

Smoking can cause irreparable damage to your mind and body. Chemicals in the tobacco travel to all parts of the body, leaving no area unaffected. According to available data, smoking causes 30% of all cancer deaths and about 80% deaths from emphysema and bronchitis. In addition to adversely affecting yourself, smoking also has a severe impact on your near and dear ones. According to WHO, about 600,000 people die every year from passive smoking. Out of the deaths that occur due to this, 1/3rd is that of children.

The Indian situation
While 85% of tobacco users worldwide consume it in the form of cigarettes, in India only 13% use it in that form. Additionally, 54% use it in the form of beedis. A study conducted on Indian smokers has revealed that an average of 8.2 cigarettes is smoked by an individual daily.

The study also revealed that the number of cigarettes smoked every year had grown to over 6 trillion. While 1 out of 10 adults dies from tobacco use worldwide, 5% of deaths in women and 20% of deaths in men in India are caused by cigarette and beedi smoking.

What happens when you smoke?
Cigarette smoke is made up of 4000 chemicals that are present either as tiny particles or gases and about 50 are known to lead to cancer, the toxin nicotine being one of them. In addition to nicotine, the chemicals that make up cigarette smoke also include tar and carbon monoxide. Prolonged exposure to these toxins can hamper your body's ability to filter air and clean the lungs. The smoke not only irritates the lungs but also causes excess production of mucus.


It also causes a paralysis of the tiny hair-like structures like cilia that line the airways and are responsible for removing dust and dirt from the organ. Paralysis of these hair-like structures also causes a buildup of mucus and toxic substances, leading to lung congestion. The extra mucus that is produced causes smokers to suffer from the very ubiquitous smoker's cough and chronic bronchitis.

It's also one of the many triggers of asthma, which brings about the narrowing and inflammation of the airways. Long-term exposure to tobacco smoke causes the destruction of the structure of the lung, walls of the airways as well as lung tissue. The result is a condition known as emphysema. Additionally, smoking also leads to cancer of the lung and over 80% lung cancer cases occur due to this habit. If you wish to discuss about any specific problem, you can consult a pulmonologist.

3091 people found this helpful

Physiotherapy For Emphysema!

MSPT (Master of Physical Therapy)
Physiotherapist, Delhi
Physiotherapy For Emphysema!

Emphysema is a lung disease, where the walls of the air sacs are destroyed completely and the lungs lose their elastic gradually. This makes it inconvenient for the person to breathe in/out as the size of the lungs lessens. This, in turn, increases the breathing rate and finally, you may end up with breathlessness. If proper care is not taken, it can also lead to heart enlargement which may further increase your chances of having a heart failure.

Causes of Emphysema:
Some of the common causes of Emphysema are:

  1. Irrespective of whether you are exposed to direct or second-hand smoking, chemical fumes, pollution you can still be affected by Emphysema. Although one of the main and most common reasons for Emphysema is Smoking. The tobacco smoke has almost 4000 chemicals in it. These chemicals will first destroy the airways, then the elastic sacs and finally the elastic fibers.
  2. Another reason for Emphysema is protein deficiency, but this is a very rare reason. Only one or two percent of the people will be affected by Emphysema due to this reason. A protein called AAT deficiency can damage the elasticity of the lung structure and can cause lung damage.
  3. Aging is also a cause of Emphysema. As you grow older, lungs also start aging and hence that can damage the elasticity of the lungs.

Physiotherapy treatment for Emphysema:
When you meet your physiotherapist, you will have a discussion in order to find the actual symptoms of Emphysema. Based on the symptoms, the physiotherapist will analyze how it is affecting your lifestyle.
A physiotherapist will make sure to provide the best and specialized treatment for the symptoms of Emphysema. Your treatment will be decided and started based on the severity of your symptoms.

Breathing techniques:
Your physiotherapist will work on controlling the respiratory rates, Diaphragmatic breathing, reduction of breathing volume and exercises related to relaxation breathing. These techniques will help in retraining your breathing.

Secretion clearance:
The physiotherapist will work on productive and effective coughing techniques, manual assistance which includes shaking and vibrating and postural drainage. They will help in removing the mucus out of the airways as they block the airways. This way you will be able to keep your airways as hygienic as possible. This will also help in reducing any kind of infections that may be caused due to the excessive mucus.

Educating the patients:
Your physiotherapist will help you understand the causes of Emphysema, how the allergens and environment are responsible for it, how to manage your medication and how to identify the possible asthmatic attacks.
With the help of physiotherapy, Emphysema sufferers will be able to lead a normal life as much as possible.

1 person found this helpful

Diagnosis And Treatment Of Emphysema!

DM - Pulmonary Med. & Critical Care Med., MD, DNB
Pulmonologist, Ghaziabad
Diagnosis And Treatment Of Emphysema!

Emphysema is a breathing disorder that has no cure and worsens with time. The symptoms of emphysema - a feeling of tightness in the chest, persistent cough, wheezing and breathlessness – are caused due to destroyed or impaired functioning of lung tissue.

Diagnosing Emphysema
A thorough physical examination which would include weight and blood pressure checks would be performed. The doctor would also listen to the heartbeat to determine if it sounds strange or different.

In addition to checking for the signs and symptoms of emphysema, a physical examination would also help the doctor in determining the following:

  • Whether the fingertips are rounded. This condition is also known as “clubbing”.
  • Whether you have a rounded or “barrel chest” which is caused by lungs that are larger than normal.
  • If the lips have a blue tinge also known as cyanosis, which is a sign of low levels of oxygen in the blood.
  • Signs of malnutrition as in advanced cases of emphysema the muscles slowly waste away.

Tests For Emphysema
A doctor would recommend additional tests to confirm his diagnosis of this lung condition. Some of the tests are:

  • Pulmonary Function Tests or PFTs and spirometry tests would be advised to measure the volume and capacity of the lungs.
  • A chest X-ray is useful to diagnose advanced emphysema as the lungs appear larger than normal in patients with this condition.
  • A CT scan of the chest will show the air sacs or alveoli have been destroyed.
  • The blood test report of patients with emphysema would show a high amount of red blood cells. The production of red blood cells in the body increases due to the reduced levels of oxygen.
  • A pulse oximetry test also known as an oxygen saturation test could be done to measure the amount of oxygen in the blood. A monitor would be attached to the patient’s forehead, finger or earlobe to carry out this test.
  • An arterial blood gas test is usually performed on patients as their condition worsens. It measures the amount of oxygen and carbon dioxide in the blood.
  • An electrocardiogram or ECG might be advised to rule out condition such as heart disease as a cause of shortness of breath.

Management and Treatment
There is no known cure for emphysema and the condition can worsen with time. Treatment will slow the speed of decline and will depend on the severity of the condition when diagnosed. Some treatment options are:

  1. Quit smoking to protect your lungs.
  2. Bronchodilator medications used to treat asthma are useful in relaxing the muscles around the airways.
  3. Anti-inflammatory medications reduce inflammation around the airways.
  4. Oxygen therapy is recommended to patients when they are not able to breathe enough oxygen from the air.
  5. In some severe cases, lung volume reduction surgery might be advised to relieve pressure on the muscles required for breathing and to improve the elasticity of the lungs.

Keeping your home clean and free of dust and pollutants will help to prevent respiratory infections and disorders such as emphysema.

1763 people found this helpful

Popular Questions & Answers

Table of Content

What is the treatment?
How is the treatment done?
Who is eligible for the treatment? (When is the treatment done?)
Who is not eligible for the treatment?
Are there any side effects?
What are the post-treatment guidelines?
How long does it take to recover?
What is the price of the treatment in India?
Are the results of the treatment permanent?
What are the alternatives to the treatment?
Play video
Pulmonary Physiotherapy
Hello everybody!

I am Dr. Ankita Grover, Cardio-Pulmonary Physiotherapist at Xcell Physiocare Pvt. Ltd. These days as you all know that the pollution levels are rising in India and especially when we talk about Delhi NCR, the situation is even worse. There are many respiratory problems that are associated with pollution and which is causing problems to the patients such as COPD, asthma, emphysema, pneumonia etc. All these are the problem very common that you will be able to find around your surroundings. This is not only creating diseases but it is also causing patients to frequently go to the hospital. And hospital admission rates have gone up, their medication usage has gone up which is creating internal side effects for them.

So, what we at Xcell have come up with is state of the art physio or pulmonary-physio specialised labs that we have set up here and it is properly dedicated to lung rehabilitation in India. It is first of its kind in Delhi NCR and it is properly dedicated to all the lung issues that you are facing. Now coming over to what we do at Xcell Physiocare. Our first start of the treatment before the treatment is the patient screening part and the assessment part that whenever the patient comes to us we access him thoroughly through the screening test and through our specialised scales that we use. We focus on proper assessment of the patient then after the assessment is done we chart some goals for the patient.

We frame some targets for him to achieve so that symptoms are reduced and his problems related to lung issues instead of getting worse, they lower down. After framing the goals for the patient, we start a customised treatment plan and that plan is according to the patients situation. It's like ABC, A part is your assessment, B is your goal formation and C is your customised treatment plan. Now coming to our treatment plan we are having certain specialised part of pulmonary and lung rehabilitation at our setup. Firstly we focus on airway clearance techniques. Now airways clearance techniques is something which is something very important for any patient who is having a lung issue. Their airways are blocked may be due to any kind of situation, be it asthama, maybe it is Bronchitis. So our motto is to clear their airways and for that we are having specialised devices in our setup and through them, we help in getting clearance techniques.

Secondly we have focus on breathing exercises of the patient which is very important because many of the patient that come up to a centre are either complaining of shortness of breath which we call Dyspnea in medical terms and they are not able to breathe properly or even if they are breathing the breath is very shallow. We focus on training their breathing and make them do breathing exercises. Now breathing exercises and not just the exercises that we do teaching them manually but we also have devices here which specially train the respiratory muscles of the patients. You all have heard about muscle training through equipments, the body muscle training through various equipments for exercises but when it comes to respiratory muscle training I think India is far behind compared to the western countries.

We have dedicatedly planned an inspiratory muscle training program also for the patients so that we can increase their inspiratory and expiratory muscle strength which is very important for their lung rehabilitation program. Coming over the third aspect that we deal is their overall increased energy levels and that will come through their increased strength, their increase stamina or endurance and this is done through our gym section which we have at our set up at Xcell Physiocare. We also train the patients through specialised equipment that we have had for strength and conditioning as well as for endurance. This is all how our Xcell Physiocare pulmonary setup is. I have just given you an introduction about it and I would like you all to come and visit us and also I would like to you to know that on your first visit we have a special free consultation offer going for you for this month. So please do make a visit and let us know about your experience.

Thank You!
Having issues? Consult a doctor for medical advice