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Emphysema: Not a Simple Cough

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Emphysema is a lung disease in which the alveoli get damaged. Read the article to learn about emphysema's symptoms, diagnosis, and treatment.

Written by

Dr. Saberitha

Medically reviewed by

Dr. Rajesh Gulati

Published At October 10, 2022
Reviewed AtApril 3, 2024


Emphysema is a respiratory ailment in the lungs due to the habit of chronic smoking. It also affects people with prolonged occupational exposure to irritants. The term emphysema is classified under chronic obstructive pulmonary disease (COPD). The inner layer of the air sacs (alveoli) is ruptured in emphysema patients. Alveoli are very thin and fragile, present in clusters at the end of each bronchus. There are 280 to 300 million tiny air sacs in a normal person's lungs. Pulmonary emphysema progresses very slowly.

What Are the Causes of Emphysema?

  • Smoking is the major cause of emphysema.

  • The people are affected by emphysema due to occupational exposure or residing in an environment filled with air pollutants.

  • Family history of emphysema.

  • Inheritance of the gene causing alpha-1 antitrypsin deficiency.

  • Other respiratory illnesses, like chronic bronchitis, may result in emphysema.

What Are the Symptoms of Emphysema?

The patient notices the symptoms only after 50 % destruction of the lungs. The symptoms of emphysema are as follows;

  • Cough - The first symptom of respiratory illness is cough. The pollutants or tobacco smoke damage the lungs and produce long-term cough. This condition is also known as a smoker's cough. The inflammation due to emphysema causes swelling in the airways.

  • Mucus - Due to the irritation in the lungs, there is an increase in mucus production. The patient feels extremely difficult to clear the airways.

  • Breathing Difficulty - During inspiration, the alveoli expand and intake oxygen and transport it to the blood. During expiration, the alveoli relax and force the waste gas (carbon dioxide) out of the body. The working capacity of the alveoli is interfered with due to the destruction of lung tissue and alveoli. The alveoli are unable to support the bronchial tubes (airways). This results in the failure of bronchial tubes. So the emphysema patient has shortness of breath along with wheezing.

  • Chest Pain - The narrowing of airways obstructs the airflow inside the lungs. The air accumulates inside the chest. This condition is called barrel-chest appearance and causes pain in the chest. The destruction of alveoli reduces the oxygen supply to the bloodstream.

  • Fatigue - The patient becomes restless due to the effort taken for respiration. The patient gasps for breath while climbing the stairs and gets exhausted easily.

  • Infections - Emphysema patients are more prone to microbial infections. It results in mucus formation in the lungs. The mucus obstructs the air passage. Due to this, the patient cannot get enough oxygen during inspiration.

What Are the Diagnostic Procedures for Emphysema?

The emphysema condition can be diagnosed using the following tests;

  • Chest X-Rays - Chest X-rays are used to observe the abnormal condition of the lungs and ribs; if the image shows any deformity in the chest, the medical professional proceeds with other tests to determine the lung capacity.

  • Computed Tomography (CT) Scan - Minor ailments in the respiratory system can be identified by computed tomography. It is used to observe the width of the air passages. The thickness of the bronchial tissue is assessed to determine the severity of emphysema.

  • Pulse Oximetry - The tool is attached to the finger or earlobe. It is used to measure the oxygen present in the bloodstream. It is used to examine the oxygen saturation in the body.

  • Pulmonary Function Tests - These determine the obstruction in the bronchi or bronchioles. Spirometry is used to estimate lung volume. It measures the amount of airflow during inspiration and expiration. The expired air is blown into a tube forcefully. The variation in the results shows an abnormality in lung function.

  • Arterial Blood Gas - In severe cases of emphysema, the patient requires oxygen for breathing. In such situations, arterial blood gas is used to measure the oxygen and carbon dioxide levels in the blood vessel.

  • Sputum Culture - The mucus is collected for a sample while the patient coughs. It is examined in the lab using culture techniques. The infection responsible for the respiratory disease can be identified with the help of a sputum culture.

What Are the Various Treatment Methods for Emphysema?

  • Bronchodilators - Bronchodilators relax the breathing muscles and widen the air passages. This helps the patient to expel the mucus while coughing. These medications last for about three to six hours. It is used either as a nebulizer, inhaler, or tablet (oral route). The commonly used drug to relieve shortness of breath is Albuterol.

  • Anti-Inflammatory Drugs - The anti-inflammatory drugs reduce the inflammation in the air passages. It inhibits mucus production and acts against the triggering agents, relieving emphysema in patients. The anti-inflammatory drugs reduce the damage and make the airflow better.

  • Oxygen Therapy - A catheter is inserted inside the nose, or a facemask is used to supply oxygen to the patient. Alveoli responsible for gaseous exchange are damaged in emphysema. So the patient gets supplemental oxygen. Oxygen therapy is given to the patient to assist with breathing and getting more oxygen through the facemask or catheter. Oxygen can also be given at home using portable containers.

  • Lung Volume Reduction Surgery - The portion of the lungs affected by emphysema is removed. The remaining lung tissues are combined. This improves the elasticity of the lungs. The lungs can expand easily without much effort over the breathing muscles. The strain exerted on the breathing muscles is reduced with the help of lung volume reduction surgery. Compared to other treatments for emphysema, this surgical method has been proven to be more efficient and with a better prognosis.


The symptoms of emphysema are irreversible. The patient should quit smoking to avoid further complications. Individuals can avoid emphysema by getting flu shots once every year. The patient affected by emphysema should exercise regularly to improve breathing conditions. Use antibacterial mouthwash and antiseptic handwash to avoid infections entering the respiratory system. To boost immunity, the patient must take multivitamin tablets, vitamin C, and antioxidant-rich foods.

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Dr. Rajesh Gulati
Dr. Rajesh Gulati

Family Physician


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