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What is emphysema?

Emphysema is a chronic (long-lasting) disease that gradually destroys the lungs. The damage makes it hard to breathe. You have trouble breathing out carbon dioxide, and eventually you become unable to breathe in enough oxygen.

How does it occur?

Cigarette smoking is the main cause of emphysema. The smoke damages the cells in your lungs. As the air sacs (alveoli) in your lungs become damaged, it gets harder for you to breathe out carbon dioxide after you breathe in air. This means more carbon dioxide stays in your lungs and you have less room for oxygen to be breathed in. Once the damage occurs, it does not go away. About 15 to 20% (1 in 5 or 6) of smokers develop emphysema.

An inherited disorder (meaning it's passed down from your parents) called alpha-1 antitrypsin deficiency, or AATD, can also cause emphysema. Alpha-1 antitrypsin (AAT), also called alpha-1 proteinase inhibitor, is a substance that is made in the liver. The liver releases AAT into the bloodstream. AAT helps protect the lungs against damage from other chemicals in the blood. If you have AATD, you have too little of this substance and your lungs can be damaged more easily. If you are a smoker AND have this genetic disorder, the lungs become damaged more quickly.

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What are the symptoms?

The most common symptom of emphysema is a feeling of shortness of breath. At first this occurs with mild exercise or normal daily activities. After a while, you have trouble breathing all the time. Another symptom is coughing.

Sometimes the first obvious symptom of emphysema is wheezing, which can also be a symptom of asthma. These two medical problems can be confused with each other.

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How is it diagnosed?

Your health care provider will ask about your medical history, including your smoking history and family medical history. Your provider will examine your heart and lungs. Then he or she will examine your hands and feet to look for signs that your body is not getting enough oxygen.

Your provider will check for other problems that could cause your symptoms, such as asthma.

Spirometry, a breathing test also called a pulmonary function test, is the most helpful test for emphysema. It checks your ability to breathe out forcefully and quickly.

You may have blood tests and chest X-rays. Early in the disease, you may not have any physical symptoms, and lab tests of your blood and X-rays of your chest may be normal. However, once you begin to have symptoms, blood tests may show that you have more red blood cells than normal. Red blood cells are the cells that carry oxygen in your blood. Other blood tests may show that too much carbon dioxide is staying in your body. As damage to your lungs gets worse, chest X-rays will usually show changes that suggest emphysema. In the early stages of emphysema, chest X-rays are normal.

If you are young or a non-smoker and have symptoms of emphysema, your healthcare provider will do a blood test to check the level of alpha-1 antitrypsin.

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How is it treated?

There is no cure for emphysema, but treatment can help control the disease. The treatment goals for emphysema are to:

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How long will the effects last?

There is no cure for emphysema. It gradually worsens over many years until the lungs can no longer function.

How can I take care of myself?

Call your healthcare provider if you have:

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How can I prevent emphysema?

The best way to prevent emphysema is to never smoke. If you are a smoker, quit now. The fewer years you smoke, the less likely it is that you will develop emphysema.

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