What is emphysema?

Emphysema is a long-term (chronic) lung disease. In emphysema, the tiny air sacs (alveoli) at the end of the airways in the lungs are damaged. When the air sacs are damaged or destroyed, the inner walls break down and the sacs become larger. These larger air sacs move less oxygen into the blood. This causes difficulty breathing or shortness of breath that gets worse over time. After air sacs are destroyed, they cannot be replaced.

Emphysema is a type of COPD (chronic obstructive pulmonary disease). Emphysema is usually caused by smoking. But chemical fumes, dust, or air pollution also can cause it over time. People who get it in their 30s or 40s may have a disorder that runs in families, called alpha-1 antitrypsin deficiency. But this is rare.

What can you expect when you have emphysema?

Emphysema gets worse over time. You cannot undo the damage to your lungs.

Over time, you may find that:

• You get short of breath even when you do things like get dressed or fix a meal.
• It is hard to eat or exercise.
• You feel weaker and limit activity.

But there are things you can do to prevent more damage and feel better.

What are the symptoms?

The main symptoms of emphysema are:

• A cough that will not go away.
• Mucus that comes up when you cough.
• Shortness of breath that gets worse when you exercise.

At times, your symptoms may suddenly flare up and get much worse. This is a called an exacerbation (say "egg-ZASS-er-BAY-shun"). When this happens, your usual symptoms quickly get worse and stay bad. This can be dangerous. You may have to go to the hospital.

How can you keep emphysema from getting worse?

Don't smoke. That is the best way to keep emphysema from getting worse. If you already smoke, it is never too late to stop. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.

You can do other things to keep emphysema from getting worse:

• Avoid bad air. Air pollution, chemical fumes, and dust also can make emphysema worse.
• Stay up to date on your COVID-19 vaccines. The vaccines help prevent COVID-19. If you do get COVID-19 after being vaccinated, you're much less likely to get seriously ill.
• Get an influenza (flu) vaccine every year. This may keep the flu from turning into something more serious, like pneumonia. A flu vaccine also may lower your chances of having a flare-up.
• Get a pneumococcal vaccine. Most people need only one shot to prevent pneumonia, but doctors sometimes recommend a second shot for some people who got their first shot before they turned 65. Talk with your doctor about whether you need a second shot.
• Get a pertussis shot. A whooping cough (pertussis) shot may help protect you from getting whooping cough.

How is emphysema treated?

Emphysema is treated with medicines and oxygen. You also can take steps to stay healthy and keep your condition from getting worse.

Medicines and oxygen therapy

• You may be taking medicines such as:
  • Bronchodilators. These help open your airways and make breathing easier. Bronchodilators are either short-acting (work for 4 to 9 hours) or long-acting (work for 12 to 24 hours). You inhale most bronchodilators, so they start to act quickly. Always carry your quick-relief inhaler with you in case you need it.
  • Corticosteroids. These reduce airway inflammation. They come in inhaled or pill form.
  • Antibiotics. These medicines are used when you have a bacterial lung infection.
• Take your medicines exactly as prescribed. Call your doctor or nurse advice line if you think you are having a problem with your medicine.
• Oxygen therapy boosts the amount of oxygen in your blood and helps you breathe easier. Use the flow rate your doctor has recommended, and do not change it without talking to your doctor first.

Other care

• If your doctor recommends it, get more exercise. Walking is a good choice. Bit by bit, increase the amount you walk every day. Try for at least 2½ hours a week.
• Learn breathing methods—such as breathing through pursed lips—to help you become less short of breath.
• If your doctor has not set you up with a pulmonary rehabilitation program, ask your doctor if rehab is right for you. Rehab includes exercise programs, education about your disease and how to manage it, help with diet and other changes, and emotional support.
• Eat regular, healthy meals. Use bronchodilators about 1 hour before you eat to make it easier to eat. Try eating smaller, frequent meals so your stomach is never too full. A full stomach can push on the muscle that helps you breathe (your diaphragm) and make it harder to breathe. Drink beverages at the end of the meal. Avoid foods that are hard to chew.