Pulmonary Emphysema

According to Theinternetfaqs, pulmonary emphysema is irreversible damage to the lungs. Since damage that has already occurred cannot be reversed, therapy for pulmonary emphysema can only slow down or prevent the progression of the disease.

Pulmonary Emphysema

What is pulmonary emphysema?

In pulmonary emphysema, the small, air-filled structures in the lungs become overinflated. Inflammatory processes in the lungs are caused by harmful substances in the air we breathe or by the body’s own reactions.

These also cause increased external pressure on the bronchioles, causing the air sacs in the lungs, the so-called alveoli, to inflate until they burst.

This can cause large emphysema blisters to develop in pulmonary emphysema. Because these bubbles in the lungs have become inactive, breathing becomes difficult.


Pulmonary emphysema can have different causes. Normally, there is a balance between different enzymes within the lungs. The granulocytes are tissue-splitting enzymes and the alpha-1 proteinase inhibitors are protective enzymes that restore balance.

If there is a hereditary predisposition to a deficiency in this protective enzyme, pulmonary emphysema can develop. However, only the severe form of this disease inevitably leads to pulmonary emphysema. In milder forms, the risk of pulmonary emphysema only exists in connection with the intake of harmful substances. Because pollutants that are inhaled can also lead to pulmonary emphysema.

For example, [smoking|smokers]] absorb substances with the smoke that lead to inactivation of the important alpha-1 proteinase inhibitor. In addition, smokers have an increased risk of infection.

However, chemical substances such as aluminum or cadmium and occupational exposure to dust, such as in mines, animal feed or raw cotton, can also be the cause of pulmonary emphysema.

Symptoms, Ailments & Signs

The disease usually develops gradually. Signs of the onset of pulmonary emphysema are a morning cough with sputum and shortness of breath during physical exertion. Some patients experience rattling noises when breathing, which are otherwise only associated with bronchitis. External signs are a blue discoloration of the lips and fingers and conspicuously curved fingernails.

The lack of oxygen can also lead to paleness and dark circles under the eyes. In the later stages, the thorax is deformed as a result of the overinflation of the lungs, which eventually resembles a barrel. The patients are usually physically and mentally ailing, symptoms such as listlessness and fatigue become noticeable. If left untreated, the lungs continue to enlarge, reducing mobility of the chest.

The result is breathing difficulties, especially breathing out is difficult. The increasing lack of oxygen also impairs the organ functions and thus causes a variety of complaints. Typical are headaches, indigestion, cardiac arrhythmia and jaundice. The initial shortness of breath is now permanent.

In the long term, right heart failure can develop, which in turn is associated with serious symptoms. A pulmonary emphysema damages the entire body in the course. If the disease progresses further, it will inevitably lead to the death of the patient.

course of the disease

Pulmonary emphysema leads to reduced performance and, in advanced stages, even to severe shortness of breath. As pulmonary emphysema progresses to instability of the airways and the pulmonary structure, exhalation in particular becomes more difficult. Overall, this lengthens the exhalation phase. Therefore, many sufferers use the so-called pursed lip to exhale. The breath is let out through the pursed lips. In more severe cases, there is still severe inflation of the chest.

In the further course, pulmonary emphysema can develop in two different directions. A distinction is made between “blue bloater” and “pink puffer”. The “blue bloater”, i.e. “blue cougher”, tends to be overweight and has blue-red nails and lips due to the existing lack of oxygen. He suffers less from shortness of breath than the “pink puffer”, but has an increased and profuse cough.

This course of pulmonary emphysema easily develops right heart failure. The “pink puffer”, i.e. the “pink panter”, has a rather lean appearance. He suffers from severe shortness of breath and occasional dry cough without sputum. Although its oxygen content is lower, the carbon dioxide content is normal. In this course of pulmonary emphysema, breathing can suddenly fail.


Pulmonary emphysema can lead to various complications. They can be both acute and chronic in nature. The emergence of a spontaneous pneumothorax is considered to be an acute consequence. Doctors speak of this complication when emphysema blisters burst. Air escapes into the gap between the chest wall and the lungs.

Eventually, the lungs partially or even completely collapse. Also among the acute effects of pulmonary emphysema are infections of the airways. They result in a worsening of the patient’s state of health, who suffers from increasing cough, shortness of breath and sputum production. For this reason, he receives additional treatment with antibiotic preparations.

In addition, chronic complications can occur with pulmonary emphysema. This includes cor pulmonale. Due to the chronic lack of oxygen in the context of pulmonary emphysema, the pulmonary vessels constrict, which in turn leads to an increase in blood pressure in the pulmonary circulation. In addition, the right heart is strained. In the further course, right heart failure threatens.

Another chronic consequence of pulmonary emphysema is respiratory insufficiency. It is not uncommon for partial insufficiency to turn into global insufficiency. Being underweight is also one of the effects of the disease. The heavy strain on the respiratory muscles results in high calorie consumption, which can often lead to underweight. Furthermore, the patient feels shortness of breath and a feeling of fullness when eating meals, so he eats less.

When should you go to the doctor?

If the person concerned experiences coughing attacks immediately after waking up, this is a sign of an irregularity. A doctor should be consulted if the symptoms persist unabated for several days or weeks. A doctor is needed in the event of heart palpitations, cardiac arrhythmia or irregular breathing.

If your skin becomes discolored, your lips, fingers or toes have poor blood circulation and you feel short of breath, you need to see a doctor. Blue discolorations indicate a lack of oxygen in the organism and should therefore be clarified by a doctor as soon as possible. Without timely medical care, it can become a life-threatening condition that must be prevented in good time.

Exhaustion, exhaustion, inner weakness or a general feeling of illness are indications that should be followed up. A doctor’s visit is necessary when the usual level of performance drops, everyday tasks can no longer be performed or sleep disorders occur. If you experience anxiety or behavioral problems, consult a doctor.

Since untreated pulmonary emphysema can lead to premature death, it is advisable to consult a doctor at the first signs and irregularities. If existing symptoms increase or spread further, a doctor should be consulted as soon as possible. Headaches, digestive disorders or a yellow complexion should also be examined and treated.

Treatment & Therapy

Since the changes in the lungs in pulmonary emphysema are irreversible, the disease cannot be cured. One can only try to prevent further progression of the disease.

First of all, contact with harmful substances, such as cigarette smoke, must be stopped immediately. Respiratory tract infections should be treated consistently and early to prevent further damage to the lungs.

Physiotherapeutic exercises can strengthen the respiratory muscles and thus make breathing easier. In the case of a congenital enzyme deficiency, this deficiency should be compensated for by a weekly infusion of this enzyme. If large emphysema blisters already exist, it may be necessary to surgically remove them.

If the pulmonary emphysema is already more advanced, an existing shortness of breath can be reduced by the administration of oxygen. However, in particularly severe cases, pulmonary emphysema may require a lung transplant.

Outlook & Forecast

Pulmonary emphysema occurs remarkably often in smokers. But gases and dust can also cause the disease. According to scientific research, the best way to alleviate the symptoms is to stop smoking immediately. However, this and the use of other therapies do not result in a cure. Patients have to live with sometimes difficult limitations.

Future life expectancy sometimes depends on their willingness to participate. Old age and other underlying diseases of the respiratory tract significantly worsen the prospect. If the person concerned already suffers from smoker’s cough, a life expectancy of five to seven years results if the therapy is carried out consistently. In this forecast, swings up and down are a common deviation.

Those who fail to receive treatment sooner or later accept their death. There is a risk of lung failure. Patients also do without existing therapies such as operations, breathing exercises and oxygen supply. The destruction of the tissue progresses irrevocably. Depending on the basic condition at the time of diagnosis, life expectancy is between a few months and a few years. Difficulties in everyday life and the typical symptoms of pulmonary emphysema are increasing more and more.


In order to prevent the development of pulmonary emphysema, the inhalation of the harmful substances mentioned should be avoided in the first place. Respiratory infections should also be prevented as far as possible. On the one hand, this can be done with flu and pneumococcal vaccinations, on the other hand, this can also be achieved through respiratory therapy and exercise in the fresh air. In the case of congenital enzyme deficiency, the same points should be observed. Furthermore, the enzyme deficiency can be compensated to prevent damage to the lungs and the development of pulmonary emphysema.


One of the aims of aftercare is to keep the shortness of breath caused by the pulmonary emphysema under control as far as possible. These include, among other things, the omission of lung-irritating stimulants such as smoking. Smoking is considered to be the primary cause of obstruction or narrowing of the airways. It is scientifically proven that ending nicotine addiction contributes to healing, insofar as consumption is actually responsible for the typical symptoms.

Preventive measures that the patient can take themselves are also effective in many other cases. The inhalation of certain substances and baths with essential oils can possibly prevent an illness. A doctor will provide information about suitable measures. In principle, no immunity builds up after a single illness. Those affected therefore have to constantly struggle with respiratory problems, which can manifest themselves differently depending on the severity of the underlying disease.

Follow-up care becomes an ongoing issue. Imaging procedures such as CT or X-rays provide information about the progression of the airway obstruction. Patients get relief through certain inhalations or breathing techniques. The attending physician prescribes medication on an ongoing basis or orders therapies as needed. This prevents complications.

You can do that yourself

Pulmonary emphysema cannot be cured, but actively dealing with the disease can make a significant contribution to maintaining quality of life. Above all, this includes eliminating harmful influences as far as possible: stopping smoking immediately can slow down the progression of the disease, and those affected should avoid spending time in polluted air if possible. So that the diseased lungs are not additionally burdened by infections, more attention must be paid to wearing appropriate clothing and washing hands thoroughly, especially during the typical cold season. Preventive vaccination against influenza and pneumococci is advisable.

Physical activity strengthens the lungs and cardiovascular system. Duration and intensity must be tailored to the severity of the disease and individual resilience – ideally, a training plan is drawn up with the doctor treating you before starting movement training. In addition, respiratory and physiotherapy can help to improve the symptoms.

In the advanced stage of the disease, it is important to take into account the decreasing performance in everyday work and at home: Even routine tasks can take up more time, regular breaks ensure the necessary recovery. In the household, aids make many activities easier – but those affected should not shy away from accepting help from outside if necessary. In order to process the illness mentally, the exchange of experiences in a self-help group can be helpful.