There are different kinds of lung diseases, including emphysema, and there are also a few different types of emphysema.

Emphysema is a chronic and progressive lung disease caused by exposure to substances that damage the lungs, most often cigarette smoke. Other causes include air pollution, fumes and dusts at the workplace, and rarely, an inherited form of emphysema related to alpha 1-antitrypsin (AA1) deficiency.

Emphysema damages the air sacs (alveoli) in the lungs, making it harder to breathe. The sacs may be collapsed, overinflated, or narrowed. Once the air sacs are damaged, they cannot be fixed.

There are different types of emphysema, and knowing more about the condition can help you better understand it.

Emphysema, also called pulmonary emphysema, is a progressive lung disease. It’s a form of chronic obstructive pulmonary disease (COPD). Its hallmarks are continued respiratory symptoms and impaired airflow. Symptoms can include cough, shortness of breath, wheezing, and sputum production.

There are three types of emphysema:

  • Centrilobular: most common type, associated with smoking and coal workers
  • Panacinar: usually associated with alpha1-antitrypsin deficiency
  • Paraseptal (distal acinar): can occur alone or with the other kinds; when it occurs alone, it’s often with a collapsed lung in a young adult

There are three main types of emphysema, and each one tends to be expressed in its own way:

  • Centriacinar/centrilobular: starts in the respiratory bronchioles, and mostly spreads in the upper half of the lungs
  • Panacinar: usually found in the lower half of the lungs, causing damage to air sac tissues
  • Paraseptal: often around the septa or pleura, associated with inflammation

Most people with emphysema have symptoms that are vague and nonspecific, like shortness of breath or cough (with or without sputum). As the disease progresses, these symptoms get worse, and wheezing occurs.

As the disease continues to get worse, there may be significant weight loss because of systemic inflammation and the fact that the person is working so hard to breathe, they’re burning many calories.

Stages of the disease

In addition to the different types of emphysema, there are different stages of the disease (sometimes this is merely referred to as stages of COPD). This is called the Global Initiative for Chronic Obstructive Lung Disease (GOLD) system. It divides it up into four different stages:

  • Stage I. Early
  • Stage II. Moderate
  • Stage III. Severe
  • Stage IV. Very severe

Treatment typically depends on specific symptoms, severity of symptoms, and the stage.

Emphysema is caused by exposure to gases and substances that irritate and damage the lungs. The exposure is chronic and considerable, over a period of time. Cigarette smoking is the most common cause of emphysema. Other causes include:

  • exposure to air pollution like chemical fumes
  • irritating workplace fumes and dust
  • alpha1-antitrypsin deficiency (rare; this accounts for 1% to 2% of cases)

Risk factors can also include secondhand smoke, lung infections, allergies, and low birth weight.

If you have symptoms of emphysema, a complete health history will be taken by a medical professional, as well as a physical exam. Your doctor will ask whether you smoke and if you work around or live near hazardous substances that may affect your breathing.

A healthcare professional may order some tests to help assess lung function and get a better idea of what’s going on with your lungs. These tests measure how your lungs exchange oxygen and carbon dioxide. They may also order imaging tests to see your lung structure. Tests that help in the diagnosis of emphysema can include:

Your healthcare professional will likely order a combination of tests, because no singular tst may be able to firmly diagnose the disease and associated issues.

There is no cure for emphysema. No treatment is known to stop or reverse the disease process, but there are ways to manage symptoms and help to slow disease progression. Treatment and management can also help improve quality of life.

Treatment options include:

  • medical therapy: using bronchodilator, alone or with anti-inflammatory medication like corticosteroids and other drugs, antibiotics for bacterial infections
  • supportive therapy: oxygen therapy and ventilatory support, pulmonary rehabilitation, palliative care

Lifestyle changes can include:

  • getting the flu and pneumococcal vaccines
  • nutritional support to keep your weight up
  • smoking cessation programs
  • avoiding secondary smoke from others outside the home and at work
  • pulmonary rehabilitation

If your emphysema co-occurs with other diseases, talk with your healthcare team about how to improve overall health and ease symptoms.

Emphysema is a chronic and progressive lung disease that is a form of COPD. COPD and/or emphysema usually occur with other conditions, which may affect the disease course or progression. While there is no cure for emphysema, there are ways to treat and manage the disease to slow progression, ease symptoms, and improve quality of life.

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