Emphysema is a condition in which there is over-inflation of structures in the lungs known as alveoli or air sacs. This over-inflation results from a breakdown of the walls of the alveoli, which causes a decrease in respiratory function (the way the lungs work) and often, breathlessness.

Early symptoms of emphysema include shortness of breath and cough. Emphysema and chronic bronchitis together comprise chronic obstructive pulmonary disease (COPD)

One tragedy of emphysema is that most patients lose 50 to 70% of their functional lung tissue before they become aware of the symptoms of the disease. Breathlessness (a feeling of being out of breath during routine physical activity) is usually the first symptom people notice. If walking up a flight of stairs takes your breath away, that could mean you have emphysema (but is also a symptom of heart disease and some types of cancer). Other common symptoms of emphysema are unexplained weight loss; increased chest size (barrel chest); wheezing or labored breathing (or reduced breath sounds); a productive cough yielding large amounts of dark, thick phlegm or mucus; and a lingering cough, often dismissed as "smoker's cough."

Doctors can help persons with emphysema live more comfortably with their disease. The goal of treatment is to provide relief of symptoms and prevent progression of the disease with a minimum of side effects. The doctor's advice and treatment may include:

Quitting smoking: the single most important factor for maintaining healthy lungs.

Bronchodilator drugs (prescription drugs that relax and open air passages in the lungs): may be prescribed to treat emphysema if there is a tendency toward airway constriction or tightening. These drugs may be inhaled as aerosol sprays or taken orally.

Antibiotics: if you have a bacterial infection, such as pneumococcal pneumonia.

Exercise: including breathing exercises to strengthen the muscles used in breathing as part of a pulmonary* rehabilitation program to condition the rest of the body.

*The term "pulmonary" refers to the lungs.

Treatment: with Alpha 1-Proteinase Inhibitor (A1PI) only if a person has AAT deficiency-related emphysema. A1PI is not recommended for those who develop emphysema as a result of cigarette smoking or other environmental factors.

Lung transplantation:This is a major proceedure, which can be effective.

Lung volume reduction surgery is a surgical procedure in which the most severely diseases portions of the lung are removed to allow the remaining lung and breathing muscles to work better. The short term results are promising but those with severe forms are at higher risk of death.

There are many ways to diagnose emphysema, but the most accurate is the chest x-ray. Chest x-rays are also very useful in determining the amount of lung damage already sustained. Tapping on a patient's chest while listening with a stethoscope is a favorite technique of experienced doctors. Ruptured alveoli and overinflated lungs respond with a hollow sound. A registered respiratory therapist (RRT) can conduct a number of pulmonary function tests (PFTs). Spirometry measures the amount of air the patient can exhale in 1 second (forced expiratory volume, or FEV1) into a tube connected to the spirometer. The total amount of air the patient can exhale (forced vital capacity or FVC) is then compared to the FEV1 to determine the extent of airway obstruction.

A peak flow meter is a small, hand-held device that measures the severity of breathing impairment at a given moment. The patient takes a deep breath and blows into the machine as hard and long as possible. Arterial blood gas tests measure how well the lungs are oxygenating the blood stream and removing carbon dioxide from it, and pulse oximetry uses light waves to measure blood oxygen levels. Serum alpha-1-antitrypsin levels can be confirmed by blood workup, while urine pH test, pulmonary ventilation-perfusion scan, and chest MRI may all provide valuable indicators to a medical doctor or respiratory therapist.

Don't smoke. If you smoke, quit. If you don't smoke, don't start. Avoid smoke-filled rooms and all sources of second-hand cigarette smoke. Your life depends on it. Avoid air pollutants such as fine particulate matter (lime dust, dry livestock waste dust, and the dust associated with the movement of stored grain), aerosol sprays, industrial pollutants, herbicides, pesticides, fumes from fuel and exhaust, smoke from bonfires or burning waste, and the dust stirred up while cleaning carpets and upholstery. An air purifier can help, and so can regular maintenance and cleaning of air conditioning and heating system ducts and filters.

Sound nutrition, including vitamin supplementation, may help to prevent emphysema. Special attention should be given to the intake of antioxidants to prevent the breakdown of functional lung tissue by free radicals. Regular aerobic exercise builds up lung capacity and helps cleanse the lungs of stale air. Walking is an excellent choice, if one avoids polluted areas. Unproven preventive measures often recommended by doctors include yearly pneumonia and influenza vaccinations.