Treatment and Prevention
The first treatment for emphysema is to stop smoking. Your lungs won't repair themselves, but at least further damage can be slowed. There's still no way to repair emphysematous lung tissue in humans, although researchers are studying the use of retinoic acid (a vitamin A derivative) for this purpose.
Treatments include:
- Oxygen therapy, which is used to increase the percentage of oxygen that the body receives on each breath. Machines that concentrate oxygen may be used in the home.
- Bronchodilators such as beta-agonists and anticholinergic medications, which help to relax and open the airways.
- Corticosteroids that reduce inflammation may be used, and these may prevent flare-ups that require hospitalization.
- Antibiotics when there is evidence of infection.
- Exercise can help strengthen leg muscles so that less demand is placed on the lungs with activity.
- Lung surgery in the form of lung transplantation can be lifesaving in the small proportion of patients who are candidates for it. In a newer type of surgery called lung volume reduction, the most diseased (20% to 30%) part of the lung is removed. This allows the remaining lung and muscles to work better, improving breathing. Investigations are ongoing to determine if the same benefit can be achieved by non-surgically removing the emphysematous lung tissue (i.e., by using valves or glue).
- Surgery for pneumothorax is done by permanently joining the separated portion of lung wall and chest wall. An irritant such as talc is blown into the gap, forming scar tissue that binds the two surfaces.
- Purified human alpha-1-antitrypsin for treatment of emphysema due to alpha-1-antitrypsin deficiency.
- Vaccinations against influenza and pneumonia, as recommended by your doctor to help avoid respiratory infections. This doesn't treat the emphysema but can prevent flare-ups.
For the vast majority of people with emphysema, the best way to prevent it and slow it down is to not smoke. This outweighs all other considerations.
Following these tips can help protect your lungs if you have emphysema:
- Don't smoke.
- Avoid secondhand smoke.
- Avoid air pollution as much as possible.
- Use air conditioning with a filter and humidity control.
- Avoid allergic "triggers" that can aggravate emphysema if asthma coexists.
- Avoid high altitudes.
- Wash your hands and brush your teeth frequently to avoid infections.
- Drink plenty of fluids to reduce the buildup of thick mucous in your air passages.
Andrew Schriber, MD, FCCP, Specialist in Pulmonary, Critical Care, and Sleep Medicine, Virtua Memorial Hospital, Mount Holly, New Jersey. Review provided by VeriMed Healthcare Network.