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Emphysema

Lung Disease

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 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 in a small percentage of people who have an asthmatic component to their emphysema, or with more severe disease and frequent exacerbations.
  • antibiotics when there is evidence of bacterial infection.
  • exercise to help to strengthen the muscles that surround the lung. Better-conditioned lungs bring in more air, increasing the body's oxygen supply.
  • lung surgery is often necessary if an expanded lung is pressing against the heart. Lung transplants for emphysema in the U.S. have increased from only two in 1994 to over 800 in 1999. 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. The technique is safer, easier, and cheaper than a transplant.
  • 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 1-antitrypsin for treatment of emphysema due to 1-antitrypsin deficiency. This is useless against emphysema due to smoking. Gene therapy for this deficiency is being studied.

For the vast majority of people who aren't genetically predisposed to the disease, the best way to prevent emphysema is, of course, to not smoke. This outweighs all other considerations. Following these tips can help protect your lungs if you have emphysema:

  • Don't smoke.
  • Avoid second-hand 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 co-exists.
  • Avoid high altitudes.
  • Elevate the foot of the bed by several centimeters to help reduce the accumulation of fluid in the feet.
  • Wash your hands and brush your teeth frequently to avoid infections.

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