If you or someone else are having severe trouble breathing call triple zero (000) immediately or go to your nearest emergency department

What is emphysema?

Emphysema is a condition that causes shortness of breath and coughing. It is one of several conditions that grouped together are known as chronic obstructive pulmonary disease (COPD).

In people with emphysema, the air sacs, or alveoli, of the lungs are damaged. This causes the small airways to collapse when air is breathed out, which makes it hard for air to flow into the lungs and even harder for it to flow out. Over time, the lung tissue becomes stiff and cannot take oxygen into the body as effectively.

What are the symptoms of emphysema?

The symptoms of emphysema depend on how severe the underlying lung disease has become. People with emphysema are often short of breath. As the disease progresses, the periods of breathlessness become more frequent. It becomes harder to do everyday activities or to exercise. Eventually, people are continually short of breath, even when sitting or lying down.

People with emphysema also often have:

• a persistent cough
• phlegm
• wheezing
• weight loss
• swelling of the feet and legs, which can be a sign of heart problems

At times, the symptoms may get worse suddenly. This may mean you should see a doctor - for example, in case you need antibiotics for a chest infection.

What causes emphysema?

Most people with emphysema smoke or have smoked in the past. A very small proportion of people get emphysema because they inherited a faulty gene that normally helps to keep the air sacs of the lungs healthy.

Other causes of emphysema include:

• passive smoking, particularly when you are a baby
• exposure to industrial dust and chemicals
• exposure to air pollutants

Whatever the cause, smoking makes emphysema worse.

How is emphysema diagnosed?

Most people are diagnosed in their 50s, though if you have a faulty gene you may be diagnosed earlier. Your doctor can diagnose emphysema by talking to you and examining you. They may also ask for:

• blood tests
• chest x-rays
• a separate test of blood from an artery to check oxygen levels
• breathing tests to see how well your lungs work

Some people may also be asked to have:

• a CT scan of the lungs
• an ECG (electrocardiogram) to look at the heart

How is emphysema managed?

The damage to the lungs caused by emphysema cannot be reversed, but many treatments can help manage the symptoms and improve a person's quality of life. These treatments improve the flow of air into the lungs and by preventing complications.

Treatment is tailored to how severely the emphysema is affecting your health and your ability to do things.

Quitting smoking is the best treatment to slow the worsening of emphysema symptoms.

If you have emphysema, you may be given inhalers or tablets to help open up your airways and reduce inflammation. You may need antibiotics if you have a chest infection.

A pulmonary rehabilitation program provides exercises and education to help people with emphysema manage their breathlessness. It may include exercises to increase physical function, and knowledge about breathing techniques, how to use medication correctly and how to conserve energy.

In more severe cases, people with emphysema will need to breathe oxygen from a portable cylinder to temporarily boost oxygen levels in the blood. Very occasionally, surgery can be useful.

There are other things you can do to manage:

• eat a balanced diet
• get enough rest
• exercise regularly (speak to your doctor first)
• avoid air pollution and other people's smoke
• get vaccinated against the flu and pneumococcal pneumonia
• have regular check-ups with your doctor

Can emphysema be prevented?

The best way to prevent emphysema is to quit smoking. Most people who develop emphysema have smoked for many years, and most long-term smokers will have some degree of emphysema.

Quitting smoking also prevents complications of emphysema.

Complications of emphysema

Emphysema can stop people from doing their daily activities, sleep or exercise. They often develop other chronic conditions such as asthma, back problems, cancer, diabetes, heart problems, stroke and kidney disease.

COPD, which includes emphysema, chronic bronchitis and chronic asthma, is the second leading cause of hospital admissions in Australia and the fifth most common cause of death.