Emphysema of the lungs: symptoms and treatment
Emphysema of lungs is called an airway disease, characterized by the development of the pathological process in the lungs, which causes a strong expansion of the distal bronchioles, accompanied by a violation of the gas exchange and the development of respiratory failure.
To date, the incidence of this disease has increased significantly, and if earlier it was mostly found among persons of retirement age, today people aged 30 or older suffer from it (men with emphysema are twice as likely to get sick). Moreover, the disease (in combination with asthma and obstructive bronchitis) belongs to the group of chronic lung diseases that have a progressive course, often become the cause of temporary disability of patients or lead to their early disability. At the same time, such a disease as emphysema of the lungs is characterized by the fact that it can be accompanied by a fatal outcome, so everyone should know its symptoms and the basic principles of treatment.
Etiology, pathogenesis and varieties of disease
One of the characteristics of emphysema of the lungs is that as a separate nosological form, it is found only in a small percentage of patients. In most cases, emphysema is a final pathological process that occurs against the background of severe morphological lesions of the bronchopulmonary system that manifest themselves after such diseases as:
- obstructive bronchitis
- bronchial asthma
In addition, lung emphysema can be caused by prolonged smoking or inhalation of some toxic compounds of cadmium, nitrogen or dust particles that are floating in the air (for this reason, this disease is often found in builders).
Mechanism of disease development
Under normal conditions, gas exchange in the human body takes place in the alveoli — these are «small bags» pierced with a large number of blood vessels located at the end of the bronchi. During the inhalation, the alveoli are filled with oxygen and swell, and when exhaled, they contract. However, with emphysema of the lungs, certain abnormalities occur in this process — the lungs are stretched too much, their tissue becomes denser and loses its elasticity, which leads to an increase in the concentration of air in the lungs and causes a disruption in their functioning. With the passage of time, emphysema of the lungs progresses, which is manifested by the development of respiratory failure, so it is necessary to start treating it as early as possible.
Classification of the disease
Depending on the causes that lead to the development of the pathological process in the pulmonary tissue, lung emphysema is classified into:
- Primary (diffuse), which causes tobacco smoke, dust or inhalation of nitric oxide — is characterized by a loss of elasticity of the lung tissue, a morphological change in the respiratory part of the lungs and an increase in pressure in the alveoli
- secondary (obstructive) occurs when the alveoli and respiratory bronchioles are caused by airway obstruction
- vicar — it is a kind of compensatory reaction of one lung to some changes (and sometimes the absence) of another, as a result of which a healthy lung increases in volume, but only in order to ensure a normal gas exchange in the human body (abdominal emphysema of the lungs Occurs only within one lung and is not considered a pathological process, the prognosis is favorable).
There is also bullous emphysema of the lungs, which is characterized by the fact that it proceeds imperceptibly, is often found already at the stage of pneumothorax (air accumulation in the pleural cavity) and requires immediate surgical intervention, the prognosis of development is unfavorable (often leads to the patient’s death)
Clinical picture of the disease
Speaking about the main symptoms of emphysema of the lungs, doctors first of all mention:
- shortness of breath;
- visual increase (expansion) of the chest on the background of a decrease in her excursion during breathing (emphysema can be determined from the photo, which shows that the chest is in a phase of deep inspiration)
- cyanosis (blue hue) of the tongue, nails and lips, occurs against the background of oxygen starvation of tissues
- expansion of intercostal spaces;
- Smoothing of the supercluster areas.
At the very beginning of emphysema of the lungs manifests itself as shortness of breath, which first arises during sports (mainly in winter) and is characterized by inconsistency, and then worries a person at the slightest physical effort. The characteristic signs of the disease include the fact that patients make short breaths with closed lips and inflated cheeks, and also pay attention to the fact that during the inspiration, the muscles of the neck are involved (in the normal state this should not be). Also, emphysema of the lungs is accompanied by a cough, chest pain and weight loss (the latter is explained by the fact that patients spend too much energy on maintaining the normal functioning of the respiratory muscles).
Patients often occupy the forced position of the body on the abdomen (the head is lowered down), because this position brings them relief, but this is at the first stages of the disease. As the emphysema of the lungs develops, changes in the chest prevent patients from being in a horizontal position, as a result of which they even sleep in the sitting position (this facilitates the work of the diaphragm).
Basic methods for diagnosing emphysema of the lungs
Diagnosis of pulmonary emphysema should be done exclusively by a pulmonologist, who makes a primary diagnosis based on the patient’s examination and auscultation of pulmonary breathing using a phonendoscope. These are the main methods of diagnosis, but they do not allow to make a complete clinical picture of the disease, therefore, as additional methods of research are carried out:
- X-ray of the lungs (shows the density of the lung tissue)
- computed tomography (considered one of the most accurate methods of diagnosing emphysema of the lungs)
- spirometry (examination of the function of breathing, to determine the degree of disruption of lung function).
How to treat?
The main methods of treatment of emphysema are:
- quitting smoking (this is a very important issue that doctors pay special attention to, since if the patient does not quit smoking, then it will be impossible to cure the emphysema of the lung even with the help of the most effective medicines)
- Oxygen therapy (designed to saturate the patient’s body with oxygen, since lungs can not cope with this function)
- gymnastics (breathing exercises «strengthens» the diaphragm and helps to get rid of shortness of breath, which is the main symptom of emphysema of the lungs)
- conservative treatment of concomitant diseases (bronchial asthma, bronchitis, and so on) that cause emphysema, the symptoms of which are determined by the doctor; When the infection is attached to the main treatment of emphysema, antibiotics are added.
Surgical treatment of emphysema of the lungs is only indicated if the disease occurs in the bullous form, and it reduces to the removal of bullae — air-filled thin-walled blisters that can be localized in any part of the lung (they are almost impossible to see in the photo). The operation is performed by a classical and endoscopic method. The first method involves surgical opening of the chest, and during the second the surgeon makes all the necessary manipulations with the help of special endoscopic equipment through small incisions on the skin. The endoscopic method of removing bulls with emphysema of the lungs will cost more, but this operation has a shorter rehabilitation period.
The main number of conservative methods of treatment of this disease is characterized by low efficiency, because unlike bronchitis, lung emphysema causes irreversible structural changes in the pulmonary tissue. The prognosis depends on the timeliness of the treatment started, observance of the doctor’s recommendations and the correctly selected method of drug therapy for both primary and secondary diseases.
In any case, the treatment of emphysema should only be done by a doctor. The disease is considered chronic and the patient has to take life-long medications that support the basic functions of the respiratory system. The life expectancy of people with emphysema depends on the degree of damage to the lung tissue, the age of the patient and the individual characteristics of his body.