What's the treatment for emphysema?
No treatment can reverse or stop emphysema, but steps can be taken to relieve symptoms, treat complications and minimize disability. The first step in treatment for smokers is to quit, so as to prevent any further deterioration of breathing ability. Physicians may recommend smoking-cessation programs for them. Many patients are also taught controlled coughing techniques to help remove excess mucus from the lungs, which could promote infection. This involves two short,
sharp coughs to help expel mucus. Mild exercise may be ordered to help improve breathing. Patients are often instructed on exercise techniques designed to strengthen muscles involved in breathing, as well as other breathing techniques.
Commonly used medications include bronchodilators, which relax the bronchial muscles so the airways are widened and it's easier to breathe. Bronchodilators include albuterol (Proventil, Ventolin and other brand names), salmeterol (Serevent) or ipratropium (Atrovent). These medications are taken via hand-held inhalers or machine-driven nebulizers, which create a fine mist that can be inhaled. Theophylline (sold under several brand names) is a pill form of a bronchodilator. Because it can interact with medications and cause side effects, it is used less often than the inhaler medications. Bronchodilators help to open the bronchial tubes in your lungs and reduce shortness of breath, wheezing and cough.
Steroids called corticosteroids also can help to reduce inflammation in the lungs. During an acute flare-up of symptoms, they often are given in pill form or by injection. Inhaled corticosteroids or pills may be given continually to help control the inflammation of chronic bronchitis. However, these types of drugs usually aren't prescribed for long-term use because of their side effects.
Antibiotics are often prescribed for people with emphysema who have increased shortness of breath. Even when the chest x-ray does not show pneumonia or evidence of infection, people treated with antibiotics tend to have shorter episodes of shortness of breath. It is suspected that infection may play a role in an acute bout of emphysema, even before the infection worsens into a pneumonia or acute bronchitis.
Oxygen therapy has been proven to increase life expectancy in people with emphysema who have below-normal blood oxygen levels. Oxygen usually is administered through a plastic tube (nasal cannula) worn under the nostrils. The oxygen either is stored in metal cylinders, or is purified from air by an electrical machine (an oxygen concentrator). A number of lightweight, portable devices are now available that allow those who need oxygen to leave their homes for hours at a time. Some people with emphysema need oxygen only at night. Because supplying oxygen at home is very expensive, most medical insurance companies have strict requirements to qualify for home oxygen.
Proper nutrition includes the increase of unprocessed foods such as fruits and vegetables and high-quality protein and the decrease of fried foods, alcohol, refined carbohydrates, and processed foods. Also, it is wise to eliminate the use of all mucous producing foods like dairy and gluten-containing grains. If sound nutrition is important in preventing emphysema, it is crucial once the disease has been diagnosed. Malnutrition may increase the risk of respiratory failure in patients with COPD.
Volume reduction surgery has been used with increasing frequency to help improve pulmonary function in patients with advanced emphysema. In the procedure, parts of the lungs are removed to reduce overall volume and improve efficiency of the remaining lung structure. Volume reduction surgery can improve the lung function and quality of life in patients with severe emphysema who are carefully selected based on known factors. Lung transplantation has become a better option for patients with severe emphysema. Transplantation may involve one or both lungs. Statistics show that survival after lung transplantation has been reported at 77% at 2 years and 75% at 3 years. Lung transplantation is a risky and expensive procedure and donor organs may not be available. Once the disease progresses to acute respiratory failure, a patient may be hospitalized and advanced inhalation therapy may be required.