What is emphysema?

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Emphysema is lung disease that occurs when the tiny air sacs in the lungs are damaged, usually as a result of long-term smoking. Once this damage has occurred, it cannot be repaired. It causes difficulty breathing and shortness of breath that gets worse over time. Emphysema is a respiratory disease in which the alveoli, the tiny air sacs in the lungs, become enlarged. This enlargement causes the alveoli walls to break down, or rupture, narrowing the airways. The narrowed airways make it difficult to breathe in oxygen and exhale carbon dioxide. Emphysema gradually destroys the lung tissue. Emphysema and chronic bronchitis, which often occur together, cause a condition known as chronic obstructive pulmonary disease. Emphysema permanently enlarges and irreversibly damages the alveoli, damages the ends and walls of the smallest bronchioles (the tiny breathing tubes that branch off from the trachea and bronchi), and diminishes the elasticity of the lungs. Emphysema ranks 15th among chronic diseases that contribute to limitation of physical activity. About 44% of those with emphysema report that their daily activities have been limited by the condition.

The most common cause of emphysema is smoking. Long-term exposure to smoke causes destruction of the alveoli. The ability of the lungs to provide oxygen to the body decreases. As a result, the person finds it increasingly difficult to breathe and to exercise without discomfort. Emphysema occurs most often in people older than age 40 who have smoked for many years. Long-term exposure to secondhand smoke also may play a role. Among other causes of emphysema are industrial pollutants, aerosol sprays, non-tobacco smoke, internal-combustion engine exhaust, and physiological atrophy associated with old age (senile emphysema). Physical damage caused by an accident and followed by scarring can give rise to scar emphysema; severe respiratory efforts can rupture alveoli in cases of near suffocation, whooping cough, labor (child-bearing), and acute bronchopneumonia. Tuberculosis and asthma can also give rise to lung overstretching, severely damaging the elastic fibers of the alveoli walls and bringing on emphysema.

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