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Emphysema is a chronic lung condition that is a type of Chronic Obstructive Pulmonary Disease (COPD). Emphysema is defined as an abnormal dilation of the airspaces distal to the terminal bronchiole. In more common language this means that the air sacs in your lungs that allow oxygen to be transferred to you blood become expanded and do not function properly. Air gets trapped in the lungs and does not flow in and out properly.

The most common reason for this abnormal dilation and air trapping is an excessive breakdown of the elastin in the lungs. Elastin is a protein that allows the lungs to snap back to a resting shape when you exhale. Without the proper amount of elastin, your lungs become like a rubber band that's been overstretched - they just stay big and floppy and don't recoil back to normal size. By far the most common reason for theelastin to be destroyed and subsequent development of emphysema is cigarette smoking. There is a rare genetic cause as well, but it's not nearly as common as cigarette smoking.

Emphysema can develop for many years without obvious symptoms. When it does reach a point where it is symptomatic, the most commonly reported problem is shortness of breath. At first a person will become short of breath only when they try to exert themselves, but over time this can worsen to a point where you are short of breath even when you are sitting still.

Most people will develop emphysema in their 50-60s, although the genetic form often has a much younger onset.

In cases of pure emphysema cough is not very common. If a person has some degree of chronic bronchitis (the other type of COPD), a cough can be more common and severe, but lack of a cough does not rule out emphysema. Most people with emphysema will not produce a lot of mucus or sputum in pure emphysema. This is another point of contrast to chronic bronchitis where there is a lot of mucous being coughed up from the lungs.

When a person has suffered from emphysema for a long time, they will often appear thin and gaunt. Weight loss is not uncommon and can be quite dramatic in many cases where the disease progresses rapidly. Because of the trapping of air in the lungs, people with later stages of emphysema will often develop a "barrel chest". This happens because the lungs are chronically overinflated. Imagine taking a deep breath and holding it there for 10-20 years - it's not hard to imagine that your chest wall may become permanently stretched out. When an X-ray is taken, this over inflation of the lungs can be quite easy to see.

The other notable sign of emphysema is a the use of what are known as accessory muscles to breath. A normal person at rest only uses the diaphragm to breath. This is a large and very powerful muscle in the chest, just below the lungs. When you exercise, or in the case of severe emphysema, the diaphragm is not enough to push the proper amount of air in and out of the lungs. A series of other muscles in the chest wall and neck then kick in to help the diaphragm move air. Next time to exercise take a look at how you are breathing and you will see a good example of this. People with emphysema don't need to wait for exercise - they use these extra muscles to breath all the time, which can burn a lot of energy and be quite exhausting.

Emphysema is treatable but not curable. Once you have it, you can only try to treat the symptoms and not let it get worse. It is important to work with your doctor and get the proper testing done if you think you may be in the early stages of emphysema. Should you have any questions about the symptoms or signs of emphysema, talk to your doctor.

Learn more about this author, Erich Rosenberger M.D..
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