Emphysema

Emphysema is a chronic disease of the lungs that prevents adequate oxygen from reaching the blood. There is destruction of the small air sacs in the lungs with over-inflation of the lungs.

Along with chronic bronchitis and asthma, Emphysema is part of a condition known as chronic obstructive pulmonary disease or C.O.P.D. It occurs when the alveoli (small air sacs in the lungs) become overinflated and damaged. This causes a loss of elasticity in the lungs, preventing gases from being properly exchanged. This interferes with the levels of oxygen and carbon dioxide in the blood. Smoking nearly always causes emphysema.

Emphysema occurs most often in smokers aged over 50 years. There is no cure for the condition although careful management can improve symptoms and prolong life expectancy. Eventually the disease will progress to either right-sided heart failure or respiratory failure.

A different type of Emphysema, called pulmonary interstitial Emphysema, can occur in newborn babies. The air leaks out through the alveoli into the surrounding space. It affects babies with poor lung function, such as those on mechanical ventilators, premature births and those with respiratory distress syndrome. The condition usually resolves over days or weeks.

SIGNS AND SYMPTOMS
Symptoms do not appear until at least one-third of lung function has been impaired. They include:
• Shortness of breath, beginning mildly but rapidly becoming severe.
• Cough or wheeze, which may be misdiagnosed as asthma.
• Barrel-shaped chest due to overexpansion of the lungs.
• Weight loss.
• Little or no mucus is produced when coughing (Mucus production is more likely to signal chronic bronchitis).

TREATMENT OPTIONS
There is no cure for Emphysema. Quitting smoking is the best way to prevent it from developing. Even those people with existing Emphysema will benefit from quitting. Smoking cessation is the only treatment known to reduce the rapid decline in lung function in patients with Emphysema.

Emphysema requires ongoing monitoring and treatment by a medical practitioner. Treatment is aimed at preventing chest infections and inflammation in the lungs. This can include antibiotics and anti-inflammatory drugs. As the condition progresses, it may be necessary for the patient to have an oxygen mask at home. Oxygen therapy is particularly necessary when sleeping, as oxygen loss and hypoventilation is greater when lying down. Patients with severe Emphysema will need home help, as their activity levels become increasingly restricted.

Surgical treatment is rare but possible. Lung volume reduction surgery involves removing the damaged portions of lung (usually about 20-30% of each lung) to improve oxygen exchange and elasticity. It is an option for severe cases in people under 75 years of age. Short-term results are good but temporary; after 2 or 3 years, lung function usually deteriorates again. For this reason it is not often recommended.
Total lung transplantation will restore the lung function to normal. However, the mortality rates following this surgery are high (50% in 5 years) and due to the shortage of donor organs, it would only be considered in a very young patient.

DIET HINTS
• A healthy diet is an important foundation for good health. Always follow the advice of your Doctor.
• Eat a variety of nutritious foods, including fruit, vegetables, wholegrains, legumes (beans, peas, lentils etc.), lean meats and dairy products.
• Fresh fruit and vegetable juices are an excellent way to include a variety of nutrients in the diet.
• Drink plenty of water.
• Certain vegetables, especially onions and garlic, can help liquefy mucus and allow it to be coughed from the lungs.
• Drink alcohol in moderate amounts only. For men no more than 3 standard drinks per day; for women no more than 2 standard drinks per day.
• Maintain a healthy weight by balancing food intake with activity levels.
• Eat cold-water fish such as tuna, salmon or swordfish at least 2-3 times per week. Fish oil (DHA) may be of benefit in inhibiting the progression of Emphysema.

VITAMINS/MINERALS/HERBS
• Vitamin C, vitamin A and echinacea may improve immune function if dietary intake is inadequate.
• Antioxidants such as vitamin E, grape seed extract and selenium may help with inflammation.
• Liquorice herb may help relieve cough.
• Garlic has antibacterial properties that may help prevent infection. Garlic and horseradish have traditionally been used to help resolve mucus.
• Omega-3 fatty acids may be of benefit.

PHARMACIST'S ADVICE
Ask your MedAux Pharmacist for advice.
1. Follow the Diet Hints.
2. Smoking should definitely be avoided. If you need help to stop smoking ask your Pharmacist for suggestions.
3. Have as much rest as possible, with light exercise. Regular exercise can help improve general health and resistance to infection.
4. Keep salt intake low to avoid heart problems.
5. If the diet is inadequate consider some nutritional supplements.