Causes and risk factors:
Alveoli in the lungs are the place where exchange of gases takes place by normal breathing pattern. Alveoli suck in pure oxygen in the lungs. Certain causative and risks factors damage these alveoli resulting into their permanent distention, are unable to exhale out impure gases completely and inhale pure oxygen. Smoking, Atmospheric pollution, recurrent respiratory infection in childhood is the contributing factors. A strong familial history is the cause. Infections are the precipitating factor of emphysema. Low birth weight babies, exposure to organic and inorganic dust are other causes. Hence people engaged in occupation like coal miner, and industrial worker are more prone for COPD.
Clinical presentations:
Dyspnoea (shortness of breath or breathlessness) is the cardinal symptom of emphysema. Cough is another major symptom seen. The sputum expelled out is mucoid and scanty. The cough is aggravated due to exposure to cold or during winter but later it becomes continuous. Long standing coughs cause shortness of breath. A whistling sound is produced during breathing. A sound somewhat like snoring can also be heard on examination of the chest by the doctor. Emphysema is a gradual process over the years leading to ‘barrel shaped chest’. These patients tend to lose weight and there occurs bluish discoloration of the mucus membrane and nails (Cyanosis) Acute respiratory infective attacks can lead to fever and can aggravate the complaint of cough.Sorethroat, malaise, Coryza can be the other complaints associated with cough. Emphysema can lead to complications like cor pulmonale, pneumothorax or giant bullae.
Diagnosis and investigations:
Symptoms narrated by the patient and the physical examination carried out by the doctor will help to confirm the diagnosis. Certain investigations can be advised which are routine blood test, chest X ray and culture of sputum is done to find out the causative agent. Along with this pulmonary function test is a useful aid for diagnosis, Measurement of arterial blood gas is done. ECG can be done to rule out other causes related to heart.
Treatment:
Complete abstinence from smoking is the most important measure, along with avoidance of exposure to air pollutants.steam inhalation and use of hot drinks can provide temporary relief. Use of protective mask to avoid the adverse effect of pollution can be done. Bronchodilating medications are prescribed. In cases with infection antibiotics can be given. Use of meter dose inhalers (MDI), nebulisation and use of humidifiers is recommended.
Other Modes of treatment
The other modes of treatment can also be effective in treating the complaints. Homoeopathy is a science which deals with individualization and considers a person in a holistic way. This science can be helpful in combating the symptoms. Similarly the ayurvedic system of medicine which uses herbal medicines and synthetic derivates are also found to be effective in treating pain. Yoga exercises and pranayam are really found to be effective.
Recent update:
Researchers from the Royal College of Surgeons in Ireland (RCSI) and Beaumont Hospital have made an important breakthrough in the understanding and treatment of hereditary emphysema. Their findings show how the protein Alpha-1 Antitrypsin (AAT) plays an important role in controlling inflammation from white blood cells and its importance for good health.
