Symptoms
The air trapped in the lungs cannot be fully exhaled due to the absence of the alveolar walls. It is not enriched with sufficient oxygen and does not participate in the regular air exchange of the lungs. The section of the lung affected by emphysema is therefore not functional.
The immediate consequence is an undersupply of oxygen to the body. The symptoms associated with this are shortness of breath, bluish lips (cyanosis), fingers and toes and rapid exhaustion, which increases with the extent of the emphysema. Due to the pollutants that accumulate in the lungs of smokers, the mucous membranes produce a yellowish-brown mucus to protect the respiratory tract.
This must be coughed up, which is known as the typical “smoker’s cough“. Longtime smokers suffer from this severe cough for many years. Cough suppressants can also only help to a limited extent here.
If the emphysema is already very pronounced, exacerbations and a grasping thorax can occur. In case of an “exacerbation” the condition and the shortness of breath worsens so drastically that the patients have to be hospitalized and sometimes have to be ventilated. If the lung is so severely over-inflated that it can be seen externally, it is called a fasted thorax. The chest together with the ribs deforms under pressure to form a kind of barrel.
Diagnosis
A lung emphysema develops over many years as a result of chronic inflammatory lung diseases. The detailed anamnesis can provide many clues. If the patient presents with a lung disease, as a chronic smoker, with shortness of breath, severe coughing, yellow-brown sputum, or if a grasping thorax can already be recognized, this can already substantiate the suspicion of a lung emphysema.
Pulmonary function tests can then be carried out by lung specialists or in hospital. By means of a so-called “spirometer”, lung volumes in different breathing phases and the breathing activity can be checked. Based on these values, the physician can see exactly whether there is a functional impairment of the lung and if so, whether there is a restriction or obstruction.
If the latter is the case, this means a narrowing of the airways, which makes exhalation more difficult and is typical for COPD. If this is the case, pulmonary emphysema is also suspected. The suspected diagnosis of emphysema can be definitively established by means of X-ray or CT examinations.The severity of the disease can also be assessed, which is ultimately the basis for the therapy.
Blood tests, in which the enzyme deficiencies typical of emphysema are detected, can also confirm the diagnosis. Computed tomography is the more detailed variant to conventional x-rays. The radiologist can detect the development of emphysema in its early stages by examining various changes in the chest.
The CT image also allows the diagnosis of emphysema much earlier than the pulmonary function tests or clinical symptoms. From the beginning of the disease, computer tomography can be used to closely monitor the gradual development. The CT examination of the thorax is then used to decide on the future therapy.
The therapy of emphysema consists of several components. These include lifestyle changes, sports, physiotherapy and drug therapy. The degradation of lung tissue cannot be reversed, but the progression of the disease can be halted and patients learn to live with the lung disease and improve their quality of life.
In severely advanced emphysema, permanent oxygenation and ventilation may be given therapeutically. In acutely life-threatening emphysema, surgical interventions are also becoming increasingly important. Lung transplantation is one way to cure the disease completely.
After the diagnosis of emphysema, the most important step to stop the disease is to stop smoking immediately or to eliminate possible other causes. If the patient continues to smoke, it is difficult to stop the progression of the disease and the prognosis worsens. Furthermore, drug therapy is recommended.
The aim is to dilate the airways and prevent pneumonia with cortisone-containing medication. The drugs are administered as a cortisone spray so that they can act as specifically as possible on the lungs. Through physiotherapy and endurance sports, if possible, lung function can be largely restored and the patient gains a better quality of life.
The result is that respiratory distress is reduced even under stress. In naturopathy, too, there are now a number of approaches that can bring relief from the symptoms. Here there are different points of attack of the therapy.
For the relief of respiratory distress, Kneipp’s chest compresses, hydrotherapy, stays in brine baths and steam baths, as well as acupressure and acupuncture have proven effective for some patients. To relieve the slimy cough, various herbal remedies based on herbal antibacterial effects are available. These include oil dispersion baths made of ginger, eucalyptus or sage.
Also cough juices from thyme and ivy are frequently used. A new approach is the implantation of so-called “coils”. Coils are wire spirals that are inserted into the lung tissue and can stop the progression of the disease to relieve the symptoms of respiratory distress. This works by the coils contracting the diseased lung tissue, thus stopping the over-inflation and creating space in the chest for the remaining healthy lung sections. The first clinical studies since 2010 have proven its effectiveness by means of lung function tests carried out after implantation.
