Definition: what is pulmonary emphysema? Emphysema is a disease in the lung alveoli, the small sacks that trap necessary air for our respiration. The disorder means that there has been an increase of the volume of alveoli, as well as a destruction of their elastic wall. This can lead to it being impossible for them to completely empty the air they hold during when exhaling. Bubbles then take the place of the destroyed alveoli, and don’t allow for correct oxygenation of the blood. The emphysema can potentially lead to destruction of the lungs. Whilst inhaling, the diaphragm separates the thoracic cavity from the abdominal cavity and allows the air to enter by contracting. Normally, the diaphragm relaxes when the person exhales. In the case of emphysema, air remains in the lungs and makes them bigger, which weighs down and pushes on the diaphragm, causing breathing difficulties. Causes: what causes emphysema? The destruction of an essential substance in the alveoli structure, called elastin, is responsible for emphysema. Elastin is the elastic substance that forms the alveoli walls, and is essential for the lungs to work properly and for the exchanges between air and blood to be carried out. The main cause of emphysema is long term use of tobacco (at least 15 to 20 years) which is true in around 85% of cases. Next comes air pollution (domestic and industrial contaminants) and respiratory infections. In rare cases, emphysema can be due to a genetic anomaly which disrupts the proportion of present enzymes in the lungs. Symptoms: how to recognise emphysema? For those who suffer emphysema, the main symptom is shortness of breath (dyspnea) which progressively becomes worse. Initially, it can be caused by physical efforts and then occurs during the slightest daily movement. The thorax is shaped like a barrel. The patient can also become pale and fatigued, and can potentially lose weight. Nevertheless, the symptoms of emphysema can go on for a long time unnoticed, which often means the illness isn’t discovered till later on. Treatment: how to treat emphysema In case of emphysema that’s caused by tobacco, the first step is to stop smoking pure and simple. It doesn’t allow the lungs to regenerate on their own, but will slow down further damage. This step is the most important although often the most neglected. In effect, in smokers, deterioration of the respiratory capacities happens on average 3 to 4 times faster than is observed with the normal ageing of lungs. This measure is generally achieved through medical treatments which can take the form of bronchodilators (aimed at expanding the airways), corticosteroids (to reduce inflammation) or antibiotics (in case of infection). Oxygen therapy which raises oxygen levels provided by each breath, can also be prescribed. In the most severe cases, a lung operation can be carried out. This is done to try and reduce the volume of the lungs in order to optimise the remaining pulmonary and muscle functions, and also to improve breathing. This operation is effective more often than not, but does carry risks. Research is currently underway to develop a similar but more invasive strategy.