Emphysema primarily involves alveolar destruction and airway enlargement. The alveoli are small, fragile sacs with thin walls at the very end of the respiratory tract (in the lower airways, within the lungs).
These air-filled sacs usually cluster together at the end of bronchial tubes within the lungs. The alveoli is the site at which oxygen is delivered into the blood and carbon dioxide is removed from the body. In emphysema, the alveoli may be destroyed, collapsed, narrowed, overinflated, or stretched, causing 2 major pathologic consequences:
- First, the supporting bronchial tubes to collapse, causing an obstruction in the airway and trapping air within the lungs.
- Second, due to the reduced number of alveoli, there will be less oxygen available for delivery to the blood.
Emphysema and phlegm
As emphysema develops, the lungs produce more mucus which the patient will cough out as phlegm. It is important for patients to take note of the color of this phlegm, which may range from clear, white, green, reddish (blood tinged), or yellow. This may imply that the patient has acquired a concomitant respiratory infection such as pneumonia or tuberculosis. It is also necessary to monitor for an increase in phlegm or sputum production.
Patients with emphysema are advised to cough out their phlegm on a tissue in order to observe its color. If changes are present, it is best to seek medical assistance.
Management of cough and phlegm with emphysema
Management goals for the treatment of patients with emphysema should focus on improving quality of life, controlling symptoms, and preventing complications, as lung tissue cannot regenerate or undergo repairs. Treatment options available for patients include the following:
- Antibiotics (if associated with an infection)
- Smoking cessation
- Reducing exposure to environmental pollutants and chemicals
- Vaccination (such as the influenza vaccine and pneumococcal vaccine)
- Nutritional support (patients with emphysema are at an increased risk of developing malnutrition)
- Pulmonary rehabilitation programs (breathing exercises and physical exercise)
- Oxygen therapy
- Bronchodilators (may help widen lung airways)
- Lung transplant
- Surgical resection of affected lung tissue
Causes of emphysema
The association between emphysema and smoking has been well established, and it is considered the number one risk factor for its development, this is because smoking cigarettes can directly destroy lung tissue and cause irritation of the airways. In doing so, it causes your airway to swell and produce mucus as a defense against the noxious substances entering the lungs.