Emphysema

Emphysema: Frequently Asked Questions

Here are some frequently asked questions related to emphysema.

Q: Why do people with emphysema sometimes have problems with fluid retention and ankle swelling?

A: Swelling, or edema, of the ankles, legs, and abdomen often accompanies emphysema. This is because damage to the lungs can also lead to heart damage.

• In addition to the gradual removal of lung tissue (which includes blood vessels) by progression of emphysema, as the amount of oxygen in the blood decreases, it causes blood vessels in the lungs to constrict.
• The blood pressure in the lungs rises, making it harder for the right side of the heart to pump blood to the lungs.
• This may result in an enlargement of the right side of the heart, called cor pulmonale, and edema.
• When the heart cannot pump blood efficiently, the movement of blood through the body slows, and the flow of blood to other organs decreases.
• Therefore, the liver and kidneys can no longer function normally. This leads to protein and salt imbalances, which cause fluid – mostly water – to “leak” into the spaces between the blood vessels and into the surrounding tissues and cells.
• Most of the fluid goes to areas that are not within the circulatory system or the cells, which normally act as “overflow containers.” Since the fluid is not contained, it responds to the pull of gravity, often moving to the hands and feet.

Some medications, especially steroids, which are often prescribed for people with emphysema, can make edema worse.

Q: What is the treatment for edema?

A: Medications called diuretics, also called “water pills,” are commonly used to treat edema. These medications increase urination, making your body shift fluid and salts from the blood. Other treatments are aimed at increasing the heart’s ability to pump.

Q: What impact can nutrition and diet have on emphysema?

A: Plenty. First of all, food is fuel. Emphysema sufferers use extra energy in the simple act of breathing, so their caloric requirements can higher than those of healthy people. Food also provides vital vitamins and nutrients. Good nutritional support helps to maintain lung function, while improper nutrition can cause the diaphragm and other breathing muscles to weaken.

Q: Where can I find moral support to help me deal with a diagnosis of emphysema?

A: Contact the American Lung Association http://www.lungusa.org via the Internet or by telephone (toll-free, 1-800-LUNGUSA) to find a support group near you. Your local hospital also may sponsor a support group.

Q: It’s hard to know if my breathing problems are being caused by asthma or emphysema. How can we tell?

A: Sometimes the first obvious symptom of emphysema is wheezing, which also can be a symptom of asthma. Asthma and emphysema sometimes are confused with each other and often coexist. In general, wheezing while inhaling is due to asthma while wheezing during exhalation but not during inspiration is due to emphysema and/or bronchitis. Another way to tell the difference is to try asthma medications and see if they make a difference. People with emphysema usually do not respond to asthma medications.