Definition

Emphysema is a type of Kronis Obstructive Lung Disease (PPOK) in the form of damage to the lung compiler tissue, causing symptoms of difficulty exhaling (excitation). In the lungs of a person who has emphysema, air bags (alveolus) are damaged so that they are no longer elastic. Alveoles are also getting bigger, so it is difficult for the body to remove carbon dioxide from the lungs into the atmosphere. Carbon dioxide is trapped in the lungs so that the lungs have difficulty getting oxygen.

Another type of COPD is chronic bronchitis, which is prolonged inflammation of the airways in the throat branching. Sometimes, someone with an emphysema also experiences chronic bronchitis simultaneously. Cigarettes are the main cause of COPD.

The prevalence of COPD increases with age and the most common occurs at the age of 60. Men have more frequent COPD than women. Research in 2013 in DKI Jakarta, Banten, and West Java showed that around 5.4% of smokers experienced COPD.

Cause

Exposure to cigarettes and other irritants can cause inflammation in the respiratory tract. Inflammatory cells aim to overcome irritation, but at the same time produce enzymes that can damage alveolus, namely metalloproteinase matrix. The enzyme can degrade elastin, one of the alveoles compilers that causes alveoles to become elastic. Loss of elasticity in alveoles causes alveolus to expand (when inhaling), but cannot return to its original size to emit carbon dioxide. 

In addition to damaging alveoles, the inflammation process also causes the respiratory tract to narrow due to excess mucus production. 

Risk Factors

Risk factors that increase the risk of developing emphysemas include:

• Smoking. Emphysema is often caused by smoking. The risk of developing an emphysema increases along with the increasing number of cigarettes consumed.
• Age. Although lung damage to emphysemas occurs slowly, people who smoke have experienced emphysema symptoms since the age of 40 '60 years
• passive smokers. passive or passive smokers second hand smoker is a term used to describe people who do not smoke but are exposed to cigarette acid. Exposure to cigarette smoke from others also increases the risk of developing emphysema.
• Exposure to pollution. Vehicle smoke or factory smoke also increases the risk of emphysema.
• Genetics. Some specific genetic conditions, such as alpha-1 antitripne deficiency, can cause a person to have an emphysema.
• Having other medical conditions, which increases emphysema, such as asthma.

Symptoms

Initially, emphysema did not cause any symptoms or only mild symptoms. Along with the increase in Alveoles damage, the symptoms felt will be even more severe. These symptoms include:

• Often coughs and sounds can be heard (gik ngik sound)
• Huk bedahak
• Shortness of breath, especially when doing activities
• The chest feels heavy

Most people who experience emphysema more often experience respiratory tract infections, such as common cold. In a heavier condition, emphysemas can also cause weight loss, muscles feel weak, and swelling in the leg.

Diagnosed

The diagnosis of the emphysema refers to the diagnosis criteria of COPD as a whole. Doctors will ask about the main complaints, the symptoms experienced, the risk factors, and exposure to certain irritants. The diagnosis of COPD requires a supporting examination in the form of sparometry. If the spreader results show you have COPD, the next stage is to determine the classification of COPD experienced based on the questionnaire score COPD Assessment Test (CAT) and Modified Medical Research Council (MMRM). This classification will determine the treatment plans you receive.

Support checks carried out, among others:

• Spirometry. Spirometry serves to identify obstructions or barriers in the airway. You will be asked to perform several procedures or maneuvers, such as inhaling and removing them as quickly as possible in 1 minute. Scyrometry checks are carried out by measuring the volume successfully ejected on certain maneuvers.
• The peak flow of ekspiration. This examination is carried out if the spriometry cannot be carried out or the examination needs to be carried out in the ER. The principle of examination is similar to that of the spirometry.
• Oxygen saturation. This examination is carried out to measure oxygen levels in the blood.
• Analysis of blood gas. This examination is carried out to measure levels of oxygen and carbon dioxide in the blood.
• Chest X-rays. Photos of chest torques or X-rays function to get rid of other causes that can cause symptoms similar to emphysemas. 

Laksana Procedure

There is no treatment that can treat emphysema as a whole. The drugs given serve to control symptoms, slow disease progression, and improve the quality of life so that you can continue to do physical activity. Some treatments can also be given if complications from emphysemas have occurred. These treatments include:

• Medicines, like:
  • Broncodillator. Broncodillator drugs function to relax muscles in the respiratory tract so as to expand the respiratory tract diameter. In some cases, the preparation of broncodillators also contains corticosteroids that can help relieve inflammation. Other types of drugs will depend on the classification of your disease.
  • Vaccine. Influenza and pneumonia vaccines are recommended for emphysema sufferers. Severe respiratory tract infections occur more frequently in emphysema patients.
  • Antibiotics. If you have secondary bacterial infection, the doctor can give antibiotics to control the infection.
• Oxygen therapy. If you experience a COPD attack (exaserbation), oxygen levels in your blood can drop so you need oxygen therapy. Oxygen therapy can help facilitate your respiratory process.
• Rehabilitation. Rehabilitation programs can be carried out for patients to improve their quality of life. This program can include sports programs, symptom management, nutrition counseling, and psychosocial.
• Operation performed as a last treatment option for patients who do not respond to treatment or experience complications.

Changes in lifestyle are important steps that must be taken by emphysema patients. These changes include:

• Quit smoking and avoid exposure to cigarette smoke. Cigarettes are the main cause of emphysema, thereby reducing exposure to cigarette smoke can help stop disease progression.
• Eat patterns. Consult to your doctor about food that you need to reduce to reduce the symptoms of shortness of breath. Emphysema patients also often experience malnutrition, so nutritional intake needs to be monitored properly.
• Physical activity on a regular basis

Complications

Someone with an emphysema has a higher risk for it to happen:

• Lung collapse (pneumotoraks). Pneumotoraks is the collapse or depletion of the lungs. Pneumotoraks occurs in 20'60% of COPD patients and can be life-threatening.
• Kor pulmonale is a type of heart failure caused by disorders in the bloodstream.
• Malnutrition can occur in 25-40% of emphysema patients
• Bula. Bula is a hole in the lungs that inhibits the lungs to expand perfectly. Large foreigners in the lungs can burst and cause pneumotoraks.

Prevention

The main prevention of emphysema is not smoking and not being a passive smoker. Use a mask to protect your lungs while working, especially if you are in the textile industry or exposed to a lot of dust.

When do you have to go to a doctor?

Immediately check your condition to the doctor if you experience shortness of breath which is not triggered by anything for several months, especially if the shortness of breath interferes with daily activities. Don't assume that the shortness of breath experienced is caused by aging. Early diagnosis and implementation can help you quickly avoid complications from emphysemas.

Visit the emergency room if you or your closest people experience the following symptoms:

• Feeling so tight that you can't climb stairs or walk
• Lips and nails look pale
• Confusion and not fully conscious
• Da'ak, which is usually white, turns greenish