How is pulmonary emphysema treated (drugs and physiotherapy)

Treatment for pulmonary emphysema is done with the use of daily medications to expand the airways, such as bronchodilators and inhaled corticosteroids, indicated by the pulmonologist, and it is also very important to adopt healthy lifestyle habits, especially avoiding smoking, in addition to respiratory rehabilitation exercises.

Pulmonary emphysema, which is one of the forms of chronic obstructive pulmonary disease (COPD), is a chronic respiratory disease that has no cure, and its treatment is important to reduce symptoms and reduce the worsening of the disease, in addition to improving health conditions and independence of the affected person. Know how to identify the symptoms of pulmonary emphysema.

In the most severe cases, it may be necessary to use the oxygen mask, for a few hours or continuously, as well as surgery to reduce lung volume or even lung transplantation may be indicated.

1. Bronchodilators

The use of medications that dilate the airways are the main form of treatment for emphysema, usually made in the form of inhaled inhales. Some examples are:

• Short-acting beta-2-agonists, such as Fenoterol, Salbutamol and Terbutaline: they are used from the early stages of the disease, and must be inhaled whenever necessary or when symptoms worsen; Long- acting beta-2-agonists, such as Formoterol: most used in the middle phase of the disease, in which symptoms are more prolonged, generally used daily; Anticholinergics, such as Ipratropium Bromide: usually used in conjunction with beta-2-agonists, to enhance the dilating effect in the lungs; Methylxanthines, such as Aminophylline and Theophylline: may be an alternative in more severe cases, improving breathing capacity, however, because it causes many side effects, such as nausea, tremors and accelerated heartbeat, it should be used with caution and with regular medical monitoring.

The medicine firecrackers may already be composed of a combination of bronchodilators or in association with corticosteroids, to facilitate use and reduce the number of doses, as in the case of examples such as Seretide or Alenia, for example.

2. Glucocorticoids

Corticoid remedies are used mainly in the inhaled form. The continuous use of these drugs, together with bronchodilators, can reduce the worsening of lung function and the risk of complications, and should be indicated by the pulmonologist.

They are usually used twice a day, and can already be combined with bronchodilators in the same medication. It is recommended to rinse your mouth after use to reduce the risk of oral infections, such as oral candidiasis.

Corticosteroids in tablet are not recommended for continuous use, as they cause many side effects and few benefits in the treatment of the disease, and should be used in cases of exacerbation of the disease with infection, and can bring benefits for recovery.

3. Pulmonary rehabilitation

It is a physiotherapy treatment program that includes exercises to strengthen the muscles of the chest and improve breathing capacity, such as exercises for lung expansion, stretching of the muscles, breathing, awareness of posture and correct breathing, providing a better ability to perform activities of the day-to-day. Learn more about this type of treatment.

In addition, it is recommended to perform physical exercises, such as walking with professional guidance, after medical recommendation, to improve physical fitness, increase breathing capacity and decrease symptoms.

4. Oxygen

The use of a nasal oxygen catheter is indicated only in the most severe cases, when the lungs can no longer supply the body's oxygenation by itself. They are indicated by the doctor, and may be needed for a few hours or throughout the day.

5. Vaccines

People with pulmonary emphysema are at increased risk of acquiring respiratory infections, which should be avoided, both because they become more severe in these patients and because they cause worsening emphysema during crises.

Therefore, it is indicated that people with COPD receive influenza vaccine annually, and against pneumococcal infections, avoiding cases of pneumonia and life-threatening. Flu vaccines are also indicated annually.

6. Other remedies

N-acetyl-cysteine ​​can be indicated in many cases, due to its antioxidant and mucus-reducing properties.

Antibiotics may be needed in case of respiratory infection caused by bacteria, which is not uncommon in patients with COPD.

7. Surgery

Although it is more rare, in some more severe cases, the doctor may advise to have surgery to remove the most affected parts of the lung, allowing healthy regions to expand better and function more properly, however, this surgery is only done in some very serious cases and in which the person can tolerate this procedure.

Lung transplantation can also be a possibility in specific cases, indicated by the doctor.

8. Quit smoking

Although it is not exactly a treatment, smoking is one of the main causes of pulmonary emphysema and, therefore, people who suffer from pulmonary emphysema should stop using cigarettes.

Even secondhand smoke or industrial smoke inhalation, pollution, are a risk in the development of emphysema. So, drugs that help reduce or stop tobacco use can be included in the treatment, one of the main treatment goals being to make the person with pulmonary emphysema stop smoking altogether.

9. Diet

Food can also help a lot to improve breathing, since carbohydrates, fat and proteins, when consumed, consume oxygen and release carbon dioxide. And since people with pulmonary emphysema have difficulty with gas exchange in the lung, diet can also help facilitate this process.

One of the nutrients that most consumes oxygen and releases carbon dioxide is carbohydrate. Therefore, it is recommended that people with emphysema reduce the amount of carbohydrates in their food, especially simple sugar, present in foods such as cookies, candies, cakes and other sweets. Therefore, preference should be given to foods rich in fiber and good fats, which consume less oxygen, such as avocados, salmon, tuna, sardines or olive oil.

In any case, it is important to consult a nutritionist to make a well-adapted nutritional plan that meets all needs. This is because, people with respiratory diseases and who are treated with corticosteroids may also have decreased levels of calcium and vitamin D, which can be replaced with food.

Signs of improvement

Emphysema has no cure, so symptoms do not go away completely. However, if the treatment is done correctly, after a few days it is already possible to notice a decrease in almost all symptoms, such as shortness of breath, chest pain or cough.

In addition, with treatment, there may be less difficulty in doing activities that have become very tiring, such as taking walks.

Signs of worsening

The signs of worsening are more common in cases where the treatment is not being adequate or when the disease progresses and becomes very severe, which is more common in cases where the diagnosis was delayed.

These signs include extreme difficulty in breathing, bluish fingers, a purple-colored face and intense wheezing when breathing. In these cases, it is advisable to go immediately to the hospital to start the appropriate treatment and to avoid serious complications, such as cardiorespiratory arrest.

Natural treatment option

A treatment for pulmonary emphysema that can be done at home, is to learn a physiotherapy exercise called lip balm and perform it several times a day, as a way to complement the treatment guided by the doctor, never replacing it. To do this, just take a deep breath and let the air out through your mouth with your teeth parted and your lips parted in order to move them with the air that comes out of your mouth.

This simple exercise strengthens the expiratory muscles and helps to completely eliminate the air from the lungs, allowing more oxygen to enter the next inspiration and, preferably, should be guided by the physiotherapist.