How is Emphysema Diagnosed?
Doctors may suspect emphysema based on symptoms and then use chest X-rays to rule out other lung conditions. CT scans generally provide more detailed images compared to X-rays. Doctors also recommend pulmonary function tests to measure airflow obstruction and determine how much air your lungs can trap or exhale, while blood gas tests evaluate how well oxygen is entering your bloodstream.
Spirometry is the most commonly recommended lung function test. It measures how much air your lungs can hold and how quickly you can breathe it out. Additionally, arterial blood gas analysis and AAT deficiency blood tests may also be suggested by doctors to get more information about your overall lung health.
How is Emphysema Treated Based on Severity?
Emphysema treatment is largely based on how severe the lung damage is. Here are the possible emphysema treatment options based on severity:
| Clinical Severity | Treatment Approach |
| Mild | Smoking cessation (essential at all stages), quitting smoking and medicines such as short-acting bronchodilators. |
| Moderate | Longer-acting bronchodilators, inhaled medicines, and therapies like pulmonary rehabilitation. |
| Severe | Lung volume reduction surgery, endoscopic lung volume reduction, bullectomy, or lung transplantation. |
Types of Emphysema and Their Treatment
Here is an overview of the types of emphysema and how they are treated:
| Type of Emphysema | Treatment Approach |
| Centrilobular Emphysema | Strongly related to smoking. Inhaled medicines like bronchodilators or corticosteroids, along with oral corticosteroids, oxygen supplementation, and pulmonary rehabilitation. |
| Paraseptal Emphysema | Treated with standard bronchodilators, anti-inflammatory medicines, and chest tube drainage or surgery if a lung collapse occurs. |
| Panlobular Emphysema | Bronchodilators, supplemental oxygen therapy, lung volume reduction surgery, and AAT Augmentation Therapy (weekly IV infusions) if caused by Alpha-1 Antitrypsin Deficiency. |
Emphysema Treatment Based on Stages
Let us understand the four stages of emphysema and how the condition is treated at each stage:
| Stage | Treatment |
| Stage 1 | Often undiagnosed at this stage. Treatment focuses on quitting smoking, avoiding lung irritants, vaccinations, and inhaled bronchodilators. |
| Stage 2 | Medical attention is sought during this stage. Treated with daily long-acting inhaled bronchodilators, pulmonary rehabilitation, and lifestyle changes. |
| Stage 3 | Inhaled medicines, pulmonary rehabilitation, and monitoring for oxygen needs. |
| Stage 4 | Supplemental oxygen therapy and surgeries like endoscopic valve placement, lung volume reduction surgery or lung transplant. |
Medications for Emphysema
The following medicines may be prescribed to manage symptoms, reduce inflammation, or treat complications associated with emphysema:
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Bronchodilators: These medicines relax the muscles around the airway. They even help the patient breathe easily. Some doctors may prescribe short-acting bronchodilators for quick relief or long-acting bronchodilators for long-term treatment.
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Corticosteroids: These can reduce inflammation in the airways and may also help decrease symptoms & prevent exacerbations.
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Combination Inhalers: These inhalers combine bronchodilators and corticosteroids to provide more comprehensive symptom control.
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Phosphodiesterase-4 Inhibitors: These oral medicines can help reduce airway inflammation and may be used in people with severe emphysema.
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Antibiotics (Oral or IV): Some doctors prescribe these to treat bacterial respiratory infections or acute exacerbations that can occur alongside emphysema.
Surgical Treatments for Emphysema
Surgery may be considered for severe emphysema when other treatments do not provide adequate relief. Here are common options:
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Lung Volume Reduction Surgery In this surgery, the surgeon removes the most damaged parts of the lungs. It creates more space in the chest for healthier lung tissue to expand. This improves breathing, lung function, and quality of life in selected patients with severe emphysema.
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BullectomyA bullectomy removes large, non-functioning air spaces called bullae that develop when the walls of the lung’s air sacs are damaged. Removing these bullae relieves pressure on remaining lung tissue and improves airflow and breathing.
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Lung Transplant During a transplant, severely damaged lungs are replaced with healthy lungs from a donor, and it can improve the patient’s lung function and quality of life. It is considered only in very severe cases when other treatments are no longer effective and requires lifelong immunosuppressive medicines to reduce the risk of organ rejection.
Other Treatments for Emphysema
Here are some other treatment options for emphysema that can help manage symptoms and improve daily functioning:
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Pulmonary Rehabilitation Therapy This rehabilitation programme includes education, exercise training, nutrition advice, and counselling to reduce breathlessness and help you become more active. It can improve fitness, make daily activities easier, provide peer support, and may reduce the need for hospital visits.
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Oxygen Therapy This therapy is often suggested for emphysema patients who have low blood oxygen levels. Extra oxygen is delivered through a face mask or nasal tubing connected to an oxygen tank. These tanks are lightweight and portable so that patients can carry them and move around easily.
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Endoscopic Lung Volume Reduction A procedural alternative to open surgery for severe emphysema. Doctors insert tiny one-way endobronchial valves via a tube (bronchoscope) into the airways to collapse damaged lung tissue without open surgery.
Note: You must follow the advice of a qualified doctor when undergoing any such treatment.
Ayurvedic and Alternative Treatments for Emphysema
The following alternative approaches may supplement regular emphysema treatment and help you manage symptoms associated with this lung condition:
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Pranayama: Breathing exercises such as Bhastrika, Anulom Vilom, Kapalbhati, and Bhramari may help improve breathing and support lung function.
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Ayurvedic Herbs and Medicines: Herbs such as Vasaka (Adhatoda vasica), Ashwagandha, Tulsi (Basil), Liquorice (Mulethi), and Pushkarmool are traditionally used for respiratory concerns such as breathing difficulties, cough, and wheezing.
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Detox Therapies: Ayurvedic therapies such as Vamana (therapeutic emesis), Nasya (nasal therapy), Virechana (therapeutic purgation), and herbal steam inhalation may be used as part of alternative care.
Note: Consult a qualified medical practitioner before undergoing alternative treatments for emphysema.
Home Care for Managing Emphysema
The following home-care measures can help manage symptoms, support breathing, and improve overall well-being while recovering from emphysema:
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Use steam inhalation to help relieve nasal congestion and improve airflow.
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Follow all prescribed medicines, including corticosteroids, antibiotics, and other medications, as directed by your doctor to avoid complications and side effects. Do not skip any medicine even if you are feeling better.
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Clean medical respiratory equipment regularly, including nebulisers, inhalers, CPAP machines, and BiPAP machines.
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Eat small, balanced, and frequent meals, and avoid meals that are particularly heavy in carbohydrates.
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Include soups, herbal teas and foods prepared with ginger or turmeric to help with cough management and overall health.
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Consider counselling or support groups to help you cope emotionally while you are dealing with the condition.
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Be wary of strong chemicals, air fresheners and scented candles as they can trigger breathlessness.
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Consider using an air purifier at home to help maintain cleaner indoor air.
Latest Treatment for Emphysema in India
Modern innovative techniques are being researched and introduced to make emphysema procedures more minimally invasive and easier to perform. Bronchoscopic Thermal Vapour Ablation (BTVA) is an advanced endoscopic lung volume reduction technique for severe emphysema that uses thermal vapour to reduce lung volume and hyperinflation. The procedure can take less than 15 minutes and may be performed under light sedation.
Another recent development is a once-daily nebulised long-acting muscarinic antagonist (LAMA) launched by Zydus in India, which provides sustained bronchodilation for up to 24 hours and may benefit patients with COPD, including emphysema.
How Long Does Emphysema Treatment Take?
The estimated recovery durations for different treatment methods of emphysema are as follows:
| Treatment | Duration |
| Short-acting Bronchodilators | Effective for 4 to 6 hours (to be taken only when needed) |
| Long-acting Bronchodilators | Effective for 12 hours (to be taken daily) |
| Lung Volume Reduction Surgery | Hospitalisation required for 3 to 7 days. Recovery in a few weeks. |
| Bullectomy | Hospitalisation required for up to 1 week. Recovery in up to 6 weeks. |
| Lung Transplant | Hospitalisation required for 12 to 14 days. Recovery in 3 to 6 months or more. |
| Pulmonary Rehabilitation | 6 to 12 weeks |
| Oxygen Therapy | Up to 15 hours a day, until the doctors recommend. |
Emphysema Treatment Side Effects
Various emphysema treatments, such as bronchodilators and surgeries, have side effects. Here is an overview of the side effects of some of the treatments:
Bronchodilators Side Effects:
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Feeling nervous
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Increase in heart rate
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Shakiness
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Paradoxical bronchospasm (rare cases), with wheezing and severe shortness of breath.
Lung Volume Reduction Surgery Side Effects:
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Air leakage from the suture line
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Infections like pneumonia
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Reaction to anaesthesia
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Heart attack
Bullectomy Side Effects:
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Bleeding
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Wound infections
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Respiratory failure
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Prolonged air leakage
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Pain or discomfort
Lifestyle Changes for Managing Emphysema
The following lifestyle changes can help support lung health and make it easier to manage emphysema:
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Quit smoking and try to avoid being exposed to second-hand tobacco smoke as well.
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Eat a nutritious, balanced diet to support overall health.
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Build a good sleep schedule where you get sufficient sleep (at least 8 hours) every night. Avoid taking afternoon naps.
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Avoid drinking alcohol.
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Limit the consumption of caffeine.
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Engage in regular, low-impact exercise like daily walking.
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Drink plenty of water daily to thin lung mucus.
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Use a hospital bed or recliner to sleep upright. This may make breathing more comfortable.
Triggers That Can Worsen Symptoms of Emphysema
The factors mentioned below can aggravate the breathing problems caused by emphysema:
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Smoking cigarettes.
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Being exposed to secondhand smoke.
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Respiratory infections like colds, flu, and pneumonia.
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Exposure to air pollution for a prolonged time. This includes industrial emissions, vehicle exhaust, and even indoor cooking fumes.
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Extreme cold weather or sudden temperature changes.
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Overexertion due to physical activity.
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Emotional stress and anxiety.
Emphysema Treatment Cost
Emphysema often requires ongoing treatment and maintenance. Treatment costs also tend to increase as the severity of COPD worsens. The average cost of ongoing care for chronic lung conditions like emphysema in India is around ₹3 lakh to ₹4.5 lakh per year or more. Corticosteroid medications may cost ₹300 to ₹1,000, while antibiotic tablets may cost ₹25 to ₹500 per box. Lung rehabilitation therapy can cost ₹6,000 to ₹20,000 per 8–12-week programme, while inhaler therapy may cost ₹500 to several thousand rupees per month.
Surgeries for emphysema can be quite expensive. Bullectomy costs around ₹85,000, lung volume reduction surgery costs more than ₹10 lakh, and lung transplant costs around ₹15.5 lakh to ₹30 lakh.
Does Health Insurance Cover Emphysema Treatment in India?
Yes, health insurance policies in India generally cover emphysema treatment. Inpatient expenses like room rent, boarding and nursing expenses, ICU charges, and surgeon and anaesthetist charges, etc., are covered. In fact, some plans may also cover outpatient expenses if your policy include OPD cover.
Moreover, critical illness insurance plans may cover lung transplants and complications such as end-stage lung disease. Upon first diagnosis, these plans provide a lump-sum payout that can be used towards treatment expenses. However, such coverage may be subject to a waiting period of around 90 days and a survival period of up to 30 days, depending on the policy.
Health insurance coverage of ₹15 lakh to ₹20 lakh would be sufficient for emphysema treatment in most cases. However, a higher coverage of ₹40 lakh to ₹50 lakh is recommended to help cover expensive procedures such as lung transplantation.
Disclaimer: Review the policy documents carefully to know the exact coverage available, as it can differ with each policy.
Frequently Asked Questions (FAQs)
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Q1. What is the best treatment for emphysema?
Ans: The best treatment for emphysema depends on the severity of lung damage and overall health. It may include bronchodilators, pulmonary rehabilitation, oxygen therapy, and, in severe cases, procedures such as lung volume reduction surgery or lung transplant. -
Q2. Can you live a long life with mild emphysema?
Ans: Yes, you can live a long life with mild emphysema, provided that you take proper medical treatment and follow lifestyle factors like quitting smoking and avoiding exposure to pollution. -
Q3. What is the newest treatment for emphysema?
Ans: One of the newer treatments for emphysema is Bronchoscopic Thermal Vapour Ablation (BTVA), an endoscopic lung volume reduction technique for severe emphysema. A once-daily nebulised long-acting muscarinic antagonist (LAMA) has also been launched in India for COPD, including emphysema.
