Emphysema: symptoms, causes, treatment and which doctor to see
What emphysema does to the lungs, why smoke and cooking fuel matter, how spirometry confirms it, treatments that help breathing, and when to get help.
Also known as: Pulmonary Emphysema
What emphysema is
Emphysema is a long-term lung disease in which the tiny air sacs at the ends of the airways, called alveoli, are gradually damaged. Healthy air sacs are elastic: they stretch as you breathe in and spring back to push air out. In emphysema their walls break down and lose that springiness, so the many small sacs merge into fewer, larger, floppy spaces. There is less surface for oxygen to pass into the blood, and stale air gets trapped in the lungs, leaving less room for each new breath.
Emphysema is one of the main forms of chronic obstructive pulmonary disease (COPD), and many people have it together with chronic bronchitis. The lung damage cannot be undone, but treatment can ease symptoms, keep people more active, reduce flare-ups and slow how fast the disease progresses, especially if the cause is removed.
Symptoms
Emphysema develops slowly over many years, and symptoms are often put down to age or being unfit until a lot of lung has been damaged:
- Breathlessness, first on climbing stairs or walking briskly, and later with everyday tasks such as bathing or dressing
- A chronic cough, sometimes with phlegm
- Wheezing and a feeling of tightness in the chest
- Tiredness and reduced ability to exercise
- In more advanced disease, weight loss, a barrel-shaped chest, and swelling of the ankles
Flare-ups, also called exacerbations, are periods when breathlessness, cough and phlegm suddenly get worse, often triggered by a cold, flu or chest infection, or by air pollution. They can be serious and may need hospital care.
Causes and risk factors in India
Emphysema is caused by breathing in substances that irritate and damage the lungs over a long time:
- Smoking cigarettes, beedis or hookah is the leading cause; the more and the longer you smoke, the higher the risk
- Second-hand smoke at home or work
- Smoke from cooking or heating with wood, dung cakes, crop waste or kerosene in poorly ventilated kitchens, a major cause among women in rural India who have never smoked
- Long-term exposure to dust, fumes and chemicals at work, for example in mining, construction, stone quarrying, textile mills and some factories
- Outdoor air pollution in cities
- A rare inherited condition called alpha-1 antitrypsin deficiency, which can cause emphysema at a young age, sometimes even in non-smokers
Most people are over forty when symptoms appear. A history of frequent chest infections or tuberculosis can also leave the lungs more vulnerable, and post-tuberculosis lung damage can cause similar symptoms.
How it is diagnosed
The doctor will ask about smoking, cooking fuel, your work and your symptoms, and examine your chest. The key tests are:
- Spirometry — you blow out as hard and fast as you can into a machine. It measures how much air you can breathe out and how quickly, and is the main test to confirm COPD and judge its severity
- Chest X-ray — may show over-inflated lungs and helps rule out other problems such as infection or tuberculosis
- CT scan of the chest — shows emphysema in detail and is used when the diagnosis is unclear or surgery is being considered
- Pulse oximetry — a clip on the finger that measures oxygen levels; an arterial blood gas test may be done in hospital
- Other lung function tests, an ECG or echocardiogram, and a blood test for alpha-1 antitrypsin in younger people or those with a family history
Asthma, heart failure and post-tuberculosis lung disease can all cause similar breathlessness, which is why a proper diagnosis matters. See our page on asthma for how the two differ.
Treatment
Stopping smoking is the most important treatment at every stage. It is the most effective way to slow the loss of lung function, and it is never too late. Your doctor can suggest counselling and medicines that make quitting easier. Reducing exposure to cooking smoke, for example by switching to LPG or improving kitchen ventilation, also helps.
Bronchodilator inhalers relax the muscles around the airways and make breathing easier. Some act quickly and are used for symptoms; others are long-acting and used every day. People with frequent flare-ups may also be given an inhaled steroid in combination. As with asthma, correct inhaler technique makes a large difference, so ask for it to be checked at each visit.
Pulmonary rehabilitation is a supervised programme of exercise, breathing techniques and education, often run by physiotherapists. It improves breathlessness, stamina and quality of life. Oxygen therapy at home is prescribed for people whose blood oxygen stays low; it should only be used as prescribed. Vaccination against flu and pneumococcal infection, and other vaccines your doctor advises, reduces infections that trigger flare-ups.
For a small number of people with severe emphysema, specialists may consider procedures to reduce the volume of the most damaged lung, or a lung transplant. Flare-ups are treated with extra inhaled medicines, steroid tablets and antibiotics when an infection is likely.
Living with emphysema
- Stay as active as you can; regular walking, paced to your breathing, keeps muscles strong
- Learn breathing techniques such as pursed-lip breathing to ease breathlessness
- Eat regular, nourishing meals; smaller, more frequent meals are easier if a full stomach makes breathing harder
- Avoid smoke, incense and dust at home, and limit time outdoors on days when air pollution is high
- Ask your doctor for a written plan for flare-ups, including when to start extra medicines and when to go to hospital
- Breathlessness can cause anxiety and low mood; tell your doctor, as help is available
When it is an emergency
Call 112 or 108, or go to the nearest emergency department, if:
- You are much more breathless than usual and your inhalers are not helping
- You are too breathless to speak in full sentences
- Your lips or fingertips look blue or grey
- You feel confused, very drowsy or unusually agitated
- You have chest pain, a fast or irregular heartbeat, or are coughing up blood
Which doctor to see
Many people are first assessed by a general physician. A pulmonologist, also called a chest physician, is the specialist for emphysema and should be involved to confirm the diagnosis, plan treatment, assess the need for oxygen, and manage frequent flare-ups. A physiotherapist often leads pulmonary rehabilitation.
You can find pulmonologists in Bengaluru or physiotherapists in Bengaluru on The Doctor Index, each with a registration you can check. Severe emphysema can sometimes strain the heart; see pulmonary hypertension.
Common questions
Questions people ask
- Can emphysema be reversed?
- No. The damage to the air sacs is permanent. But stopping smoking, using inhalers correctly, pulmonary rehabilitation and vaccinations can make breathing easier, cut flare-ups and help many people stay active and independent for years.
- I have never smoked. Can I still get emphysema?
- Yes. Long exposure to smoke from cooking with wood or dung, workplace dust and fumes, and air pollution can all cause it. A rare inherited condition, alpha-1 antitrypsin deficiency, can also cause emphysema in younger people who have never smoked.
- What is the difference between emphysema and COPD?
- COPD is an umbrella term for long-term lung diseases that block airflow. Emphysema, which damages the air sacs, and chronic bronchitis, which inflames the airways, are its two main forms. Many people have features of both, and treatment overlaps a great deal.
- Will I need oxygen at home?
- Not everyone with emphysema needs oxygen. It is prescribed when tests show your blood oxygen stays low. If you need it, your doctor will tell you how and when to use it. Using oxygen without a prescription can be unsafe.
This condition is usually assessed by a pulmonologist. Every profile shows the doctor’s registration and what has been checked.
Pulmonologists in Bangalore
A few pulmonologists listed on The Doctor Index. They are shown because of their speciality, not a stated interest in Emphysema; ask the clinic whether the doctor sees it.
Related conditions
- Acute Bronchitis
- Asthma
- Chronic Bronchitis
- COPD
- Pulmonary Embolism
- Pulmonary Fibrosis
- Pulmonary Hypertension
- Sleep Apnea
Practical reading
All postsSources
- MedlinePlus, US National Library of Medicine — Emphysema
- Government of India — Emergency Response Support System (112)
- MedlinePlus, National Library of Medicine — Emphysema — Public-domain health-topic summary
Emphysema: symptoms, causes, treatment and which doctor to see is original text by The Doctor Index; the compiled source draft was used for research. Source: MedlinePlus, National Library of Medicine. Orphadata Science: Free access data from Orphanet. © INSERM 1999; July 2026 data, CC BY 4.0. This product uses the Human Phenotype Ontology (hp/releases/2026-09-01). Only sources listed for this article apply. Source material has been selected and arranged; HPO definitions are reproduced without alteration. No source organisation endorses this compilation. Köhler S et al. The Human Phenotype Ontology project: linking molecular biology and disease through phenotype data. Nucleic Acids Research 2014;42(D1):D966–D974. doi:10.1093/nar/gkt1026.
General information, not advice about your situation. Errors can be reported through the corrections process. Reference TDI-C-0822.