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What is Bullous Emphysema?

By D. Jeffress
Updated Mar 03, 2024
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Bullous emphysema is a medical condition in which spherical air sacs in the lungs become severely enlarged and eventually rupture and deteriorate. Individuals with progressive bullous emphysema often experience chest pain, difficulty breathing, chronic coughing, and other debilitating symptoms related to a lack of oxygen in the blood. In the most severe cases, the condition can cause one or both lungs to collapse and necessitate emergency surgery to restore or remove a lung. A person who believes he or she may be experiencing the first signs of the disorder should consult a doctor immediately to make a proper diagnosis and arrange for treatment.

Normal human lungs rely on small air sacs to intake oxygen and distribute it into the blood. In the case of this type of emphysema, the air sacs become overinflated and cystic, putting excess strain on normal lung tissue and blocking oxygen from reaching the bloodstream. The air sacs often become inflamed and can even rupture, which severely limits lung functioning. Doctors and medical researchers have identified smoking, sarcoidosis, and genetic tendencies as the most common causes of this disease. Exposure to airborne pathogens, bronchitis, and chronic obstructive pulmonary disease can also contribute to the development of the condition.

Most people with bullous emphysema experience shortness of breath, wheezing, coughing up phlegm, and centralized pain in their chests, especially when engaging in physical activity. Some patients suffer from nausea, loss of appetite, and fatigue as a result of constant breathing problems. Lowered oxygen levels in the blood can result in heart problems, weakness, and discoloration of the fingernails and toenails.

Trained physicians can perform a number of tests to diagnose bullous emphysema. A patient may be asked to blow into a spirometer to measure lung capacity or wear an oximeter on his or her finger to calculate oxygen levels in the blood. A doctor may also take x-rays or computerized tomography scans to check for the presence of enlarged and damaged air sacs. Once emphysema is determined to be the cause of a patient's symptoms, the physician can design an individualized treatment plan.

Treatment for bullous emphysema usually focuses on increasing airflow into the lungs. This can be accomplished by quitting smoking, taking antibiotics to control swelling or infections, using inhalers that contain concentrated prescription steroids, or utilizing a supplemental oxygen machine. In severe cases of emphysema or emergency situations where a lung has collapsed, surgery may be necessary to remove damaged areas of lungs or entire organs. Lung transplants are usually considered a final option in relieving symptoms.

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Discussion Comments

By anon998066 — On Apr 06, 2017

I was diagnosed about fourteen years ago, and progression was slow for a few years, but now it's going at a fast pace. I have been on oxygen 24/7 for about a year and a half now, and some days walking a short sidewalk to my car is dangerous; my oxygen level may drop to 75 and heart rate 120. I moved to a small apartment and can hardly do the work there. I use 2 inhalers and I am supposed to use my updraft. I keep a sinus infection at all times which hinders my breathing and keeps me from getting the inhalation properly.

By anon328596 — On Apr 04, 2013

Look into something called alpha one antitrypsin deficiency. Pulmonologists can test for it but most don't. It's a rare genetic disorder which gave me emphysema and there are treatments (infusing your body with the enzyme your body is missing) which help. I got this at 38 due to this disease and don't smoke.

By anon276091 — On Jun 21, 2012

I am a 43 year old female and was diagnosed with bullous emphysema and COPD. The pulmonologist and I reviewed the CT scan that was performed in may 2012. I have 10 percent of my left lung left and 70 percent of my right lung left.

The doctors still have yet to give me oxygen therapy and I am on the advair 500/50 twice a day and spiriva once a day and a proventil inhaler.

How close am I to my left lung collapsing and how will I know when it happens? My husband and I are both very scared because the doctors don't tell me much. Please, I would like to know about how long I have. -- brenda

By anon269595 — On May 18, 2012

My Mum passed away last year of Bullous emphysema. I would like to know if she suffered or would it have been quick?

By anon265216 — On May 01, 2012

My husband has been diagnosed with Bullous Emphysema related to Ehlers Danlos Syndrome, a hereditary condition in which the skin is hyper-elastic and the organs relatively weakened.

He has had pneumothorax (collapse) of both lungs in the past and had pleurodesis (lung repair) during which a talc like substance was applied to the external surface of both lungs. This has delayed the onset of the emphysema but it seems that the bullae are now stretching the repairs to breaking point. The future remains uncertain for us.

By anon256697 — On Mar 22, 2012

I'm a 31 year old female and was diagnosed with emphysema bullous in 2008. I had a pneumothorax and was treated with a chest tube. I had computerized tomography scans when my emphysema was discovered in 2009. My bullous was bigger and the doctor give me one year to live.

He give me inhalers that I do not use since I suffer a little without oxygen in my body. I suffer from nausea, loss of appetite and fatigue and migraines always. The doctor did not make me a priority because I smoke and he says the cause is the tobacco. I stopped and try to live normally and I do not feel worse but mentally, I feel I'm going to die tomorrow and leave my 8 year old child.

By anon230747 — On Nov 20, 2011

I lost my father to bullous emphysema 15 years ago. We were told at the time there is a strong genetic disposition for the condition, but it's usually passed on to males. However, recently I've been experiencing some breathing problems and I've always had a hard time with chest colds. Does anyone know the probability of females inheriting bullous emphysema?

By anon167713 — On Apr 13, 2011

my dad has bullous emphysema had emergency surgery in march he is home now on oxygen but still not well. is there medication you can take for this bullous, cause doctor says it can return? --julie

By anon164455 — On Mar 31, 2011

Oh gosh, where to start? In 2002, i had my upper lobe of my right lung removed due to huge air sacs. I came out of surgery like a champ! Also, almost 10 years later in june of 2010, my left lung collapsed. I had a cold and had been coughing a lot.

I started having very sharp pains in my chest and just knew that i had broken a rib from the coughing. After an X-ray, i was told that my left lung had collapsed and it had my heart pushed over to the center of my chest.

Two days later, i developed pneumonia in my right lung and a chest tube in my left (not a good situation). I was taken to ICU where i spent seven days. Then into a regular room for another seven days.

After spending the next three months recovering, I faced another surgery to remove half of my left lung while I still had my heart pushed over. After having all this done in a matter of three months, i am very thankful to all for such state-of-the-art-care. I currently have a difficult time breathing doing everyday tasks, but i manage and thank god for each morning.

By anon110657 — On Sep 12, 2010

My husband was diagnosed with bullous emphysema in february 2007. in september 2007 he had surgery on his right lung, and the doctor told him that the left lung still had a few years left before surgery.

Just yesterday he began to feel sick and went to the emergency room where he had an xray done and also a scan. the er doc told him he needed to see his doc asap, because his lungs were looking really bad, that the left was full of air sacs and the right which was the one he had surgery on, was starting to get them again (he was out of town so he was not admitted. he was discharged and got on the next flight home).

Now he's at home, still not feeling well and with a high fever of 103-104. I'm thinking of taking him to the hospital night if the fever doesn't go down within the next 45 minutes.

By rgordon739 — On Nov 11, 2009

I have seen several patients with bullous emphysema in my ICU. One of the bullae can rupture leading to a pneumothorax (air in the chest cavity). This could lead to a progressively worsening shortness of breath. I also sometimes test those patients for alpha antitrypsin deficiency.

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