Emphysema: Causes, Symptoms, and Treatment
Medically reviewed by Achuta Uppu, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Emphysema?
A pulmonologist, a doctor who treats lung disease, usually diagnoses and treats emphysema. A primary care doctor can also check your symptoms and order tests. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is emphysema?
Emphysema is a progressive lung disease that causes shortness of breath. It is one of the two main types of COPD, or chronic obstructive pulmonary disease. COPD is a group of lung diseases that make it hard to breathe and get worse over time. The other main type is chronic bronchitis. Most people with COPD have both.
Your lungs have tiny air sacs that are normally stretchy. They fill with air like small balloons. In emphysema, the air sacs and the walls between them are damaged and less stretchy. Over time, the damaged air sacs can break and form one big air pocket instead of many small ones. The air pockets trap stale air. This stops oxygen from easily moving into your blood and makes it harder to breathe.
Symptoms
Signs of emphysema may take years to develop. Common signs include:
- Shortness of breath, especially with physical activity
- A cough that brings up a lot of mucus
- Wheezing, a whistling or squeaky sound when you breathe
- Tightness in your chest
- Fatigue, or feeling very tired
In severe cases, people can lose weight and have swelling in the ankles, feet, and legs.
Symptoms can suddenly get worse. This is called a flare-up. An infection, dust, or smoke can trigger a flare-up. Call your health care provider right away if your symptoms suddenly get worse.
Causes and who gets it
In the United States, cigarette smoke is the main cause of COPD. Indoor and outdoor air pollution can also cause emphysema.
A rare genetic condition called alpha-1 antitrypsin deficiency can also cause emphysema.
How doctors diagnose it
A health care provider will review your medical history and do a physical exam. The main test is spirometry, a lung function test.
Other tests may include chest X-rays, a CT scan, and an electrocardiogram (ECG), which is a heart test. Blood tests may include an arterial blood gas test, which measures the oxygen and carbon dioxide in your blood, or an alpha-1 antitrypsin test.
Treatment
There is no cure for emphysema, but treatments and lifestyle changes can help manage symptoms. Quitting smoking is the most important step you can take to treat COPD.
Bronchodilators are medicines that relax the muscles around your airways. This helps open your airways and makes breathing easier. In more severe cases, the inhaler may also contain steroids to reduce inflammation. Some medicines are taken as needed for shortness of breath or cough. Others are taken every day to help reduce swelling in the airways. Vaccines for the flu and pneumococcal pneumonia are part of care, because people with COPD are at higher risk for serious problems from these diseases. Antibiotics treat a bacterial lung infection.
Pulmonary rehabilitation is a program that helps people with long-term breathing problems. It may include exercise, disease management training, nutritional counseling, and psychological counseling. Oxygen therapy can help you breathe better if you have severe COPD and low oxygen levels in your blood.
Surgery is usually a last resort for people with severe symptoms that have not gotten better with medicines. For COPD mainly related to emphysema, surgery can remove damaged lung tissue. It can also remove large air spaces called bullae. Small valves can also be placed in your airways to let trapped air escape. Some people with severe COPD may need a lung transplant.
When to see a doctor
Make an appointment as soon as you notice symptoms of COPD in yourself or a loved one. Do not wait for symptoms to become serious. Call your provider if your symptoms are getting worse or you have signs of an infection, such as a fever. Call 911 if you have a hard time catching your breath or talking, or your lips or fingernails turn blue or gray. Also call 911 if people around you see that you are not mentally alert, or your heartbeat is very fast.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either type of doctor can review your symptoms and arrange breathing tests. They can also help you plan to quit smoking and coordinate care with a lung specialist.
Common questions
Is emphysema the same as COPD?
No, emphysema is one type of COPD. The other main type is chronic bronchitis, which is constant irritation and swelling of the lining of your airways. Most people with COPD have both.
Can emphysema be cured?
No, there is no cure for emphysema. Treatments and lifestyle changes can help manage symptoms. Quitting smoking is an important step.
Can you get emphysema if you have never smoked?
Yes, because air pollution and a rare genetic condition can also cause it. The genetic condition is called alpha-1 antitrypsin deficiency.
How do doctors test for emphysema?
Doctors test for emphysema mainly with a lung function test called spirometry. They may also order chest X-rays, a CT scan, or blood tests.
Sources
- American Lung Association - Emphysema
- MedlinePlus - COPD
- National Heart, Lung, and Blood Institute - COPD Symptoms
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
