Interstitial lung disease (ILD)

Interstitial lung disease (ILD) is a term commonly used for a group of diseases that involve the interstitium of the lung or in simple words involve the lining of the lungs. They may lead to scarring of the lungs which can sometimes results in fibrosis of the lungs. Lungs are normally balloon like structures and this fibrosis leads to stiffness in the lungs which makes it difficult to breathe in andout. This can disrupt their normal physiological function to get oxygen to the bloodstream. ILDs are often progressive in nature and are mostly non reversible. This has been a major focus area of research in the field with the scientists working out the reasons for this phenomenon and ways to prevent and treat these diseases. Some progress has been made over this in the last few years.

There are many pathways leading to or increasing the risk for ILD. There can also be a genetic predisposition for it. Certain medications or medical treatments such as chemotherapy or radiation can sometimes cause ILD. Exposure to hazardous materials which can sometimes be occupational can lead to ILDs such as in asbestosis and hypersensitivity pneumonitis. Autoimmune diseases such as sarcoidosis or rheumatoid arthritis can also sometimes manifest as ILDS. Heavy smoking can not only cause a certain type of ILD, but can make the condition much worse. Quitting smoking therefore is very important in this condition. Some Covid-19 patients specially who have had extensive pneumonias, ILD is being noted but fortunately this is mostly reversible. In vast majority of conditions,the cause of ILD is unknown or cannot be ascertained and these are grouped as idiopathic pulmonary fibrosis (IPF).

The most common symptoms experienced by patients of ILDs are shortness of breath and dry cough. They can also experience chest discomfort, fatigue and occasionally weight loss. Severe cases that are left untreated can develop life-threatening complications including high blood pressure, heart or respiratory failure.

Chest Xrays can sometimes show ILD but can’t always be relied on to diagnose and the most helpful test to diagnose an ILD is High Resolution CT scan (HRCT) of the chest. A lung function test may be used to measure the lung capacity, which may have deteriorated due to the ILD. In more serious cases, and to diagnose a specific type of ILD, more invasive procedures may be needed, such as a bronchoscopy or a lung biopsy.

Treatment for ILDs varies depending on the type of ILD diagnosed and the severity. Stopping any ongoing exposure is first step in managing ILD. Lung damage from ILDs can be often irreversible and progressive, so treatment may be directed towards relieving symptoms, improving quality of life and slowing the disease's progression. There have progress with the antifibrotic therapies and some of them are showing promise. The other medications such as corticosteroids, can be used to decrease inflammation in the lungs. Oxygen therapy is another common recommended tool as it compensates for the lack of Oxygen and also lessens complications from low blood oxygen levels, such as heart failure. Pulmonary rehabilitation is a very important intervention to improve daily life by and to improve lung capacity, improve physical endurance and offer emotional support overall wellbeing. Sometimes is advanced condition where patients are suitable for surgery a lung transplant may also be recommended.