What is Interstitial Lung Disease?

Key Facts About Interstitial Lung Disease You Should Know

Interstitial lung disease, or ILD, is a group of over 200 disorders that result in chronic inflammation and scarring (fibrosis) of lung tissue. This scarring stiffens the walls of air sacs in the lungs and restricts oxygen transfer into the blood over time.

Individuals with ILD tend to feel short of breath, particularly upon exertion, and can present with a chronic dry cough. However, timely diagnosis and proper treatment can help manage such conditions effectively.

Keep reading to learn more about this condition.

What Do You Mean by Interstitial Lung Disease?

Interstitial lung disease (ILD) is a category of chronic lung diseases that produce inflammation and scarring of the tissue around the air sacs (alveoli) in the lungs. This damage in the interstitium—the area between the air sacs—affects the lungs' capacity for delivering oxygen into the bloodstream.

Additionally, the scarring, or fibrosis, stiffens the lungs and reduces their ability to expand, producing symptoms such as shortness of breath and a chronic dry cough. ILD can develop slowly or suddenly worsen, depending on the aetiology and the patient's health status.

What’s more, this condition can be caused by environmental exposures (e.g., asbestos or silica dust), infections, certain drugs, etc.

What are the Symptoms of Interstitial Lung Disease?

Individuals may encounter interstitial lung disease in various ways, yet the most prevalent symptoms are as follows:

• Difficulty breathing, particularly during physical activity
• A dry, persistent cough that does not yield mucus
• Severe fatigue and weakness
• Decreased appetite
• Unaccounted weight loss
• Chest discomfort
• Strained breathing, which can be rapid and shallow
• Lung bleeding

What Risk Factors are Responsible for Causing Interstitial Lung Disease?

Certain demographic, occupational, and medical conditions can put individuals at greater risk for developing ILD. These include:

• Age: Those over 70 years of age are more vulnerable, especially to the idiopathic varieties,such as idiopathic pulmonary fibrosis.
• Gender: Women have a higher likelihood of developing a form of interstitial lung disease known as lymphangioleiomyomatosis (LAM). Conversely, a different type, idiopathic pulmonary fibrosis (IPF), is more prevalent among men.
• Smoking History: People who are current or former smokers carry a much greater risk since tobacco smoke destroys lung tissue and weakens repair mechanisms.
• Pre-existing Health Conditions: A history of illnesses like hepatitis C, tuberculosis, pneumonia, COPD, or connective tissue disorders (e.g., rheumatoid arthritis, scleroderma) predisposes individuals to ILD.
• COVID-19 Disease: Viral infections impacting the lungs, including COVID-19, could elevate your risk for interstitial lung disease.
• Occupational or Environmental Exposure: Chronic exposure to lung irritants like asbestos, silica dust, fungal spores, fungi, and specific bacteria may cause inflammation and scarring of lung tissue.
• Prior Chest Radiation: Patients who have received radiation therapy to the chest area, particularly for breast or lung cancer, are at high risk due to radiation-induced lung injury.

How is Interstitial Lung Disease Diagnosed?

The diagnosis of interstitial lung disease (ILD) is quite complex, as it is associated with respiratory and systemic illnesses. Both clinical assessment and specialised investigations are typically needed to make the diagnosis. Here are the major diagnostic methods:

• Blood tests can identify markers of autoimmune illnesses or environmental antigen exposure, such as mouldor bird proteins.
• High-resolution CT (HRCT) scans are essential, as they provide detailed images that uncover patterns of lung injury and fibrosis, assisting in narrowing the ILD subtype.
• Echocardiograms are employed to evaluate properheart function and exclude pulmonary hypertension, which may accompany ILD.
• Pulmonary function tests, such as spirometry and diffusion capacity, quantify lung volume and the effectiveness of gas exchange.
• Oximetry is used to measure both resting and exercising blood oxygen levels, assessingthe severity of the disease.
• When imaging and laboratory tests are unclear, lung tissue can be analysed using techniques such as bronchoscopy, bronchoalveolar lavage, or surgical lung biopsy.

What is the Best Treatment for Interstitial Lung Disease?

Even though lung scarring due to ILD is irreversible, treatment tries to slow down the progression, alleviate symptoms, and enhance the quality of life. Here are the major treatment approaches:

• Corticosteroids (such as prednisone) are generally prescribed initially to minimise inflammation, particularly in immune-associated ILD.
• Immunosuppressants also prevent ongoing immune-mediated lung injury.
• Antifibrotic medications such as pirfenidone and nintedanib are indicated for idiopathic pulmonary fibrosis and can slow downlung scarring.
• Oxygen therapy enhances breathing, sustains activity, and prevents complications resulting from low oxygen levels.
• Pulmonary rehabilitation integrates exercise, education, breathing exercises, and emotional support to maximise daily function.
• Lung transplant is an option for very severe cases resistant to drugs,but it depends on age and overall health.
• Making lifestyle changes, including quitting smoking, managing reflux, consuming a nutritious diet, and staying up to date on vaccinations, are crucial for long-term health and well-being.

Interstitial lung disease is a multifaceted collection of disorders that impact the lungs' capacity to perform optimally. While most are chronic and irreversible, prompt diagnosis, medical treatment, and lifestyle modifications can make a huge impact. Thus, if you have chronic shortness of breath or a dry cough, get it checked out early.

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