Interstitial Lung Diseases (ILD): Understanding the Lungs Beyond the Airways

Interstitial Lung Diseases (ILDs) are a group of chronic lung conditions that cause inflammation and scarring (fibrosis) of the lung’s interstitial tissue—the space around the air sacs (alveoli). This scarring makes the lungs stiff and less able to expand, reducing oxygen flow into the blood and making breathing increasingly difficult over time.

What Causes ILDs?

There are over 200 types of ILDs, and causes may include:

• Autoimmune diseases (like rheumatoid arthritis or scleroderma)

• Long-term exposure to dust, chemicals, or asbestos

• Radiation therapy to the chest

• Certain medications

• Smoking

• In many cases, the cause remains unknown (Idiopathic Pulmonary Fibrosis – IPF is the most common idiopathic ILD)

Common Symptoms:

• Persistent dry cough

• Progressive shortness of breath, especially with activity

• Fatigue and weakness

• Chest discomfort

• Unexplained weight loss

• “Clubbing” of fingertips (rounded nails due to low oxygen levels)

Symptoms often develop slowly, but in some cases, they can worsen rapidly.

How ILD is Diagnosed:

Accurate diagnosis is essential and may involve:

• High-resolution CT scan

• Pulmonary function tests (to measure lung capacity)

• Oxygen level assessment

• Bronchoscopy or lung biopsy (in some cases)

• Blood tests to check for autoimmune markers

Treatment and Care:

While scarring from ILD can’t be reversed, treatment helps slow progression, manage symptoms, and improve quality of life:

• Anti-fibrotic medications (especially in IPF)

• Steroids or immunosuppressants (for inflammatory ILDs)

• Oxygen therapy

• Pulmonary rehabilitation

• Lung transplant (in select advanced cases)