ILD (Interstitial Lung Disease)
What is interstitial lung disease or pulmonary Fibrosis?
Interstitial lung disease, ILD is the medical term used for a group of lung disorders that causes swelling of the interstitium (tissue and space around the air sacs of the lungs). The swelling finally heals by scarring/ fibrosis which leads to a decrease in lung function over time and thus symptoms of breathlessness and cough. The primary problem is that oxygen from the lungs is not able to diffuse into the blood due to swelling. ILD is also known by some as pulmonary fibrosis or lung fibrosis and treated best by pulmonary fibrosis doctors, ILD doctors. There are 200 types of ILD and some common types of ILD include idiopathic pulmonary fibrosis (IPF), sarcoidosis, and hypersensitivity pneumonitis (pigeon lung disease).
What causes ILD/pulmonary fibrosis?
Lung fibrosis can have many causes:
- In most cases, the precisely cause of lung fibrosis is not kwon.
- Connective tissue disorders which are Autoimmune diseases also called in which one’s own immune system attacks and damages normal healthy lung instead of killing the bugs/germs.
- Exposures to environmental and occupational toxic fumes, dust, smoke over a long period of time, moulds, dust from asbestos, silica, metals, or coal.
- Radiation therapy (X-rays in high doses which is given during cancer treatment)
- Disseminated Infections of lung like military TB
What are the symptoms of ILD?
- Breathlessness which is gradual onset and progressive in nature, especially with activity or exertion
- Long standing dry cough, not settling with medical management
- Some patient with early ILD may have no symptoms and it is picked up on preventive health checkup on chest X-ray or breathing tests.
- Autoimmune connective tissue diseases can also cause problems in other body parts like joints, eyes, skin or kidney.
There are no specific stages of pulmonary fibrosis but based on the chance of progression and long-term outcome of lung fibrosis, some pulmonary fibrosis specialist experts classify pulmonary fibrosis as progressive pulmonary fibrosis and non-progressive pulmonary fibrosis. There are some ILD which can be cured like sarcoidosis and thus they have good outcome. Non-progressive pulmonary fibrosis has a relatively fair out come and Progressive pulmonary fibrosis has very bad outcome. So sometimes we can stage ILD as good ILD, Fair ILD and Bad ILD.
Can you be tested for pulmonary Fibrosis? What are the tests for ILD?
If you have any of above symptoms, you should search for a best doctor for pulmonary fibrosis / ILD doctor near me as early diagnosis help in preventing the disease progression. Workup of ILD requires an lung fibrosis specialist who is well trained to take make a precise diagnosis of ILD and classify it. There are few trained ILD specialist in India and Delhi. Management and prognosis of different type of ILD is depends of classification of ILD which is based upon on the following tests.
Diagnosis of Interstitial lung disease is typically made after a combining finding of medical history, physical exam of patient, imaging studies (CT scan features), and lung biopsy histopathology findings. This requires a Multi-Disciplinary Team which includes a pulmonologist with special interest in ILD, A chest radiologist and a lung pathologist. Some times a autoimmune connective disease specialist called a rheumatologist is involved in this team.
- Special blood tests: a battery of test are done to rule out autoimmune diseases as lung fibrosis cause.
- Aa good quality CT scan of the chest from a good Chest Radiology centre in Delhi to know the type of ILD and extent of damage caused by ILD.
- Detailed Breathing tests, also called “pulmonary function tests” and 6-minute walk test to measure lungs function.
Sometimes, your ILD specialist Doctor may also ask for:
- An echocardiogram –an ultrasound of the heart to tell about the function of your heart as weak lung can also affect heart.
- Bronchoscopy, a test which helps us to look inside the lungs and get a sample of fluid/tissue through a thin tube with a camera attached to its tip (called a “bronchoscope”).
- A lung biopsy, means taking a small sample of tissue from the lung by a small surgical procedure. Lung biopsy is then seen by another doctor (pathologist) under a microscope. Lung biopsy is needed to confirm the diagnosis and to know the precise type of ILD. Not everyone will need a lung biopsy. It is done only if all of the above-mentioned blood and imaging tests don’t tell precisely what’s the cause of ILD.
What are the options for ILD treatment?
There is no miracle cure of pulmonary fibrosis except some kind of ILD which are curable. ILD treatment in most cases needs a lifelong follow up with ILD specialist doctor and its best to find a best pulmonary fibrosis doctor before starting your treatment. Please know that any best doctor for pulmonary fibrosis in India would take pains in meticulously working up and following ILD patient along with a multi-disciplinary team and treat each case of lung fibrosis patient differently/individually and also provide pulmonary rehabilitation and comprehensive care. There are some best hospitals/centres for pulmonary fibrosis in Delhi which have all the multi-disciplinary teams (Pulmonologist/Chest radiologist/rheumatologist/lung pathologist) who can work together and provide quality care for patients of ILD.
Lung fibrosis recovery time and medical treatment for lung fibrosis depends on the cause of your ILD and its type and how bad are your symptoms are. The following are the treatment options for ILD
- Supplemental oxygen (through an oxygen cylinder or oxygen concentrator)
- Steroids to reduce inflammation/swelling and thus preventing lung damage.
- Immunosuppressive medications which decrease activity of your immune system
- Medicines to prevent scarring of lungs and thus slow the progression of disease are some of the latest treatment for pulmonary fibrosis and include 2 major antifibrotic drugs- Perfinidone and Nintadenib.
- Pulmonary rehabilitation – Comprehensive approach including exercises and ways to breathe that can improve symptoms and quality of life of patients.
Please know that since there is no best treatment for lung fibrosis some patients try alternative medicines like treatment for ILD in Patanjali which is OK but please know that that there is no miracle cure for ILD and you should keep in touch with you ILD specialist when even when you are taking any alternative treatment and both system of medicine eg ILD treatment at Patanjali should work together to provide make life of ILD patient better. Lifestyle changes can also be important in the management of Interstitial lung disease. Avoiding exposure to environmental and occupational irritants (such as dust, chemicals, and smoke) can help to prevent further lung damage. Quitting smoking is also important for improving lung function and overall health. In some cases, lung transplantation may be necessary for severe Interstitial lung disease that does not respond to other treatments. Overall, ILD is a serious and potentially life-threatening condition that requires prompt diagnosis and management by a good ILD specialist. If you are experiencing symptoms of ILD or have concerns about your lung health, it’s important to speak with your nearest pulmonologist.