Interstitial Lung Disease

Hi everyone!

I am Dr. Hemant Kalra, I am a pulmonologist. Today I will talk about a very important topic, Interstitial Lung Disease. Before I tell you what this disorder, I must tell you something about interstitium. What is interstitium? Instertitium is a tissue in the lungs through which air from the lungs, small air sacks called alveoli passes to enter into the lungs small blood vessels called capillaries. So in Interstitial Lung disease, this instertitium is affected. So what happens in Interstitial Lung disease, in this disorder, there is reduction of the ability of the lungs to deliver oxygen to the blood vessels. Secondly, this disorder distorts the normal lungs structure. Lungs become smaller and stiffer. Interstitial Lung disease affects both men and women. It is very rarely communicable but it is not at all contagious. In some ILDs there are no clatters, but most of them are idiopathic in nature, idiopathic means there are no root causes. So what are the symptoms?

Symptoms are mostly exertion recklessness may or may not be associated with cough or cough is predominantly dry in ILDs. Sometimes, joints, skins and eyes are also affected. Only then it is associated with connective tissue disorders. So how do we classify Interstitial Lung Disease. We can classify ILD in many ways. But in a simple manner, we can classify into three types. First when ILD is only limited to the lungs. It is called idiopathic pulmonary fibrosis. Secondly when it is primarily associated with other parts of the body like in scleroderma, rheumatoid arthritis and sarcoptosis. Thirdly when ILD is associated with known triggers. First is hypersensitivity pneumonitis, second is medications which is associated with ILDS, third is Sarcoidosis, Asbestosis.

So these are the three predominant types of ILDs. So how do we diagnose Interstitial Lung Disease. First of all we have to suspect Interstitial Lung Disease in all patients with exertion, with breathlessness. Further, we can ask for chest x-ray, pulmonary function test, certain blood tests are also advised sometimes, but predominantly high-resolution ct scanning with diagnostic modality. Further, we can go for bronchoscopic biopsy, lung biopsy can also be advised but most of the time chemical suspension, illegal symptoms and high-resolution ct scan can give you the diagnosis of Interstitial Lung Disease. So what is the treatment of Interstitial Lung Disease? Treatment is first of all lifestyle changes like smoking cessation, weight reduction, exercising regularly as in all chronic respiratory disorders. Second is we must avoid drinkers like in Hypersensitivity pneumonitis, Asbestosis, and Sarcoidosis.

So treatment depends on the type of ILD and severity of ILD. Treatment of ILDshould be given by pulmonologist who is specialized in intestinal lung diseases management. There are many drugs in the market for treatment of Interstitial Lung Disease. Most of the times steroids are integrated like in connective tissue disorders, in Sarcoidosis and certain ILDs like NSIP (Nonspecific interstitial pneumonitis). Steroid works very well in such condition but in certain idiopathic conditions, there are two drugs in the market. Both the drugs are available in India. Normally we give those drugs to a patient of idiopathic pulmonary fibrosis. So the treatment is very very limited. The basic thing is we have to diagnose Interstitial Lung Disease as early as possible. Start treatment as early as possible and should be initiated by a pulmonologist only. So in the natural Interstitial Lung Disease the chronic respiratory disorder should be diagnosed as early as possible so that respective treatment can be initiated very early in the disease process. So kindly refer all your patients to specialized centers or pulmonologist who are specialized in dealing such cases so that further lung injury can be prevented.

Thank you very much!