Do you also have a persistent dry cough and difficulty breathing? It could be Interstitial Lung Disease (ILD)!

Do you also find it difficult to breathe when you are a little tired, when you climb a flight of stairs? Do you sometimes have a persistent, dry cough without phlegm for no apparent reason? We often forget that these symptoms are just normal fatigue or a minor allergy. However, they can be the first signs of serious changes taking place inside our lungs. Today we are going to talk about one such condition, Interstitial Lung Disease, or ILD for short.

Simply put, what is Interstitial Lung Disease (ILD)?

Think of our lungs as two sponges filled with millions of tiny air bubbles. These tiny air sacs are called alveoli . When we breathe, the oxygen we take in is added to our blood through these air sacs. And the unwanted carbon dioxide in the blood is also released back through these air sacs.

Now, between these air sacs, like the mortar between the bricks in a brick wall, there is a network of delicate tissues. This is what we call the interstitium . In ILD, this network of delicate tissues becomes damaged, or rather damaged, and gradually thickens, hardens, and scarring (fibrosis) occurs.

When the lung tissue thickens in this way, the passage of oxygen from the air sacs to the blood becomes blocked. As a result, our body does not get the amount of oxygen it needs. This is the main reason for symptoms such as shortness of breath and fatigue.

ILD is not a single disease. There are more than 200 conditions classified under this name. The common feature of all of them is damage to the interstitial tissue of the lungs.

What are the symptoms of someone with ILD?

The symptoms of ILD may not be very severe at first. However, over time, over months or years, these symptoms gradually increase. These are the symptoms that most people experience.

If you have these symptoms, don't necessarily assume that you have ILD. But don't ignore them either. It's important to see your doctor , especially if you have shortness of breath and a dry cough that has been going on for months .

Why does this kind of illness occur? What are the causes?

The causes of ILD can be divided into two categories: known causes and unknown/idiopathic causes .

1. Known Causes

This means we can say with certainty, "This is what caused this disease."

• Autoimmune or Connective Tissue Diseases: Sometimes our body's own immune system starts attacking our body's healthy tissues. People with conditions like Rheumatoid Arthritis (RA) , Lupus , and Scleroderma are at higher risk of developing ILD.
• Occupational and environmental exposures: Some of the dust particles we breathe in can cause long-term damage to the lungs.
• Silica dust: For those who work in quarries, mines, and ceramic factories.
• Asbestos fibers: For those who demolish old buildings, work in the shipping industry, and work with brake pads in some vehicles.
• Grain dust, hay, bird droppings: A condition called Hypersensitivity Pneumonitis that can occur in people who farm or raise animals.
• Molds and Fungi: For those who work in humid, poorly ventilated environments.
• Some medications and treatments:
• Medications such as amiodarone, which are used to treat certain heart conditions.
• Some anti-cancer drugs (Chemotherapy drugs) .
• Radiation therapy for breast or lung cancer.
• Some infections: Scarring of the lungs can occur even after severe infections such as tuberculosis and pneumonia .

2. Unidentified causes (Idiopathic)

In many cases, no specific cause can be found for ILD. The patient has no other disease or exposure to a harmful substance, but the lung tissue is scarred. We call these cases idiopathic , which means "of unknown cause."

The most common and severe of these is Idiopathic Pulmonary Fibrosis (IPF) .

Who is at higher risk for ILD?

Although anyone can develop ILD, some people are more prone to it.

How does the doctor diagnose this disease?

When you see a doctor with the symptoms you mentioned above, he will perform several tests to accurately diagnose this disease.

1. Asking you about your symptoms: First, they will ask you about your symptoms, the date they started, when they worsened, etc. They will also ask about your occupation, whether anyone in your family has had similar illnesses, and what other medications you are taking.

2. Physical examination: The doctor will place a stethoscope on your chest and listen to the sounds you make when you breathe. Many people with ILD hear "crackles" in their lungs, like Velcro being undone .

3. Pulmonary Function Tests (PFT): In this test, you are asked to breathe in and out through a tube connected to a machine. This test measures how much air your lungs can hold and how fast you can exhale it. In ILD, the lung capacity is reduced.

4. Imaging Tests:

• Chest X-ray: A chest X-ray can give a rough idea of ​​whether there are any scars in the lungs.
• High-Resolution CT (HRCT) Scan: This is the most important test for diagnosing ILD. It can produce much clearer, more detailed images than a regular CT scan. It can better show the nature of the scarring in the lungs and how it has spread (patterns such as "honeycombing").

5. Blood Tests: Blood samples are tested to detect other medical conditions, such as autoimmune diseases.

6. Bronchoscopy: In some cases, a thin tube with a camera attached is passed through the nose or mouth into the lungs, where it is examined inside and a tissue sample (biopsy) is taken.

7. Surgical Biopsy: If the above tests are inconclusive, a small surgical procedure is performed to remove a small piece of tissue from the lung for examination.

What are the treatments for ILD?

Unfortunately, there is currently no cure for ILD, meaning there is no cure for the scarring that occurs in the lungs. However, there are many treatments that can help control the progression of the disease, reduce symptoms, and improve your quality of life. Treatment depends on the type of ILD you have, the severity of the disease, and your overall health.

Here are some of the main treatment methods:

• Medications:
• Corticosteroids: Drugs like Prednisolone reduce inflammation in the lungs.
• Anti-fibrotic drugs: Drugs like Pirfenidone and Nintedanib can slow down the rate of lung scarring. These are especially given to patients with IPF.
• Immunosuppressants: People with ILD due to autoimmune diseases are given medications that reduce the activity of the immune system.
• Oxygen Therapy: For people with low blood oxygen levels, supplemental oxygen is given through a nasal tube or face mask. This can help reduce shortness of breath and fatigue.
• Pulmonary Rehabilitation: This is like 'physiotherapy' for the lungs. A specially trained team will give you breathing exercises, physical exercise, and nutritional advice. This will increase your strength and help you live with your symptoms.
• Lung Transplant: For those whose disease is very severe and cannot be controlled by any other treatment, the last resort is to transplant a healthy lung.

What can I do while living with ILD?

It's normal to feel sad and scared when you receive an ILD diagnosis. However, by making small changes to your lifestyle and following your doctor's advice, you can live a good life with this disease.

• Avoid smoking completely: If you are a smoker, the best thing you can do is to quit today.
• Eat a healthy diet: Eating a balanced diet helps maintain the body's energy.
• Exercise regularly: Ask your doctor and engage in light exercise that is suitable for you. Even something like walking is more than enough.
• Get rest: It is very important to give the body the rest it needs.
• Protect yourself from infections: Wear a face mask when going to crowded places, wash your hands frequently, and talk to your doctor about getting pneumonia and influenza vaccines.
• Consider your job: If your job involves breathing in substances that are harmful to your lungs, you may want to consider adopting safer methods or changing jobs.