Doctronic

Understanding Interstitial Lung Disease: Symptoms, Causes, Diagnosis, and Treatment

William Wadzinski | MD

Medically reviewed by William Wadzinski | MD, Uniformed Services University of the Health Sciences on September 10th, 2023.

Key Takeaways

  • This umbrella term encompasses over 200 conditions that damage the interstitium—the thin tissue layer between air sacs—with idiopathic pulmonary fibrosis being the most common, affecting 13-20 per 100,000 people annually.
  • Occupational exposure accounts for up to 25% of cases, with asbestos workers showing symptoms 20-40 years after initial exposure, while certain chemotherapy drugs like bleomycin cause lung toxicity in 10% of patients.
  • High-resolution CT scanning can detect early changes before symptoms appear, showing a characteristic "honeycomb" pattern in advanced stages that indicates irreversible scarring.
  • Antifibrotic drugs like nintedanib and pirfenidone can slow lung function decline by approximately 50% when started early, but cannot reverse existing damage.
  • Pulmonary rehabilitation programs improve exercise capacity by 20-30% and quality of life scores, even as underlying lung function continues to deteriorate over time.

Interstitial lung disease (ILD) is a group of conditions that affect the interstitium, a lace-like network of tissue that supports the lungs' tiny air sacs called alveoli. When the interstitium becomes thickened due to inflammation, scarring, or fluid buildup, it can cause breathing difficulties and other health problems.

Types of Interstitial Lung Disease

There are several types of ILD, including:

  • Interstitial pneumonia

  • Idiopathic pulmonary fibrosis

  • Nonspecific interstitial pneumonitis

  • Hypersensitivity pneumonitis

  • Cryptogenic organizing pneumonia (COP)

  • Acute interstitial pneumonitis

  • Desquamative interstitial pneumonitis

  • Sarcoidosis

  • Asbestosis

Symptoms of Interstitial Lung Disease

The most common symptom of ILD is shortness of breath, which can worsen over time. Other symptoms may include:

  • Dry cough

  • Weight loss (particularly in COP or BOOP)

Symptoms may develop slowly over months or quickly over hours or days, depending on the type of ILD.

Understanding Interstitial Lung Disease: Symptoms, Causes, Diagnosis, and Treatment

Causes and Risk Factors

The exact cause of most ILDs is unknown. However, some factors that can contribute to the development of ILD include:

  • Bacterial, viral, or fungal infections

  • Exposure to irritants like asbestos, bird proteins, coal dust, grain dust, silica dust, or talc

  • Certain medications, such as antibiotics, anti-inflammatory drugs, chemotherapy drugs, or heart medications

  • Age (adults are more likely to develop ILD)

  • Autoimmune diseases like lupus, rheumatoid arthritis, and scleroderma

  • Gastroesophageal reflux disease (GERD)

  • Genetic factors

  • Smoking

  • Radiation treatments for cancer

Diagnosing Interstitial Lung Disease

To diagnose ILD, doctors may use various imaging tests and procedures, including:

  • Chest X-ray

  • CT scan

  • High-resolution CT scan

  • Lung function test

  • Lung biopsy (bronchoscopy, video-assisted thoracoscopic surgery, or open lung biopsy)

Treatment Options for Interstitial Lung Disease

Treatment for ILD depends on the specific type and cause of the condition. Some common treatments include:

  • Antibiotics for interstitial pneumonias caused by bacteria

  • Corticosteroids to reduce inflammation in the lungs

  • Inhaled oxygen to improve oxygen levels and reduce strain on the heart

  • Lung transplant for advanced cases of ILD

  • Other medications like azathioprine or N-acetylcysteine may be used in combination with other treatments

It's essential to work closely with your healthcare provider to determine the best course of treatment for your specific condition.

Complications of Interstitial Lung Disease

Severe cases of ILD can lead to life-threatening complications, such as:

  • Pulmonary hypertension (high blood pressure in the lungs)

  • Respiratory failure

  • Cor pulmonale (right-sided heart failure)

If you suspect you may have interstitial lung disease, consult your healthcare provider for an accurate diagnosis and appropriate treatment plan. Early intervention can help manage symptoms and improve quality of life.

For more information on interstitial lung disease, visit:

The Bottom Line

Early detection is crucial since treatments can slow but not reverse lung scarring, making prompt evaluation essential for anyone with unexplained shortness of breath lasting more than 8 weeks. Avoiding known triggers like dust, smoke, and certain medications while maintaining physical activity through structured rehabilitation offers the best outcomes. If you're experiencing persistent breathing difficulties or dry cough, Doctronic can help connect you with appropriate pulmonary specialists for timely evaluation.

Related Articles

Does Mounjaro Affect Fertility?

Understanding Mounjaro and Its UsesMounjaro is a prescription medication commonly prescribed for managing type 2 diabetes. It belongs to a class of drugs that help regulate [...]

Read More