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  INTERSTITIAL LUNG DISEASE  
 

DEFINITION OF INTERSTITIAL LUNG DISEASE

Interstitial Lung Disease (ILD); this is a term which includes a variety of chronic lung disorders. In a person suffering from ILD, the lungs are affected in three ways.

First, the lung tissue is damaged in some known or unknown way.

Second, the walls of the air sacs in the lung become inflamed.

Finally, scarring (or fibrosis) begins in the interstitium (or tissue between the air sacs), and the lung becomes stiff.

Breathlessness induced by physical stress can be one of the first signs of these diseases. Dry cough could also be present. These are common symptoms that many people ignore.

People with different types of ILD may have the same kind of symptoms but their symptoms may vary in severity even though their chest X-rays may look alike. Further testing is usually recommended to identify the specific type of ILD a person has.

Some ILDs have known causes and some (idiopathic) have unknown causes.

WHY THE NAME?

          The tissue between the air sacs of the lungs is called the interstitium and as Interstitial lung disease affects this tissue hence the name. The tissue is affected by fibrosis (scarring). Interstitial lung disease is sometimes also known as "interstitial pulmonary fibrosis." The terms interstitial lung disease, pulmonary fibrosis and interstitial pulmonary fibrosis are also used for the same condition.

INTERSTITIAL LUNG DISEASES ARE PUZZLING

 The course of this disease is unpredictable. If they progress, the lung tissue thickens and becomes stiff. Breathing then becomes difficult and demanding. This may improve with medication if treated when inflammation occurs. In certain cases oxygen therapy may be needed as part of the treatment.

The diseases may have a gradual course or a rapid course. The symptoms may vary from very mild to moderate to very severe. Their condition may remain the same for long durations or may change quickly.

POSSIBLE LINKS IN INTERSTITIAL LUNG DISEASE

Eventhough the progress and symptoms of these diseases may vary from person to person, there is usually one common link between the different forms of ILD and that is their begin with an inflammation. The inflammation therefore may affect different parts of the lung, as may be explained below:

Bronchiolitis, Alveolitis, or Vasculitis.

The inflammation of these parts of the lung may heal or may lead to permanent scarring of the lung tissue. When scarring of the lung tissue takes place, the condition is called pulmonary fibrosis.

Fibrosis of the lung tissue, results in permanent loss of that tissue's ability to transport oxygen. The level of disability depends on the amount of scarring of the tissue. This is because the air sacs, as well as the lung tissue between and surrounding the air sacs, and the lung capillaries, are destroyed by the formation of scar tissue.

WHAT ARE THE KNOWN CAUSES OF PULMONARY FIBROSIS?

Several causes of pulmonary fibrosis are known. They include:

1. Occupational and environmental exposures. Exposure to metals, dust and pollen.

2. Sarcoidosis.

3. Drugs.

4. Radiation.

4. Connective tissue or collagen diseases

5. Genetic/familial.

IDIOPATHIC PULMONARY FIBROSIS (IPF)

when we do not have a known cause for this then we term it as "idiopathic" (of unknown origin) pulmonary fibrosis (IPF).

THE SYMPTOMS OF IPF

Shortness of breath - the main symptom of idiopathic pulmonary fibrosis.

Other symptoms may include a dry cough (without sputum). When the disease is severe and prolonged, heart failure with swelling of the legs may occur.

DIAGNOSIS OF IPF

A very careful patient history is an important tool for diagnosis. The history will includes environmental and occupational factors, hobbies, legal and illegal drug use, arthritis, and risk factors for diseases that affect the immune system. A physical examination, chest X-ray, pulmonary function tests, and blood tests are important..

Diagnostic Tests That May Be Used to Identify Pulmonary Fibrosis or Interstitial Lung Disease

1. Blood Tests

2. Pulmonary Function Tests

3. Chest X-ray

4. CT Scan

5. Bronchoscopy

6. Bronchoalveolar Lavage

7. Lung Biopsy

8. CT Scan

TREATMENT FOR IPF

Corticosteroids may be given to treat the inflammation.Other drugs are occasionally added when it is clear that the steroids are not effective in reversing the disease.

Oxygen therapy may be prescribed for some people with IPF. The need for oxygen will be determined by your doctor and may depend on the severity of disease, as well as your activity level. Talk with you doctor if you think you may need oxygen or if you have concerns about oxygen.

Influenza vaccine and pneumococcal pneumonia vaccine are both recommended for people with IPF or any lung disease.

Rehabilitation and education programs may help some people with IPF. Local support groups have been of benefit for people with IPF and their family members and friends.

 

 
 
 
 
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