Interstitial (in-tur-STISH-ul) lung disease refers to the spectrum of conditions that cause the development of scarring in lung tissue. The scarring caused by interstitial lung diseases eventually impacts your lung’s capacity to breathe and get sufficient oxygen into your bloodstream.
Interstitial lung disease is caused by exposure to harmful substances like asbestos. In addition, certain kinds of autoimmune disorders, such as Rheumatoid Arthritis, can also cause interstitial lung illness. In certain instances, however, the reasons remain a mystery.
When lung scarring is asymptomatic, it’s irreparable. The use of medications can slow the destruction of interstitial lung diseases; however, some people will never be able to regain the full function of their lungs. A lung transplant is an option for people who suffer from interstitial lung diseases.
The most prominent indications and symptoms of interstitial lung disease include:
- Breathlessness at rest or worsened through exertion
- Dry cough
When should you see a doctor?
When symptoms start to show, an irreparable lung injury can have already taken place. Nevertheless, it is essential to consult your physician immediately if you notice breathing issues. Aside from interstitial lung diseases, many other conditions can cause lung problems. A prompt and accurate diagnosis is essential to ensure correct treatment.
Interstitial lung disease is believed to manifest when a lung injury causes an abnormal healing process. Normally, your body produces just the right tissue to heal damage. However, in the case of interstitial lung disease, the repair process gets sloppy, and the tissue surrounding your air sacs (alveoli) is damaged and increases in thickness. As a result, it makes it harder for oxygen to enter the bloodstream.
Lung disease caused by interstitial airways can be caused by various factors — such as toxic airborne particles in the workplace or the form of drugs and some kinds of medical treatment. However, there is no explanation for the cause most of the time.
The environmental and occupational aspects
Exposure to long-term exposure to a variety of pollutants and toxins can harm a person’s lungs. Which could include:
- Silica dust
- Asbestos fibers
- Grain dust
- Animal and bird droppings
- Treatments with radiation
- Indoor hot tubs
A few people who undergo radiation treatment for breast or lung cancer may show signs of lung damage weeks or even years after the treatment.
A variety of drugs can harm your lungs, including:
- Chemotherapy medicines. Drugs designed to destroy cancerous cells, like methotrexate (Otrexup, Trexall, others) and cyclophosphamide, also harm lung tissue.
- Heart medication. Some drugs used to treat irregular heartbeats like amiodarone (Nexterone, Pacerone) or propranolol (Inderal, Innopran) could cause damage to lung tissue.
- Certain antibiotics. Nitrofurantoin (Macrobid, Macrodantin other) and Ethambutol (Myambutol) may cause damage to the lungs.
- Anti-inflammatory medications. Certain anti-inflammatory medications like the drug rituximab (Rituxan) and Sulfasalazine (Azulfidine) could cause damage to the lungs..
Damage to your lungs may be caused by the autoimmune disease that includes:
- Rheumatoid arthritis
- Polymyositis and Dermatomyositis
- A disease of the connective tissue
- Sjogren’s syndrome
The list of chemicals and conditions that could trigger interstitial lung diseases is lengthy. In certain cases, they cannot identify the cause. Disorders without a clear reason are classified under the name of idiopathic interstitial pneumonia. The most frequent and fatal one is idiopathic lung fibrosis.
Factors that could increase your risk of interstitial lung disease are:
- Age. Interstitial lung disease is more likely to affect adult patients; however, infants and young children may also suffer.
- Exposure to environmental and occupational toxins. Suppose you work in farming, mining, or construction or are exposed to chemicals known to harm your employees’ lungs. In that case, the risk of contracting interstitial lung diseases is elevated.
- Gastroesophageal reflux illness. If you have uncontrolled acid reflux and indigestion, you could be more at risk of interstitial lung condition.
- Smoking. Some forms of interstitial lung diseases are more likely to be experienced by people who have a history of tobacco. Smoking cigarettes can cause the condition to worsen, particularly if it is associated with Emphysema.
- Chemotherapy and radiation. Having radiation treatments to your chest or taking certain chemotherapy drugs increases the likelihood of getting lung diseases.
The condition can cause a variety of life-threatening issues, such as:
- Blood pressure that is high in the lung (pulmonary hypertension). Unlike systemic high blood pressure, this issue only affects the arteries of your lung. It starts when scar tissue is formed, or low oxygen levels block the blood vessels that are the smallest, which reduces blood flow to the lung. It raises pressure within the pulmonary arterial system. Pulmonary hypertension is a severe condition that is getting worse.
- Right-sided cardiac failure (cor Pulmonale). This serious condition is caused by the heart’s lower right chamber (right ventricle) -which is smaller in muscle than the left and must pump more force than normal to transport the blood around obstructed pulmonary veins. In the end, the right ventricle suffers due to the additional stress. It can be a result of the condition known as pulmonary hypertension.
- Respiratory failure. In the end stage of chronic interstitial lung disease, respiratory failure can occur when reduced blood oxygen levels with pressures rise in the pulmonary arteries and the right ventricle resulting in heart failure.
Finding and determining the reason for interstitial lung diseases can be difficult. It is because many of the conditions are included in this broad category. Additionally, the symptoms and signs from a range of medical conditions could be a symptom of interstitial lung disease. Therefore, doctors should rule these out before making a final diagnosis.
Certain tests could be required.
Tests in the laboratory
- The blood tests. Certain bloodwork can detect antibodies, proteins, and other signs of autoimmune disorders or inflammatory reactions to environmental exposures like those caused by molds or bird proteins.
- The computerized tomography (CT) scan. This imaging test is crucial to, and in some cases, the initial step in identifying lung disease. CT scanners use computers to mix X-rays taken from a variety of angles to produce cross-sectional photos of inner structures. A High-resolution CT scan is particularly useful in determining the severity of lung damage caused by interstitial lung diseases. It will reveal specifics of fibrosis, which could be useful in narrowing down the diagnosis and making the treatment options.
- Echocardiogram. A sonogram for the heart and an echocardiogram use sound waves to show the heart. It may produce still pictures of the heart’s structure and videos that demonstrate how your heart works. The test will determine the pressure level on the right side of your heart.
Tests for Pulmonary Function
- Splometry as well as diffusion capacities. This test requires the user to exhale swiftly and vigorously through a tube connected to a device that measures the air your lungs can hold and how fast you can get the air out of your lung. It also evaluates how oxygen can move through your lungs and into the bloodstream.
- Oximetry. This simple test utilizes a tiny device put on one of your fingers to determine the level of oxygen in your blood. It can be performed in the absence of activity or at rest to assess the progression and intensity of lung disease.
Lung tissue analysis
In most cases, one can identify pulmonary fibrosis only after taking a sample of lung tissue (biopsy) in a lab.
The tissue sample can be obtained using one of the following methods:
- Bronchoscopy. In this procedure, the doctor will remove very tiny tissue samples, usually no bigger than the pin’s head, with a small flexible tube (bronchoscope) inserted through your nose or mouth into your lung. The risks of bronchoscopy are usually minor, and usually, a little hoarseness and sore throat are caused by the bronchoscope. However, the tissue samples may be too small to provide a reliable diagnosis.
- Bronchoalveolar Lavage. The doctor injects around one tablespoon of saltwater through a bronchoscope in the lung in this procedure. Then, he suctions it away. The liquid that is withdrawn comprises cells derived from the air sacs in yours. Although bronchoalveolar swabs sample more in the lung than any other procedure, it’s not able to provide enough data to determine if you have the condition of pulmonary fibrosis.
- The Surgical Biopsy. Although this is an invasive procedure that could lead to possible complications, it’s usually the only way to collect adequate tissue to determine a precise diagnosis. When you’re in general anesthesia, surgical tools and cameras are placed through small incisions that are made between your ribs. The camera allows the surgeon to see your lungs through video monitors while removing lung tissue samples.
The lung scarring which occurs in interstitial lung disease cannot be reversed, and treatment isn’t always effective in stopping the development of the condition. However, certain medicines may help alleviate symptoms temporarily or slow down the process of progression. Other treatments can improve the living quality.
Since many kinds of scarring disorders have no treatment that is approved or tested, Clinical studies could be a viable option for the treatment of a trial.
Research to discover the best treatment options for interstitial lung diseases is continuing. Based on current, research-based evidence, your physician may suggest:
- Corticosteroid medicines. Many people diagnosed with interstitial lung disease are treated initially with corticosteroid (prednisone), which is sometimes used with other drugs that suppress the body’s immune. Based on the reason for the interstitial lung disease, this combination can help slow or even stop development.
- Medicines that slow the development of idiopathic fibrosis. The medications pirfenidone (Esbriet) and Nintedanib (Ofev) can slow down the progression of the disease. The effects of treatment can be severe. Discuss the advantages and disadvantages of these drugs with your physician.
- Medicines that lower the acidity of your stomach. Gastroesophageal reflux disease (GERD) is a major cause in patients with idiopathic pulmonary fibrosis. It is linked to the deterioration of lung damage. Suppose you are suffering from the symptoms associated with acid reflux. In that case, your physician might prescribe GERD treatments to reduce stomach acid. These include H-2-receptor antagonists and proton pump inhibitors, such as the lansoprazole (Prevacid 24HR) and Omeprazole (Prilosec OTC), and pantoprazole (Protonix).
Using oxygen can’t stop lung damage, but it can:
- Relax your breathing and make exercise more enjoyable
- Reduce or prevent complications caused by low levels of blood oxygen
- Lower blood pressure on the right-hand side of your heart.
- Enhance your sleeping habits and your sense of well-being.
It is the most likely time to get oxygen while you do exercises or sleep, though certain individuals may need it all day long.
Rehabilitation of the pulmonary system
The purpose of pulmonary rehabilitation isn’t solely to improve your daily living but also to help those suffering from interstitial lung disease lead a full and satisfying life. To achieve that, the pulmonary rehabilitation programs concentrate on:
- Physical exercise is a great way to increase your endurance
- Breathing techniques that boost the efficiency of your lung.
- Support emotional
- Counseling for nutrition
Lung transplantation could be an option last resort for people suffering from severe lung disease that haven’t had success with other treatments.