Interstitial lung disease (ILD) is a group of conditions in which the lung tissue becomes inflamed or scarred (fibrosis), making the lungs stiff so oxygen passes into the blood less easily. It causes slowly worsening breathlessness and a dry cough. Some types are linked to joint or autoimmune disease (CTD-ILD), birds, moulds, dust or medicines. Early diagnosis can slow progression and improve quality of life. Dr A. Ashok Kumar evaluates and treats ILD in Chittoor.
Common symptoms of interstitial lung disease
- Breathlessness that slowly gets worse over months
- Persistent dry cough
- Tiredness and reduced exercise tolerance
- Low oxygen levels on walking
- Rounded, swollen fingertips (clubbing) in some people
Get urgent care if you have
- Sudden worsening of breathlessness over days
- Oxygen level dropping at rest
- New fever with breathlessness
Emergency? Call 093448 53689 or 108, or go to the nearest hospital.
Causes and risk factors
Causes include autoimmune conditions such as rheumatoid arthritis or scleroderma, exposure to birds (pigeons), moulds, silica or asbestos dust, some medicines and radiation. In idiopathic pulmonary fibrosis (IPF) no cause is found.
Tests that help
Chest X-ray and HRCT chest
Pictures of the lungs. A high-resolution CT (HRCT) shows fine detail and is important for ILD, bronchiectasis, unexplained cough and lung spots. Dr Ashok arranges the right scan and explains the report with you.
Pulmonary function test (PFT) / spirometry
You blow hard into a tube while a machine measures how much air your lungs hold and how fast you can push it out. It confirms asthma or COPD, shows how severe it is and tracks whether treatment is working. Where needed, lung volumes and DLCO (how well oxygen passes into the blood) are also measured.
6-minute walk test
You walk at your own pace for six minutes while your oxygen level and pulse are checked. It shows how your lungs cope with everyday activity and helps decide if you need oxygen support.
Oxygen level (SpO₂) and blood gas checks
A small clip on the finger reads oxygen level at rest and while walking. In the ICU an arterial blood gas test measures oxygen and carbon dioxide directly to guide oxygen and ventilator support.
Bronchoscopy and BAL (selected cases)
A thin flexible camera is passed through the nose or mouth into the airways, under sedation and local anaesthetic, to look inside, take samples (BAL) or a small biopsy. It is used when tests are needed for infection, TB, ILD or a lung spot.
How Dr Ashok manages it
- HRCT chest and PFT with lung volumes and DLCO to confirm the type and severity
- Autoimmune / connective tissue disease work-up
- Treatment aimed at the cause: removing exposures, anti-inflammatory treatment for inflammatory ILD, and anti-fibrotic treatment for suitable progressive fibrotic ILD
- Oxygen therapy when oxygen levels are low
- Pulmonary rehabilitation
- Vaccination, reflux care and infection prevention
- Management of flare-ups, and referral for transplant evaluation in selected patients
Living well
- Stay away from birds' droppings, feathers and dust
- Stop smoking
- Stay active with guided exercise
- Keep follow-up tests on schedule
- Report any sudden change in breathing quickly
Questions patients ask
Is lung fibrosis curable?
Scarring that has already formed does not go away, but in many types of ILD treatment can stop or slow further damage. That is why early diagnosis is important.
Why do I need an HRCT and not just an X-ray?
ILD changes are often fine and can be missed on an X-ray. HRCT shows the pattern clearly, which helps decide the type of ILD and its treatment.
Can pigeons cause lung disease?
Yes. Long exposure to pigeon droppings and feathers can cause a type of ILD called hypersensitivity pneumonitis. Removing the exposure is a key part of treatment.