Interstitial Lung Disease (ILD) & Pulmonary Fibrosis in Guwahati

ILD is one of the more commonly under-recognized lung conditions, for a simple reason: its main symptoms — a dry cough and gradual breathlessness — are also symptoms of many far more common and less serious conditions. As a result, many people are treated repeatedly for “allergies,” “acidity-related cough,” or simply told they're “getting older and less fit,” while the underlying scarring continues quietly in the background.

This is why a specific, structured evaluation matters once ILD is suspected, rather than continuing to treat the symptoms alone without investigating the cause.

ILD requires evaluation by a pulmonologist experienced in interstitial lung disease specifically, since diagnosis depends on interpreting detailed imaging and lung function patterns that differ from more common respiratory conditions.

Dr. Smitakshi Medhi began her training with an MBBS at Assam Medical College & Hospital (AMCH), went on to specialize through an MD in Pulmonary Medicine at Gauhati Medical College & Hospital (GMCH), and has since spent 14+ years building specific experience in reading the scan patterns and lung function changes that ILD diagnosis depends on.

Why this distinction matters for ILD specifically:

• ILD has many different underlying types and causes, and correctly identifying which type you have directly affects which treatment will actually help
• Diagnosis typically requires careful interpretation of a high-resolution CT scan (HRCT) alongside lung function tests — a pattern-recognition skill that comes with specific experience in this area
• ILD management often involves long-term monitoring of lung function over time, requiring a doctor who tracks subtle changes between visits, not just a one-time diagnosis
• In some cases, ILD is connected to other conditions (such as autoimmune diseases), so a pulmonologist comfortable coordinating with other specialists is valuable

Book a consultation if you notice:

• A dry cough (without much mucus) that has lasted for several weeks or months without a clear cause
• Breathlessness that has been gradually getting worse over months or years, particularly during activity
• Unusual tiredness or reduced stamina that doesn't seem to match your activity level
• A history of long-term exposure to dust, mold, birds, certain chemicals, or other lung irritants at home or work
• A known autoimmune condition (such as rheumatoid arthritis or scleroderma) along with new breathing symptoms, since these are sometimes linked to ILD
• A family history of pulmonary fibrosis or ILD

Seek urgent medical care if you experience:

• A sudden, significant worsening of breathlessness over just a few days
• Breathlessness at rest that wasn't present before
• Bluish or grey discoloration of the lips or fingertips
• Chest pain along with worsening breathlessness

Already diagnosed with ILD or pulmonary fibrosis? Book a follow-up sooner than scheduled if you notice a sudden change in your usual breathlessness, a new or worsening cough, or any signs of infection like fever — these can sometimes signal a flare-up that needs prompt attention.

ILD can result from many different underlying causes, including:

• Unknown cause (idiopathic) — in many cases, particularly with idiopathic pulmonary fibrosis (IPF), no clear trigger is identified
• Autoimmune and connective tissue diseases — such as rheumatoid arthritis, scleroderma, or lupus, which can affect the lungs alongside joints or skin
• Long-term exposure to environmental or occupational irritants — including asbestos, silica dust, certain metal dusts, or bird droppings (sometimes called “bird fancier's lung”)
• Certain medications — some drugs can cause lung scarring as a side effect over long-term use
• Radiation exposure, in rare cases, particularly following treatment for other conditions
• Genetic and family-linked factors, which can make some individuals more prone to developing ILD

Identifying which category applies to your case is an important part of the evaluation, since it can sometimes guide both treatment and any necessary lifestyle or environmental changes.

Diagnosis typically involves:

1. Detailed history — your symptoms, how long they've lasted, occupational and environmental exposures, and any relevant medical or family history
2. Physical examination — listening to characteristic lung sounds that can suggest ILD
3. Pulmonary Function Test (PFT) / Spirometry — to measure how restricted your lung capacity has become
4. High-Resolution CT scan (HRCT) — arranged as the key imaging test for identifying patterns of scarring in the lungs
5. Blood tests, when needed, to check for underlying autoimmune conditions that may be linked to ILD
6. Further specialized tests, such as a lung biopsy, in select cases where the diagnosis remains unclear after initial testing

Treatment depends heavily on the specific type and cause of ILD identified, but generally includes:

• Anti-fibrotic medications — specific drugs that can help slow the rate of lung scarring in certain types of ILD, such as idiopathic pulmonary fibrosis
• Anti-inflammatory treatment — used when the underlying process involves significant inflammation, particularly in autoimmune-related ILD
• Treating the underlying cause, where identifiable — such as managing an autoimmune condition or avoiding a specific environmental exposure
• Oxygen therapy — for patients whose blood oxygen levels drop, especially during activity
• Pulmonary rehabilitation — supervised breathing exercises and activity training to improve stamina and quality of life
• Vaccinations — to reduce the risk of respiratory infections, which can be particularly risky for people with ILD
• Regular monitoring — periodic lung function tests to track how the condition is progressing and adjust treatment accordingly

While most forms of ILD cannot be reversed, the goal of treatment is to slow progression, manage symptoms, and maintain the best possible quality of life for as long as possible.