Interstitial lung disease (ILD) is an umbrella term for many different lung diseases. All cause scarring and stiffness in the lungs. The damage from ILD is usually permanent and gets worse over time.

Your lungs have tiny sacs called alveoli. They expand with each breath and allow oxygen to enter the bloodstream.

The interstitium is the tissue around the air sacs. It can get inflamed and scarred for many reasons. The stiff tissue can’t expand and contract normally to move air in and out of your lungs.

There are many different causes of ILD. They include side effects of medicine, cancer treatments, and breathing in toxic substances. In many cases, doctors don’t know what causes ILD.

Anyone can get an ILD, even children. Risk factors include:

• Family history of ILD
• A job where you get exposed to mold, chemicals, or bacteria
• A job in mining or construction
• Smoking
• Certain heart and cancer medicines
• Having an autoimmune disorder

 Symptoms of ILD include:

• Shortness of breath that gets worse over time
• Dry cough
• Unexplained weight loss
• Chest pain
• Fatigue
• Muscle pain
• Joint pain

There are many different types of ILD. They all cause scarring and stiffness in the lungs, leading to shortness of breath. Some of the most common types are:

• Idiopathic pulmonary fibrosis: The most common form of ILD. It causes lung scarring when the exact cause is unknown.
• Sarcoidosis: An autoimmune disease that causes inflammation. It can show up as nodules in the lungs and other organs.
• Hypersensitivity pneumonitis: An allergic reaction in the lungs. It’s caused by breathing in certain irritants. These include dust, mold, fungus, or workplace exposures such as coal, cotton, asbestos, or silica dust.
• Connective tissue disease–associated ILD: Autoimmune diseases can cause inflammation and scarring in the lungs. Examples include scleroderma, rheumatoid arthritis, or lupus.

At Carilion, the specialists at the Interstitial Lung Disease Clinic will order tests to confirm a diagnosis. Blood tests can check for infections or autoimmune disease. Imaging tests, such as chest X-rays and CT scans, provide detailed pictures of your lungs.

Lung function tests show how much air your lungs can hold and how well you breathe. Advanced testing may also include bronchoscopy, where doctors use a small camera to look inside your air passages.

Treatment for your ILD depends on the type you have and how severe it is. We can’t usually cure an ILD. Instead, care focuses on managing your symptoms, slowing the disease, and improving your quality of life.

In general, the earlier we catch the ILD, the more options and better outcomes you have.

ILD treatment can include:

• Medicines: Bronchodilators relax airway muscles to help you breathe more easily. Corticosteroids reduce lung inflammation. Antifibrotics slow lung damage by blocking scar-causing cells. Immunosuppressants can also help control your immune system if it's attacking your lungs.
• Lifestyle changes: If you smoke, we can help you quit. If your ILD is due to workplace exposures, you'll need to avoid them to protect your lungs.
• Positive airway pressure devices: Many people with ILD also have obstructive sleep apnea. A CPAP (continuous positive airway pressure) or BiPAP (bilevel positive airway pressure) machine can help keep airways open while you sleep.
• Oxygen therapy: In more advanced cases, oxygen therapy at home can improve your breathing and energy levels.
• Pulmonary rehabilitation: Structured programs include exercise, breathing strategies, nutrition support, education, and counseling. These services help you build strength, manage symptoms, and improve quality of life.
• Supportive care: We focus on relieving symptoms such as cough, fatigue, or anxiety. Our team can also connect you with counseling and resources to support your mental and emotional health.
• Thoracic surgery: In severe cases, surgery may be an option. Some people with ILDs may qualify for a lung transplant. While we don’t perform transplants at Carilion, we handle pre-op evaluations and partner with transplant centers for care and follow-up.