INTERSTITIAL lung disease (ILD) is an umbrella term that refers to more than 200 diseases that cause progressive scarring (fibrosis) or inflammation of lung tissue.
People with ILD experience difficulty breathing as the lung tissue becomes thickened and stiff, making it hard to expand and fill up with sufficient oxygen.
Sarawak General Hospital internal medicine physician and pulmonologist Dr Kho Sze Shyang says a patient is more likely to develop ILD if they are over the age of 70 or male, as both age and gender increase susceptibility.
Idiopathic pulmonary fibrosis (IPF) is the most common of ILDs.
Institute of Respiratory Medicine respiratory physician Dr Syazatul Syakirin Sirol Aflah says the disease typically affects older adults, most commonly men with a history of smoking.
“The term ‘idiopathic’ means that the cause of fibrosis is unknown.”
The disease advances over time. However, the speed of progression will vary from person to person. In some, IPF progresses slowly over several years, while in others it can progress rapidly within a year.
ILD remains a relatively rare and frequently underdiagnosed condition in Malaysia.
According to the Galen Centre’s White Paper on Interstitial Lung Disease in Malaysia, the estimated prevalence ranges from 67 to 98 cases per 100,000 people, with an incidence of 19 to 32 new cases per 100,000 per year.
Based on these figures, ILD may affect over 80,000 Malaysians, although the actual number is likely higher due to underreporting and diagnostic challenges.
Most cases are identified among middle-aged and older adults, particularly men over 50, but paediatric cases have also been recorded.
Environmental and occupational exposures may contribute to the disease appearing in younger patients, though men remain disproportionately affected overall.
Like most types of ILD, the main symptoms of IPF are shortness of breath and a persistent dry cough, says Dr Kho.
People with IPF often experience shortness of breath, especially during physical activity, and may notice that their breathing becomes short and shallow. A persistent and chronic dry cough for longer than four to eight weeks is also common.
“Many patients present only when the disease is advanced, often more than six months to a year after onset,” says Dr Kho.
If someone has been suffering from a chronic, persistent dry cough that lasts for longer than four to eight weeks and other symptoms such as worsening shortness of breath or fatigue, they should immediately consult a doctor to rule out ILD, he adds.
Early diagnosis is critical because permanent lung damage can occur before symptoms become obvious and limit the efficacy of treatments.
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