To understand, ILD is a condition where interstitium or skeletal of lung get fibrosed, thickened leading to Poor takeover of oxygen. Hence oxygen levels start to drop, more often with activity, walk or stair climbing. ILD is an umbrella term and has variety of reasons and outcomes. In a variant, the disease may be rapidly progressive leading to early crippling and death, however on the other extreme it may be very slowly progressive or even may respond to treatment so well that may regress.  In all , there is no need to panic rather  take a professional advice, start the proper treatment and follow up regularly to know the exact response to treatment and prognosis.

To ascertain the cause of ILD and extent of the disease many tests would be required. Routine blood test, HRCT Chest(high resolution cat scan), pulmonary function including diffusion capacity, walk test or oxygen desaturation test, work up for rheumatic disorders(CTD), HYPERSENSITIVITY PNEUMONITIS, exposure to organic dusts, occupational history all would be needed for a fresh case. Cardiac evaluation and extra-pulmonary systems would also be assessed in appropriate cases. Few of these tests might need to be repeated for response assessment.  History of exposure to pets, birds, molds/funguses, damp surroundings, grain storage, industrial gases and chemicals, indoor plants all is important and should be shared with treating doctor. For some patients, lung biopsy might be needed.  Lung -biopsy usually done by fiberoptic bronchoscopy +- cryo-probe. Some patients may be advised open lung biopsy/VATS biopsy. 

PFT and six minute walk test are functional tests needed more often. Progressive cases would need oxygen supplementation at home. Controlling weight, smoking habit, coexistent asthma or any other ailment has to be treated well. Keeping the surroundings clean and free of air-pollution also partially helps. For drug management, steroids,  immune-suppressants and anti-fibrotic medicines are frequently required. All these medicines do have serious side effects and therefore regular review and follow up is a necessity.  Drug doses, steroid doses are gradually tapered down or titrated as per control of disease and symptoms.  Other supportive drugs, nebulization or bronchodilators, cough suppressant, anti-oxidants/ vitamin supplements are prescribed. At times disease may progress despite of treatment as well there may be time to time variations and exacerbations causing unscheduled opd  or emergency visits.