Most people do not think twice about breathing — until it becomes difficult. Even then, they find explanations: the weather, a lack of exercise, or maybe just getting older. A cough lingers, climbing stairs feels harder than it used to be, but life goes on. Until one day, it does not.
As a pulmonologist, I see this pattern all the time. Patients come in, months or even years after their first symptoms appeared, and by then, the signs of interstitial lung disease are clear. The scarring in their lungs has progressed, their breathlessness is no longer subtle, and the conversation we now have is a much harder one than if they had walked in sooner. The signs that one should look out for are a persistent dry cough, shortness of breath especially during physical activity, fatigue, and chest discomfort; any of these should prompt a visit to the specialist.
When breathlessness feels normal
The challenge with ILD is not that it is difficult to diagnose — it is that people do not suspect it. Saudi Arabia has some of the best specialists, imaging technology, and treatment options, but that only matters if people know when to seek help. Right now, they don’t.
Unlike conditions such as diabetes or high blood pressure, ILD is not widely talked about. There are no routine screenings, no public awareness campaigns urging people to check their lung health. And so, patients wait. They adapt. They assume their symptoms are part of life rather than signs of something that needs medical attention.
I have met patients who thought their breathlessness was just a sign of aging. Others assumed it was allergies or the result of living in a dusty city. By the time they realize it is something more, their lung function has already declined. And here is the reality — what is lost cannot be regained.
Slowing the clock on ILD
Interstitial lung disease refers to a collection of over 200 disorders that cause inflammation and scarring of the lungs. This scarring stiffens the lungs, making it harder to breathe and for oxygen to reach the bloodstream. As a result, patients often feel short of breath and may have a persistent dry cough.
The problem with ILD is that it does not announce itself with urgency — it slips in, quietly. And while it does not wait, it can be slowed down with a proper prescribed treatment regime from the specialist. More attention to this disease means more awareness and better understanding, which could result in earlier detection and diagnosis.
No one expects you to panic over every cough. But imagine how much smoother life would be if you could simply consult a professional about that nagging symptom. If more people understood that persistent breathlessness and a dry cough could signal something serious, they would seek help sooner. And earlier intervention means more options, better outcomes, and the chance to slow the disease’s progression before it robs patients of what many take for granted. Treatments exist that can slow the decline of lung function, transforming months of uncertainty into years of stability. While those treatments cannot reverse the lung function decline, seeking help can improve outcomes.
The tools and expertise to improve ILD care in Saudi Arabia are already in place. What is missing is awareness. The real question is: how many more will continue ignoring their breath until it is too late?
In case of any side effects of the medications, please contact the Saudi Food and Drug Authority at the unified number 19999.
- The writer, Dr. Abdullah Sakkat, is a pulmonary medicine and interstitial lung disease consultant at King Abdulaziz University Hospital with Advanced Interstitial Lung Disease Fellowship at McMaster University Sep 2019 — Sep 2020.
