Increased prevalence of gastroesophageal reflux in patients with idiopathic pulmonary fibrosis

Idiopathic pulmonary fibrosis (IPF) is a progressive, fatal interstitial lu ng disease (ILD) of unknown etiology. introduction of acid into the respira tory tree can produce pulmonary fibrosis. Gastroesophageal reflux (GER) has previously been associated with several other respiratory conditions, incl uding pneumonia, bronchitis, and asthma. To investigate prospectively the p ossible association of CER and IPF, 17 consecutive patients with biopsy-pro ven IPF and eight control patients with ILD other than IPF underwent dual-c hannel, ambulatory esophageal pH monitoring. Sixteen of 17 patients with IP F had abnormal distal and/or proximal esophageal acid exposure compared wit h four of eight control patients (p = 0.02). In the patients with IPF, mean percent distal total (13.6 versus 3.34, p = 0.006), distal upright (12.4 v ersus 5.1, p = 0.04), distal supine (14.7 versus 0.88, p = 0.02), and proxi mal supine (7.48 versus 0.24, p = 0.04) esophageal acid exposure times were significantly greater than those in control patients. Only four patients w ith IPF (25%) with increased acid exposure had typical reflux symptoms such as heartburn or regurgitation. Patients with IPF have a high prevalence of increased esophageal acid exposure, usually without typical GER symptoms, GER in these patients fends to occur at: night and extend into the proximal esophagus. Acid reflux may be a contributing factor in the pathogenesis of IPF.