Idiopathic pulmonary fibrosis and GERD: links and risks

Gastroesophageal reflux disease (GERD) and idiopathic pulmonary fibrosis (IPF) are two pathological conditions often strictly related, even if a clear relationship of causality has not been demonstrated.

GERD is a frequent comorbidity in IPF patients, as demonstrated using combined multichannel intraluminal impedance-pH, despite being mostly clinically silent. According to that, it has been hypothesized that microaspiration of gastric material may play a fundamental role in the fibrotic transformation of pulmonary parenchyma.

This study aimed to determine whether patients with IPF were more likely to have GERD compared with age- and sex.

Take Home Message:

Idiopathic Pulmonary Fibrosis (IPF) patients had almost double the risk of having GERD compared with patients with no lung disease.

The odds of GERD before a diagnosis of interstitial lung disease appeared greater in patients with non-IPF ILD than IPF.

GERD may be an important contributor to the development of lung fibrosis.

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Background: It is unknown whether gastroesophageal reflux disease (GERD) is a risk factor or consequence of idiopathic pulmonary fibrosis (IPF). This study aimed to determine whether patients with IPF were more likely to have GERD compared with age- and sex-matched controls who either had 1) interstitial lung disease (ILD) other than IPF or 2) no diagnosed lung disease (population control).

Methods: We used the medical records-linkage system of the Rochester Epidemiology Project (REP) to identify patients with IPF who resided in Olmsted County, Minnesota, from January 1, 1997, through June 30, 2017. IPF cases were each matched with patients from 2 control groups (non-IPF ILD controls and population controls). We used conditional logistic regression to model associations between GERD diagnosis and IPF case status. P values were adjusted for multiple comparisons by using the Bonferroni adjustment.

Results: One hundred thirteen IPF cases were identified and matched to 226 population controls and 226 controls with non-IPF ILD. After multivariable adjustment, the odds of having GERD were 1.78 times higher in IPF cases compared with population controls. After multivariable adjustment, the odds of having GERD were 0.46 times lower in IPF cases compared with non-IPF ILD controls.

Conclusion: GERD may be an important contributor to the development of lung fibrosis. Thus, it should be investigated and addressed adequately when detected in patients with IPF and patients with non-IPF ILD.

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https://www.sciencedirect.com/science/article/abs/pii/S0954611121000159
https://pubmed.ncbi.nlm.nih.gov/33517156/

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