Gastroesophageal Reflux Disease and Idiopathic Lung Fibrosis. From Heartburn to Lung Transplant, and Beyond

Abstract

Idiopathic pulmonary fibrosis (IPF) and gastroesophageal reflux disease (GERD) are undoubtedly related. Even though it is not clear yet which one is the primary disease, they certainly interact increasing each other’s severity. Symptoms are unreliable to diagnose GERD in patients with IPF, and objective evaluation with pH monitoring and/or bronchoalveolar lavage analysis is mandatory. Pharmacological treatment with proton pump inhibitors (PPIs) may bring control of IPF in few patients, but PPIs do not control reflux but just change the pH of the gastric refluxate. Surgical therapy based on a fundoplication is safe and effective as it controls any type of reflux, independently from the pH of the gastric refluxate. In patients waiting for lung transplantation (if they can tolerate a laparoscopic operation under general anesthesia), a fundoplication before the operation might block the progression of IPF, while after transplantation it might prevent rejection by preventing the bronchiolitis obliterans syndrome.

Management of musculoskeletal pain in patients with idiopathic pulmonary fibrosis: a review

“…The presence of associated cardiovascular diseases can cause and intensify the chest pain in patients with IPF (45). IPF is also linked to GORD, which can cause discomfort or burning in the chest (46,47). Chronic pain has biological, psychological, and societal consequences.…”

Prediction and analysis of genetic effect in idiopathic pulmonary fibrosis and gastroesophageal reflux disease

“…Also, a study including over 100,000 participants revealed the prevalence of pulmonary fibrosis is significantly higher than that of healthy controls [15]. Recently, some studies have suggested that the acid inhalation caused by GERD may be associated with pulmonary fibrosis, while pulmonary diseases may promote an altered transdiaphragmatic pressure gradient and cause GERD [16,17]. However, the underlying mechanism between IPF and GERD still remains ambiguous and needs further exploration.…”