Journal of Gastrointestinal Surgery

, Volume 18, Issue 1, pp 100–105 | Cite as

Idiopathic Pulmonary Fibrosis and Gastroesophageal Reflux. Implications for Treatment

  • Marco E. Allaix
  • Piero M. Fisichella
  • Imre Noth
  • Fernando A. Herbella
  • Bernardo Borraez Segura
  • Marco G. Patti
2013 SSAT Plenary Presentation



Even though the pathogenesis of idiopathic pulmonary fibrosis (IPF) is unknown, there is mounting evidence that abnormal reflux (GERD) and aspiration of gastric contents may play a role in the pathogenesis of this disease.


The aims of this study were to determine in patients with GERD and IPF: (a) the clinical presentation, (b) the esophageal function, and (c) the reflux profile.


We compared the clinical presentation, the esophageal function (as defined by high-resolution manometry), and the reflux profile (by dual sensor pH monitoring) in 80 patients with GERD (group A) and in 22 patients with GERD and IPF (group B).


Heartburn was present in less than 60 % of patients with GERD and IPF. Lower esophageal sphincter pressure and peristalsis were normal in both groups, while the upper esophageal sphincter (UES) was more frequently hypotensive in IPF patients (p = 0.008). In patients with GERD and IPF, the proximal esophageal acid exposure was higher (p = 0.047) and the supine acid clearance was slower as compared with patients with GERD only (p < 0.001).


The results of this study show that in patients with GERD and IPF: (a) reflux is frequently silent, (b) with the exception of a weaker UES, the esophageal function is preserved, and (c) proximal reflux is more common, and in the supine position, it is coupled with a slower acid clearance. Because these factors predisposing IPF patients to the risk of aspiration, antireflux surgery should be considered early after the diagnosis of IPF and GERD is established.


Idiopathic pulmonary fibrosis Gastroesophageal reflux disease Heartburn Esophageal manometry Ambulatory 24 h pH monitoring 



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Copyright information

© The Society for Surgery of the Alimentary Tract 2013

Authors and Affiliations

  • Marco E. Allaix
    • 1
  • Piero M. Fisichella
    • 2
  • Imre Noth
    • 3
  • Fernando A. Herbella
    • 1
  • Bernardo Borraez Segura
    • 1
  • Marco G. Patti
    • 1
  1. 1.Center for Esophageal Diseases, Department of SurgeryUniversity of Chicago Pritzker School of MedicineChicagoUSA
  2. 2.Swallowing Center and Department of SurgeryLoyola University Chicago, Stritch School of MedicineChicagoUSA
  3. 3.Department of MedicineUniversity of Chicago Pritzker School of MedicineChicagoUSA

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