RT Journal Article SR Electronic T1 Gastro-oesophageal reflux and gastric aspiration in idiopathic pulmonary fibrosis patients JF European Respiratory Journal JO Eur Respir J FD European Respiratory Society SP erj01012-2012 DO 10.1183/09031936.00101212 A1 Edoardo Savarino A1 Roberto Carbone A1 Elisa Marabotto A1 Manuele Furnari A1 Luca Sconfienza A1 Massimo Ghio A1 Patrizia Zentilin A1 Vincenzo Savarino YR 2013 UL http://erj.ersjournals.com/content/early/2013/03/07/09031936.00101212.abstract AB To characterize gastro-oesophageal reflux (GOR) in idiopathic pulmonary fibrosis (IPF).Forty consecutive IPF patients underwent pulmonary high-resolution computed tomography (HRCT) scan and impedance-pH monitoring off anti-secretory therapy. The presence of pulmonary fibrosis was assessed using validated HRCT-scores. Reflux features included distal oesophageal acid exposure, number of acid/weakly-acidic reflux episodes and their proximal migration. Forty consecutive patients with interstitial lung disease other than IPF (non-IPF patients) and 50 healthy volunteers (HVs) were also enrolled.IPF patients had significantly higher (p<0.01) oesophageal acid exposure (9.25[4.7–15.4] vs. 3.3[1.4–7.4] vs. 0.7[0–2.4.2]), number of acid (45[23–55] vs. 32[19–44] vs. 18[10–31]), weakly-acidic (34[19–43] vs. 21[11–33]) vs. 18[15–28]) and proximal reflux events (51[26.5–65.5] vs. 20[9.5–34.5] vs. 9[5–20]) compared to non-IPF patients and HVs. Pulmonary fibrosis HRCT-scores correlated well with reflux episodes in both distal (r2=0.567) and proximal (r2=0.6323) oesophagus. Patients with IPF had more bile acids and pepsin (p<0.03) in broncho-alveolar lavage (BAL) (62%/67%) and saliva (61%/68%) than non-IPF patients (25%/25% in BAL, 33%/36% in saliva) and controls (0%/0% in BAL/saliva).Acid GOR is common in IPF, but weakly-acidic GOR may also occur. Patients with IPF have risk or definite pulmonary aspiration of gastric contents. Outcome studies with intense anti-reflux therapy are needed.