PT  - JOURNAL ARTICLE
AU  - G. Raghu
AU  - T. D. Freudenberger
AU  - S. Yang
AU  - J. R. Curtis
AU  - C. Spada
AU  - J. Hayes
AU  - J. K. Sillery
AU  - C. E. Pope II
AU  - C. A. Pellegrini
TI  - High prevalence of abnormal acid gastro-oesophageal reflux in idiopathic pulmonary fibrosis
AID  - 10.1183/09031936.06.00037005
DP  - 2006 Jan 01
TA  - European Respiratory Journal
PG  - 136--142
VI  - 27
IP  - 1
4099  - http://erj.ersjournals.com/content/27/1/136.short
4100  - http://erj.ersjournals.com/content/27/1/136.full
SO  - Eur Respir J2006 Jan 01; 27
AB  - The aim of this prospective study was to determine the prevalence and characteristics of acid gastro-oesophageal reflux (GER) in patients with idiopathic pulmonary fibrosis (IPF). Sixty-five consecutive patients with well-defined IPF were subjected to 24-h pH monitoring and oesophageal manometry. A total of 133 consecutive patients with intractable asthma and symptoms of GER were used as comparisons. The prevalence of abnormal acid GER in IPF patients was 87%, with 76% and 63% demonstrating abnormal distal and proximal oesophageal acid exposures, respectively. Abnormal acid GER was significantly more common in IPF patients than asthma patients. Only 47% of IPF patients experienced classic GER symptoms. Despite treatment with standard doses of proton pump inhibitors (PPIs), 12 out of 19 patients receiving PPIs during the 24-h pH monitoring had abnormal oesophageal acid exposures by pH probe. There was no correlation between IPF severity and acid GER severity. In conclusion, abnormal acid gastro-oesophageal reflux is highly prevalent, but often clinically occult in patients with idiopathic pulmonary fibrosis. Standard doses of proton pump inhibitors may not suppress the acid gastro-oesophageal reflux in this population. Therefore, further studies are needed to determine if acid abnormal gastro-oesophageal reflux represents an important risk factor for idiopathic pulmonary fibrosis development or progression, and if optimal suppression of acid gastro-oesophageal reflux slows the progression of idiopathic pulmonary fibrosis and/or decreases episodic exacerbations of idiopathic pulmonary fibrosis.