PT - JOURNAL ARTICLE AU - Edoardo Savarino AU - Roberto Carbone AU - Elisa Marabotto AU - Manuele Furnari AU - Luca Sconfienza AU - Massimo Ghio AU - Patrizia Zentilin AU - Vincenzo Savarino TI - Gastro-oesophageal reflux and gastric aspiration in idiopathic pulmonary fibrosis patients AID - 10.1183/09031936.00101212 DP - 2013 Nov 01 TA - European Respiratory Journal PG - 1322--1331 VI - 42 IP - 5 4099 - http://erj.ersjournals.com/content/42/5/1322.short 4100 - http://erj.ersjournals.com/content/42/5/1322.full SO - Eur Respir J2013 Nov 01; 42 AB - The aim of the study was to characterise gastro-oesophageal reflux (GOR) in idiopathic pulmonary fibrosis (IPF). 40 consecutive IPF patients underwent pulmonary high-resolution computed tomography (HRCT) scan and impedance-pH monitoring while off antisecretory 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. 40 consecutive patients with interstitial lung disease other than IPF (non-IPF patients) and 50 healthy volunteers were also enrolled. IPF patients had significantly higher (p<0.01) oesophageal acid exposure (median (interquartile range (IQR)) 9.25 (4.7–15.4)% versus 3.3 (1.4–7.4)% versus 0.7 (0.2–4.2)%, number of acid (median (IQR) 45 (23–55) versus 32 (19–44) versus 18 (10–31)), weakly acidic (median (IQR) 34 (19–43) versus 21 (11–33) versus 18 (15–28)) and proximal reflux (median (IQR) 51 (26.5–65.5) versus 20 (9.5–34.5) versus 9 (5–20)) events compared to non-IPF patients and healthy volunteers, respectively. Pulmonary fibrosis HRCT scores correlated well with reflux episodes in both the distal (r2=0.567) and proximal (r2=0.6323) oesophagus. Patients with IPF had more bile acids and pepsin (p<0.03) in bronchoalveolar lavage fluid (BALF) (62% and 67%, respectively) and saliva (61% and 68%, respectively) than non-IPF patients (25% and 25% in BALF, and 33% and 36%, respectively, in saliva) and controls (0% and 0% in BALF and saliva, respectively). Acid GOR is common in IPF, but weakly acidic GOR may also occur. Patients with IPF had a risk of pulmonary aspiration of gastric contents. Outcome studies with intense antireflux therapy are needed. Frequent acid/weakly acidic gastro-oesophageal reflux and high risk of pulmonary aspiration of gastric contents in IPF http://ow.ly/nSNv8