To the Editors:
Idiopathic pulmonary fibrosis (IPF) is a relentlessly progressive disease of unknown aetiology. Current theory regarding the pathogenesis of IPF suggests that recurrent exposure of the lungs to repeated injury and/or antigen of “unknown origin” leads to the release of pro-fibrotic growth factors and fibrosis 1. The nature of the triggering injury and/or antigen remains a mystery. A number of studies have documented high prevalence of gastro-oesophageal reflux disease (GERD) in patients with IPF in up to 90% of patients 2, 3. This has led to the assumption that recurrent micro-aspiration of acid droplets causes, or contributes to, the recurrent insults to the lungs and the development of …