Gastroesophageal Reflux and Idiopathic Pulmonary Fibrosis

Idiopathic pulmonary fibrosis (IPF) is a specific form of chronic and progressive fibrosing interstitial pneumonia of unknown cause. IPF is the most common form of idiopathic interstitial pneumonia (IIP) and accounts for 50–60% of these diseases. Even though the cause of IPF is unknown, various exposures such cigarette smoking, metal/wood dust, certain drugs and importantly gastroesophageal reflux (GER) have been associated with IPF. There is an increasing body of literature regarding the relationship between GER and IPF, particularly over the last decade. This has culminated in anti-acid medications receiving a conditional recommendation for use in patients with IPF in the most recent American Thoracic Society/European Respiratory Society/Japanese Respiratory Society and Latin American Thoracic Associate guidelines for the treatment of IPF. This chapter will explore the proposed pathologic relationship between IPF and GER as well as treatments, outcomes and future directions.