Idiopathic pulmonary fibrosis and gastroesophageal reflux

Idiopathic pulmonary fibrosis (IPF) is a rare and progressive chronic respiratory disease. Although interconnections between gastroesophageal reflux disease (GERD) and IPF are numerous, their relationship is still controversial. Pathogenetic hypotheses involve micro-aspiration of gastric acid causing inflammation and then remodeling of lung structure until fibrosis, even to acute accelerating exacerbations of IPF. Moreover, IPF may itself aggravate GERD increasing intrathoracic pressure. Several studies have evaluated the possible beneficial effects of antacid and antireflux therapies on patients' outcomes and pulmonary function, but results are still conflicting. This narrative review explores many aspects of the relationship between IPF and GERD, including pathogenesis, clinical implications, medical and surgical GERD therapies, summarizing the results of most important studies conducted in this specific field.