title: Gastroesophageal reflux and idiopathic pulmonary fibrosis: a prospective study.
abstract: OBJECTIVE
  Idiopathic pulmonary fibrosis (IPF) is the most common of the idiopathic interstitial pneumonias. There is evidence of the increased prevalence of gastroesophageal reflux disease in patients with IPF. The aim of this prospective study was to evaluate reflux in patients with IPF by analyzing the scores of the reflux cough questionnaire, measurement of pepsin in exhaled breath condensate (EBC) to detect extraesophageal reflux, and Helicobacter pylori serology to evaluate the prevalence of this stomach bacterium in patients with IPF.
  
  
  METHODS
  The Hull airway reflux questionnaire (HARQ) was completed by 40 patients with IPF and 50 controls in order to evaluate reflux symptoms. EBC was collected from 23 patients (17 patients with IPF and 6 controls) for measurement of pepsin by the lateral flow technique. A prospective study of 57 subjects (34 patents with IPF and 23 controls) for H. pylori antibody detection by ELISA was preformed.
  
  
  RESULTS
  Significantly higher HARQ scores (maximum score, 70) were recorded in patients with IPF compared with controls (19.6 [SD, 12.4] vs. 3 [SD, 2.9], P<0.001). There was no significant difference in EBC pepsin positivity between patients with IPF and controls (2 of the 17 patients vs. none of the 6 controls, P=0.38). There was no significant difference in H. pylori serology between patients with IPF and controls (17 of the 34 patients vs. 14 of the 23 controls, P=0.42).
  
  
  CONCLUSIONS
  Patients with IPF had significantly increased scores of airway reflux symptoms. However, no objective evidence of extraesophageal reflux or H. pylori infection in patients with IPF was obtained in this study. The role of gastroesophageal and extraesophageal reflux in pathogenesis of IPF should be evaluated in a larger prospective study.
authors.affiliation: Division of Cardiovascular and Respiratory Studies, Castle Hill Hospital, Cottingham, United Kingdom. ahmedfahim@doctors.org.uk
authors.forename: Ahmed
authors.initials: A
authors.lastname: Fahim
authors.forename: Peter W
authors.initials: PW
authors.lastname: Dettmar
authors.forename: Alyn H
authors.initials: AH
authors.lastname: Morice
authors.forename: Simon P
authors.initials: SP
authors.lastname: Hart
mesh_terms: D000368:Aged; D000907:Antibodies, Bacterial / Q000097:blood; D005260:Female; D005764:Gastroesophageal Reflux / Q000453:epidemiology* / Q000382:microbiology; D016481:Helicobacter Infections / Q000150:complications / Q000453:epidemiology*; D016480:Helicobacter pylori / Q000276:immunology / Q000302:isolation & purification; D006801:Humans; D054990:Idiopathic Pulmonary Fibrosis / Q000453:epidemiology* / Q000382:microbiology; D008097:Lithuania / Q000453:epidemiology; D008297:Male; D015995:Prevalence; D011446:Prospective Studies; D011795:Surveys and Questionnaires
chemical_list: D000907:Antibodies, Bacterial