title: Gastroesophageal Reflux and Idiopathic Pulmonary Fibrosis.
abstract: Idiopathic pulmonary fibrosis (IPF) is a progressive interstitial lung disease of unknown origin that affects about 40,000 new patients every year in the USA. Albeit the disease is labelled as idiopathic, it is thought that pathologic reflux, often silent, plays a role in its pathogenesis through a process of microaspiration of gastric contents.
  
  
  
  The aim of this study was to review the available evidence linking reflux to IPF, and to study the effect of medical and surgical therapy on the natural history of this disease.
  
  
  
  Medical therapy with acid-reducing medications controls the production of acid and has some benefit. However, reflux and aspiraion of weakly acidic or alkaline gastric contents can still occur. Better results have been reported after laparoscopic anti-reflux surgery, as this form of therapy re-establishes the competence of the lower esophageal sphincter, therefore stopping any type of reflux.
  
  
  
  A phase II NIH study in currently in progress in the USA to determine the role of antireflux surgery in patients with GERD and IPF. The hope is that this simple operations might alter the natural history of IPF, avoiding progression and the need for lung transplantation.
authors.affiliation: Department of Surgical Sciences, University of Torino, Turin, Italy.
authors.forename: Marco E
authors.initials: ME
authors.lastname: Allaix
authors.affiliation: Department of Surgical Sciences, University of Torino, Turin, Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Rebecchi
authors.affiliation: Department of Surgical Sciences, University of Torino, Turin, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Morino
authors.affiliation: Center for Esophageal Diseases and Swallowing, University of North Carolina at Chapel Hill, Chapel Hill, USA.
authors.forename: Francisco
authors.initials: F
authors.lastname: Schlottmann
authors.affiliation: Center for Esophageal Diseases and Swallowing, University of North Carolina at Chapel Hill, Chapel Hill, USA. marco_patti@med.unc.edu.
authors.forename: Marco G
authors.initials: MG
authors.lastname: Patti
mesh_terms: D005764:Gastroesophageal Reflux / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D054990:Idiopathic Pulmonary Fibrosis / Q000209:etiology*; D054328:Proton Pump Inhibitors / Q000627:therapeutic use
chemical_list: D054328:Proton Pump Inhibitors