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Idiopathic Pulmonary Fibrosis

Jeremy Feldman, MD

  • What is Idiopathic Pulmonary Fibrosis?
    • Idiopathic Pulmonary Fibrosis Definition
    • Symptoms of Idiopathic Pulmonary Fibrosis
    • Causes of Idiopathic Pulmonary Fibrosis
    • Who Gets Idiopathic Pulmonary Fibrosis
    • Gastro-Esophageal Reflux (GER) and Idiopathic Pulmonary Fibrosis
    • Interstitial Lung Disease vs. Idiopathic Pulmonary Fibrosis
    • Is Pulmonary Fibrosis Hereditary?
    • Research, Life Expectancy and Prognosis for Idiopathic Pulmonary Fibrosis
  • Diagnosing & Monitoring PF
    • Monitoring Progress of IPF
    • Idiopathic Pulmonary Fibrosis Diagnosis
    • Chest X-rays Used in IPF
    • CPET used in IPF
    • HRCT Scans Used to Evaluate IPF
    • Lung Biopsy To Diagnose IPF
    • Pulmonary Function Tests (PFTS)
    • Six Minute Walk Test To Monitor IPF
    • Stages of Idiopathic Pulmonary Fibrosis
    • Complications of Idiopathic Pulmonary Fibrosis
  • PF Treatment Options
    • Esbriet (pirfenidone) Used to Treat IPF
    • OFEV (nintedanib) Used to Treat IPF
    • Pulmonary Rehab for IPF Patients
    • Lung Transplantation for Pulmonary Fibrosis
    • Oxygen Used to Treat IPF
      • Update on Oxygen Use
    • Clinical Trials in Idiopathic Pulmonary Fibrosis
    • IPF & Leg Swelling
    • Pulmonary Hypertension and Idiopathic Pulmonary Fibrosis
    • IPF Exacerbation
  • PF Advocacy & News
  • FAQ’s
    • Respiratory failure, NSIP, diet
    • Leg swelling, lung biopsy, side effects & pets
    • FAQ’s Enzyme Therapy, Progression of IPF & Oxygen
    • FAQ: Diarrhea, Fibrosis Reversal, IPF Symptoms
    • FAQ: Oxygen Flow, Anesthesia & Genetics
    • FAQ: Contagious Cough? Stem Cells, Familial IPF, Flying
    • FAQ: GERD, Fatigue & Environmental Exposure
    • FAQ: How to Travel to Your Doctor’s Office with Oxygen
    • FAQ: Lung Biopsy with Pulmonary Fibrosis
    • FAQ’s: Alcohol, Clinical Trials, Pulmonary Function Testing
    • FAQs: Emphysema, Exercise & Lung Biopsy

FAQ: GERD, Fatigue & Environmental Exposure

October 20, 2017 By Dr. Jeremy Feldman

We appreciate our readers submitting questions. We try and choose a selection to answer that is representative of common issues in IPF. 

GERD may contribute to IPF

GERD and IPF

We receive many questions about GERD (gastro-esophageal reflux disease) and IPF. This has been a very controversial area of research in IPF. There is good quality data that GERD symptoms and signs of GERD on invasive testing are much more common in patients with IPF than age-matched healthy adults.

What remains unclear is whether the reflux causes IPF and we have not been able to show convincingly that treating GERD consistently improves the course of IPF. My general approach is to look for GERD in patients with IPF. I believe that we have become too focused on pills to treat problems rather than changing behavior. In GERD, diet often plays a huge role. Removing caffeine, citrus, alcohol, spicy foods, deep fried foods, late meals, large meals often is much more important that taking a pill to reduce stomach acid production. Elevating the head of the bed also may be very helpful. In patients who continue to have problems adding acid suppressing medicines is reasonable. For more details about GERD and IPF click here.

Fatigue and IPF

We have written extensively about cough and IPF and shortness of breath. We have not written much about fatigue in patients with IPF. Fatigue can be a disabling symptom in patients with lung disease. Patients often ask what causes the fatigue. The short answer is that there are many contributing causes:

  1. Low oxygen levels with activity
  2. Increased work of breathing results
  3. Decreased blood flow through your heart from pulmonary hypertension
  4. Poor sleep quality
  5. Emotional stress (anxiety/depression/worrying)
  6. Deconditioning (your muscles get out of shape)

Strategies to reduce fatigue involve addressing the above issues. Use your oxygen when you are active. Ask your doctor to consider if you might have pulmonary hypertension. Work on improving your sleep quality (your pulmonologist or primary care doctor will have suggestions). Take time to tackle the emotional hurdles of having IPF. Don’t neglect your muscles. Many patients benefit from pulmonary rehabilitation (structured exercise programs supervised by respiratory therapists).

Environment and IPF

We often receive questions about whether certain environmental exposures can make IPF worse. As we don’t have a precise understanding of the causes of IPF it is difficult to give a precise answer. However, my general advice is as follows:

  1. Avoid high altitude. The higher you go the less oxygen in the air. This leads to lower blood oxygen levels for everyone but especially for patients with IPF. If you have a pulse oximeter you can measure your oxygen levels. Using supplemental oxygen can help but you will still feel more short of breath and have reduced exercise capacity.
  2. Avoid poor air quality. Patients with IPF (or any chronic lung disease) already have lungs that are not working properly. Avoid dusty environments, smoke exposure and pay attention to air quality warnings from the health department.
  3. Avoid extremes of temperature. My patients consistently tell me that hot/humid conditions and very cold conditions make them feel worse.

Filed Under: FAQ's

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What is IPF?

  • What is Idiopathic Pulmonary Fibrosis?
    • Symptoms of Idiopathic Pulmonary Fibrosis
    • Causes of Idiopathic Pulmonary Fibrosis
    • Who Gets Idiopathic Pulmonary Fibrosis
    • Gastro-Esophageal Reflux (GER) and IPF
    • Interstitial Lung Disease vs. Idiopathic Pulmonary Fibrosis
    • Is Pulmonary Fibrosis Hereditary?
    • Research, Life Expectancy & Prognosis for Pulmonary Fibrosis

Diagnosing IPF

  • Idiopathic Pulmonary Fibrosis Diagnosis
    • Chest X-rays Used in IPF
    • CPET used in IPF
    • HRCT Scans Used to Evaluate IPF
    • Lung Biopsy To Diagnose IPF
    • Pulmonary Function Tests (PFTS)
    • Six Minute Walk Test To Monitor IPF
    • Stages of Idiopathic Pulmonary Fibrosis
    • Complications of Idiopathic Pulmonary Fibrosis

Treating IPF

  • Pulmonary Fibrosis Treatment Options
    • Esbriet (pirfenidone) Used to Treat IPF
    • OFEV (nintedanib) Used to Treat IPF
    • Pulmonary Rehab for IPF Patients
    • Lung Transplantation for Pulmonary Fibrosis
    • Oxygen Used to Treat IPF
    • Clinical Trials in Idiopathic Pulmonary Fibrosis
    • IPF & Leg Swelling
    • Pulmonary Hypertension and Idiopathic Pulmonary Fibrosis
    • IPF Exacerbation

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