• Home
  • About Us

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

Pulmonary Fibrosis and Gastro-Esophageal Reflux: 2019 Update

January 30, 2019 By Dr. Jeremy Feldman

GERD may contribute to IPF

Pulmonary fibrosis may result from many assaults to the lungs including chronic inflammation, severe or recurrent pneumonia and also recurrent severe gastro-esophageal reflux (GER) that leads to aspiration of stomach contents into your lungs.  Over the years there has been variable focus on GER and its contribution to idiopathic pulmonary fibrosis (IPF).  Early data suggested a strong link and then some more recent studies suggested that there was not much of a causal relationship.

WRAP-IPF Study

In a first of its kind study, 58 patients were randomized to either anti-reflux surgery (called fundoplication—wrapping the stomach around the bottom of the esophagus to prevent reflux) or the comparison group.  28 patients underwent the surgery and 28 patients served as a comparison group. To be eligible to participate all patients had to have IPF, an FVC > 50% predicted and proven GER on 24 hour pH probe testing (a test that involves a small pH probe placed in the esophagus and left there for 24 hours).  Patients were followed for 48 weeks and repeat pulmonary function tests were performed and in the surgical group repeat 24 hour pH probe testing was also done.

At the end of the 48-week period, the surgical group had less decline in lung function compared to the comparison group.  This difference did not reach statistical significance.  There were similar numerical differences favoring surgery for frequency of exacerbations, death and hospitalization but none reached statistical significance.  This means that although the results are very interesting, they failed to prove that the surgery was effective.  This type of statistically negative though numerically positive result does not prove that the surgery is useless.  The definitive answer to the role of anti-reflux surgery will require a much larger study with 400 patients not 58 patients.

Another criticism of the study is that the comparison group was not offered acid suppressing therapy. Perhaps a more clinically meaningful comparison would have been between anti-reflux surgery and patients taking optimal acid suppressing medications.

So Where do We Stand at the Start of 2019 with Acid Reflux and IPF?

Gastro-esophageal reflux remains an important concern for patients with IPF and its role in pushing the disease forward remains unclear.  The value of aggressively treating GER remains controversial and will no doubt be the topic of future studies.

Filed Under: IPF Diagnosis

Featured Blog Posts

IPF cough

2020 Update on Cough and Pulmonary Fibrosis

easing shortness of breath

Easing Shortness of Breath in Pulmonary Fibrosis

IPF cough

Coughing Up Blood – Hemoptysis

Recent Posts

  • Interstitial Lung Disease and Progressive Pulmonary Fibrosis
  • Pamrevlumab Ineffective in Treating IPF
  • New Drugs Moving Forward for IPF

Search by Keyword (Examples: GERD, Coughing, Traveling, etc.)

Search by Category

Popular Articles

IPF patient with doctor

Idiopathic Pulmonary Fibrosis Treatment Options

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

Disclaimer