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Background: While the pathogenesis of idiopathic pulmonary fibrosis (IPF) is multifactorial, it has been shown that the prevalence of abnormal reflux (GERD) is very high, and that antireflux surgery may affect the progression of this disease.
Aims: The aims of this study were to compare in a group of patients with GERD and a group of patients with GERD and IPF: a) the clinical presentation; b) the esophageal function as defined by high resolution manometry; and c) the reflux profile by dual sensor pH monitoring.
Patients and methods: We compared the clinical presentation, the esophageal function and the reflux profile in 80 patients with GERD and in 22 patients with GERD and IPF.
Results: Data are expressed as mean ± SD.
Conclusions: The results of this study show that in patients with GERD and IPF: a) heartburn is present in less than 60% of patients; b) with the exception of a weaker UES, the esophageal function is preserved; and c) proximal reflux is more common, and in the supine position it is coupled with a slower acid clearance. Because these factors expose IPF patients to the risk of aspiration, antireflux surgery should be considered early in the course of the disease.

	GERD (80 patients)	GERD + IPF (22 patients)	P value
Age (years)	55.7 ± 15	61.3 ± 8.9	0.098
Gender (male), N (%)	31 (38.8)	13 (59.1)	0.143
Heartburn, N (%)	67 (83.8)	13 (59.1)	0.028
LES pressure (mmHg)	19.9 ± 9.7	20.5 ± 11.9	0.807
Normal peristalsis, N (%)	51 (63.8)	14 (63.6)	0.810
Hypotensive UES, N (%)	6 (7.5)	7 (31.8)	0.008
% time <4, total Distal Proximal	9.7 ± 6.6 0.9 ± 1.1	12.7 ± 13.6 2.5 ± 6.9	0.149 0.047
Acid clearance, total (seconds) Distal Proximal	85.3 ± 65.2 42.4 ± 67.1	137.5 ± 112.4 169.9 ± 406.8	0.006 0.008
% time <4, supine Distal Proximal	10.5 ± 12.8 0.5 ± 1.2	8.6 ± 17.1 2.9 ± 7.6	0.569 0.007
Acid clearance, supine (seconds) Distal Proximal	181.1 ± 270.1 47.6 ± 72.3	171.5 ± 259.9 899.1 ± 1668.1	0.882<0.001