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      High prevalence of abnormal acid gastro-oesophageal reflux in idiopathic pulmonary fibrosis.

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          Abstract

          The aim of this prospective study was to determine the prevalence and characteristics of acid gastro-oesophageal reflux (GER) in patients with idiopathic pulmonary fibrosis (IPF). Sixty-five consecutive patients with well-defined IPF were subjected to 24-h pH monitoring and oesophageal manometry. A total of 133 consecutive patients with intractable asthma and symptoms of GER were used as comparisons. The prevalence of abnormal acid GER in IPF patients was 87%, with 76% and 63% demonstrating abnormal distal and proximal oesophageal acid exposures, respectively. Abnormal acid GER was significantly more common in IPF patients than asthma patients. Only 47% of IPF patients experienced classic GER symptoms. Despite treatment with standard doses of proton pump inhibitors (PPIs), 12 out of 19 patients receiving PPIs during the 24-h pH monitoring had abnormal oesophageal acid exposures by pH probe. There was no correlation between IPF severity and acid GER severity. In conclusion, abnormal acid gastro-oesophageal reflux is highly prevalent, but often clinically occult in patients with idiopathic pulmonary fibrosis. Standard doses of proton pump inhibitors may not suppress the acid gastro-oesophageal reflux in this population. Therefore, further studies are needed to determine if acid abnormal gastro-oesophageal reflux represents an important risk factor for idiopathic pulmonary fibrosis development or progression, and if optimal suppression of acid gastro-oesophageal reflux slows the progression of idiopathic pulmonary fibrosis and/or decreases episodic exacerbations of idiopathic pulmonary fibrosis.

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          Author and article information

          Journal
          Eur Respir J
          The European respiratory journal
          European Respiratory Society (ERS)
          0903-1936
          0903-1936
          Jan 2006
          : 27
          : 1
          Affiliations
          [1 ] Division of Pulmonary and Critical Care Medicine, University of Washington, Seattle, WA 98195, USA. graghu@u.washington.edu
          Article
          27/1/136
          10.1183/09031936.06.00037005
          16387946
          2aa996f7-daeb-4c45-b99d-783740cd3a6d
          History

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