Gastro-esophageal reflux and idiopathic pulmonary fibrosis-new evidences of a causal relationship

Edoardo Savarino, Roberto Carbone, Elisa Marabotto, Simona Inferrera, Lorenzo Gemignani, Alberto Malesci, Vincenzo Savarino

Research output: Contribution to journalArticlepeer-review


Idiopathic pulmonary fibrosis (IPF) is a relentless and progressive lung disease of unknown etiology with no effective cure available. Recent data support the concept that chronic silent microaspiration (ie, aspiration of gastric acid, food, bile salts, and trypsin in forms of small droplets) could be involved in the pathogenesis, development, and progression of IPF. However, limited data are present on this direction and the precise relationship between chronic microaspiration and IPF remains poorly understood. It has been demonstrated that gastroesophageal reflux (GER) plays an important role in causing extra-esophageal symptoms, including chronic bronchitis, bronchiectasis, diffuse panbronchiolitis, recurrent pneumonia, chronic cough, hoarseness, and asthma. Moreover, it is considered a presumed risk factor for microaspiration. Recent studies evidenced that it is strongly associated with IPF with an estimated prevalence of up to 90%. This review aims to explore the relationship between GER and pulmonary fibrosis by highlighting the pathophysiologic mechanisms, the role of diagnostic testing, as well as the therapeutic options for this important group of patients. Furthermore, the gaps in our current understanding of the diagnosis and treatment of chronic microaspiration in patients with IPF will be highlighted. Clarifying the role of chronic microaspiration in IPF is essential because it could potentially have a widespread clinical impact on the progression of this fatal disease.

Original languageEnglish
Pages (from-to)39-46
Number of pages8
JournalAnnals of Respiratory Medicine
Issue number1
Publication statusPublished - 2012


  • Acid and nonacid reflux
  • Asthma
  • Impedance ph-metry
  • Interstitial lung disease
  • Microaspiration
  • Pulmonary fibrosis
  • Reflux disease

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine


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