A new study has demonstrated a causal link between gastroesophageal reflux disease (GERD) and the development of idiopathic pulmonary fibrosis (IPF) and other chronic respiratory diseases, including asthma, chronic obstructive pulmonary disease (COPD), and chronic bronchitis.

The study, published in BMC Pulmonary Medicine, suggests that a process in GERD-associated microaspiration of stomach contents might contribute to pulmonary fibrosis in these conditions.

“With the availability of summary data from genome-wide association study databases, it is possible to explore the potential relationship and causality between GERD and chronic respiratory diseases,” the authors wrote. “In this study, we utilized published genome-wide association study summary data and conducted Mendelian randomization analyses to comprehensively evaluate the causality.”

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The research team assessed causation between exposure and causality, specifically between GERD and chronic respiratory diseases and 12 related risk factors. Seventy-one single-nucleotide polymorphisms in GERD were included as genetic variables.

Read more about IPF etiology

The risk factors included were smoking status, initiating smoking, exposure to tobacco smoke, alcohol consumption, type 2 diabetes, vitamin D deficiency, obesity, and lung function.

The results revealed a positive association between GERD and asthma, IPF, COPD and chronic bronchitis. No significant association was found between GERD and bronchiectasis. GERD was also found to be positively associated with 7 of the risk factors studied: smoking initiation, exposure to tobacco smoke, obesity, and type 2 diabetes, and it was negatively associated with alcohol consumption.

A potential association was found between GERD and smoking status, and no association was found with vitamin D deficiency or lung function.

The research team concluded that the study provided new evidence that individuals with a genetic predisposition to GERD are at increased risk of IPF and other chronic respiratory disease. They recommend further studies to assess the epidemiological and mechanistic interactions between these diseases.  


Cheng X, Shi J, Zhang D, et al. Assessing the genetic relationship between gastroesophageal reflux disease and chronic respiratory diseases: a mendelian randomization study. BMC Pulm Med. Published online July 4, 2023. doi.10.1186/s12890-023-02502-8