There is an association between idiopathic pulmonary fibrosis (IPF) and gastroesophageal reflux disease (GERD), according to results published in Chest. The study is being presented virtually at the Chest 2021 Annual Meeting on Oct. 17-20, 2021.

The association between IPF and GERD was already known possibly due to chronic micro-aspiration leading to lung parenchyma remodeling. A team of researchers led by Andrew Berman, MD, further investigated the potential link between the 2 conditions and sought to characterize the sources of inpatient mortality in patients with IPF and GERD.

However, data are limited about the demographics, distribution of significant comorbidities, and clinical outcomes of patients who have both conditions.

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They first assessed the prevalence of IPF and the major causes of inpatient mortality in patients with IPF and GERD using data from the National Inpatient Sample database for 2015-2016.

Of the 6,304,222 patients who were admitted due to GERD between 2015 and 2016, 49,870 also had IPF. The majority of these were females above age 60. 

Other comorbidities in patients with both diseases were emphysema, pulmonary hypertension (PAH), chronic obstructive pulmonary disease (COPD), asthma, achalasia, and diaphragmatic hernia. 

The in-hospital mortality was increased in patients with concomitant emphysema, PAH, pulmonary embolism, heart failure, and systemic sclerosis but not those with hypertension, diaphragmatic hernias, diabetes, or hypothyroidism.

Finally, the average length of stay in the hospital was higher in patients with GERD and IPF with an average of 5.2 days compared to patients with GERD but not IPF (an average of 4.4 days).

“Although a causal relationship between GERD and IPF has not been clearly established, our findings add to the growing knowledge that those with these simultaneous diseases are at higher risk for poor outcomes while in-hospital,” the researchers concluded. “Further studies will be needed to explore how treatment of GERD in the setting of IPF may improve complication rates.”


Ng T, Damiris K, Seltzer E, Wing M, Berman A. Studying the link between idiopathic pulmonary fibrosis and GI reflux disease: a nationwide perspective. Chest. 2021;160(4):A1238. doi:10.1016/j.chest.2021.07.1138