Prevalence of Gastroesophageal Reflux in Interstitial Lung Diseases Clinic

Background Interstitial lung diseases (ILDs) are a group of non-infectious diseases characterized by interstitial inflammation and fibrosis on histological examination. Gastroesophageal reflux disease (GERD) is common in this patient population, but whether there is a causal or coincidental relationship is not yet clear. It still remains unsettled how to diagnose GERD, and the role of different treatment modalities for GERD, in these lung disorders. Furthermore, most of the work is done to find the association of GERD with idiopathic pulmonary fibrosis (IPF) only. The aim of this study was to determine the prevalence of GERD in ILD patients presenting to an ILD clinic. Methods Prospective study of registered ILD patients during a period of eight months (May-December 2016). Diagnosis of GERD was made on a clinical basis (presentation with typical symptoms of heartburn and regurgitation). Current use of acid-reducing medications and steroids was also recorded. Results A total of 79 patients were included in the study. Females (58, 73.41%) outnumbered males (21, 26.58%). The heaviest burden of ILD was contributed by IPF (32, 40.50%), followed by non-specific interstitial pneumonia (NSIP) (26, 32.91%), hypersensitivity pneumonitis (HP) (8, 10.12%), sarcoidosis (5, 6.3%), silicosis (3, 3.8%), desquamative interstitial pneumonia (DIP) (2, 2.5%), and Langerhans cell histiocytosis (LCH) (3, 3.79%). Fifty (63.29%) patients were on steroids, and 29 (36.70%) were already taking anti-reflux medications at presentation. GERD was reported in 21 (65.6%) IPF, 12 (46.15%) NSIP, one (12.5%) HP, one (33.3%) silicosis, two (40%) sarcoidosis, and all (2,100%) of DIP patients. The overall prevalence of GERD was 39 (49.36%) in ILD patients. Conclusion The prevalence of abnormal acid reflux in ILD patients is high. It may be one of the underlying etiologies of lung fibrosis. Long-term follow-up is necessary to determine if control of reflux alters the natural history of these lung disorders. GERD must be investigated and managed optimally for patients with ILD.