Marco E Allaix1, Fabrizio Rebecchi1, Mario Morino1, Francisco Schlottmann2, Marco G Patti3. 1. Department of Surgical Sciences, University of Torino, Turin, Italy. 2. Center for Esophageal Diseases and Swallowing, University of North Carolina at Chapel Hill, Chapel Hill, USA. 3. Center for Esophageal Diseases and Swallowing, University of North Carolina at Chapel Hill, Chapel Hill, USA. marco_patti@med.unc.edu.
Abstract
BACKGROUND: Idiopathic pulmonary fibrosis (IPF) is a progressive interstitial lung disease of unknown origin that affects about 40,000 new patients every year in the USA. Albeit the disease is labelled as idiopathic, it is thought that pathologic reflux, often silent, plays a role in its pathogenesis through a process of microaspiration of gastric contents. AIMS: The aim of this study was to review the available evidence linking reflux to IPF, and to study the effect of medical and surgical therapy on the natural history of this disease. RESULTS: Medical therapy with acid-reducing medications controls the production of acid and has some benefit. However, reflux and aspiraion of weakly acidic or alkaline gastric contents can still occur. Better results have been reported after laparoscopic anti-reflux surgery, as this form of therapy re-establishes the competence of the lower esophageal sphincter, therefore stopping any type of reflux. CONCLUSIONS: A phase II NIH study in currently in progress in the USA to determine the role of antireflux surgery in patients with GERD and IPF. The hope is that this simple operations might alter the natural history of IPF, avoiding progression and the need for lung transplantation.
BACKGROUND:Idiopathic pulmonary fibrosis (IPF) is a progressive interstitial lung disease of unknown origin that affects about 40,000 new patients every year in the USA. Albeit the disease is labelled as idiopathic, it is thought that pathologic reflux, often silent, plays a role in its pathogenesis through a process of microaspiration of gastric contents. AIMS: The aim of this study was to review the available evidence linking reflux to IPF, and to study the effect of medical and surgical therapy on the natural history of this disease. RESULTS: Medical therapy with acid-reducing medications controls the production of acid and has some benefit. However, reflux and aspiraion of weakly acidic or alkaline gastric contents can still occur. Better results have been reported after laparoscopic anti-reflux surgery, as this form of therapy re-establishes the competence of the lower esophageal sphincter, therefore stopping any type of reflux. CONCLUSIONS: A phase II NIH study in currently in progress in the USA to determine the role of antireflux surgery in patients with GERD and IPF. The hope is that this simple operations might alter the natural history of IPF, avoiding progression and the need for lung transplantation.
Authors: Joyce S Lee; Jay H Ryu; Brett M Elicker; Carmen P Lydell; Kirk D Jones; Paul J Wolters; Talmadge E King; Harold R Collard Journal: Am J Respir Crit Care Med Date: 2011-06-23 Impact factor: 21.405
Authors: Ganesh Raghu; Derek Weycker; John Edelsberg; Williamson Z Bradford; Gerry Oster Journal: Am J Respir Crit Care Med Date: 2006-06-29 Impact factor: 21.405
Authors: Ruxandra Ciovica; Michael Gadenstätter; Anton Klingler; Christoph Neumayer; Gerhard P Schwab Journal: J Gastrointest Surg Date: 2005 May-Jun Impact factor: 3.452
Authors: Stephen Farrell; Cyril McMaster; David Gibson; Michael D Shields; William A McCallion Journal: J Pediatr Surg Date: 2006-02 Impact factor: 2.545
Authors: Christopher S Davis; Bernardino M Mendez; Diana V Flint; Karen Pelletiere; Erin Lowery; Luis Ramirez; Robert B Love; Elizabeth J Kovacs; P Marco Fisichella Journal: J Surg Res Date: 2013-06-29 Impact factor: 2.192
Authors: Jinhee Kim; Jin Hwa Lee; Yuri Kim; Kyungjoo Kim; Yeon-Mok Oh; Kwang Ha Yoo; Chin Kook Rhee; Hyoung Kyu Yoon; Young Sam Kim; Yong Bum Park; Sei Won Lee; Sang Do Lee Journal: BMC Pulm Med Date: 2013-08-09 Impact factor: 3.317
Authors: Thị Hằng Giang Phan; Panagiotis Paliogiannis; Gheyath K Nasrallah; Roberta Giordo; Ali Hussein Eid; Alessandro Giuseppe Fois; Angelo Zinellu; Arduino Aleksander Mangoni; Gianfranco Pintus Journal: Cell Mol Life Sci Date: 2020-11-17 Impact factor: 9.261
Authors: David F Woods; Stephanie Flynn; Jose A Caparrós-Martín; Stephen M Stick; F Jerry Reen; Fergal O'Gara Journal: Antibiotics (Basel) Date: 2021-06-24