Idiopathic pulmonary fibrosis (IPF) is a devastating disease with a median survival of 3 to 5 years, but its mechanisms are not fully understood.Gastroesophageal reflux disease (GERD) is a frequent comorbidity in IPF, which is suggested to be involved in the progression and exacerbation of IPF.Microaspiration may induce persistent inflammation that impairs lung infrastructure and lead to fibrosis, while IPF may increase intrathoracic pressure that aggravates GERD vice versa.The possible beneficial effects have been shown by retrospective studies of anti-acid therapy on lung function, acute exacerbation and survival, and anti-reflux surgery has been shown to be beneficial to IPF patients in a prospective study.Basing on these data, the recent international and Chinese IPF guidelines recommend anti-acid therapies for all IPF patients regardless of symptomatic GERD.Yet, these recommendations are not supported by some newer conflicting data.Elucidation of these questions by further clinical and bench-to-bedside research may provide us with rational clinical diagnostic and therapeutic approaches concerning GERD in IPF.

Gastroesophageal reflux; Idiopathic pulmonary fibrosis; Microaspiration; Anti-acid therapy; Proton pump inhibitor; Anti-reflux surgery