GastroEsophageal Reflux Disease (GERD) and Pulmonary Fibrosis (PF)

Our support theme for this month is about the connection between GERD and PF. Please sign up to receive a reminder leading up to the meetup on Tuesday, February 14th and on Saturday, February 25th. If you are unable to attend, reach out for support in our community forum, where you can connect with people who have or are impacted by PF 24 hours a day, 7 days a week. 

Understanding the connection between PF and GERD

Pulmonary Fibrosis is a progressive chronic lung disease in which there is scarring of lung tissue. It is estimated that 60 to 90% of people with idiopathic pulmonary fibrosis (IPF) have GERD. Having GERD is thought to be a risk factor for PF. However, it is not clear which condition comes first.

Some researchers think it starts with GERD – small amounts of the acid that come up into the esophagus get aspirated into the lungs and cause lung scarring. Aspiration is when something you swallow goes down the wrong way and enters your airways. Others think PF comes first – the stiff fibrosed lungs in IPF put pressure on the stomach and esophagus, causing GERD.

Some research showed that people with IPF who use GERD medication had less lung scarring, a slower decline in lung capacity, and fewer episodes of acute exacerbation of IPF. However, other studies did not show a similar beneficial effect of taking antacids in people with IPF. Since it is possible that GERD can contribute to the development and progression of lung fibrosis, it needs to be thoroughly investigated in people with PF. It is beneficial to treat GERD in people with GERD symptoms, no matter which came first – PF or GERD.
 

What is GERD and what are the symptoms?

GERD or gastroesophageal reflux disease is a chronic condition where there is backward flow of stomach contents and stomach acid rises up into your esophagus. Some common symptoms of GERD include a burning chest discomfort called heartburn after eating, chest pain, a sour-tasting acid backing up into your throat, feeling of nausea, feeling of food being stuck in your throat with difficulty swallowing, chronic sore throat and a dry cough.

How is GERD diagnosed?

If you have any of the above symptoms 2 or more times per week, you must consult your doctor. Your doctor might be able to make a diagnosis based on your signs and symptoms and a physical examination. You will likely be diagnosed with GERD if your symptoms of heartburn are controlled with lifestyle changes, over the counter antacids or acid controlling medications. For people who continue to have more frequent and severe symptoms, other tests to confirm a diagnosis are generally ordered. Some of these tests are: upper endoscopy which involves inserting a flexible tube with a camera attached to see down your throat and stomach; placing a monitor in your esophagus to see when and how for long stomach acid comes up; x-ray of the upper digestive system after drinking a chalky liquid which can help diagnose narrowing of the esophagus.   

How is GERD managed?

• Diet: Eating smaller meals; eating at least 2 hours before laying down; avoiding coffee, alcohol or other foods that trigger symptoms; minimizing fried and fatty foods. Talk to your doctor about dietary supplements – especially licorice – as well. 
• Lifestyle changes: Using a wedge pillow or raising the head of the bed by 4 to 6 inches with blocks; sleeping in a chair for daytime naps; avoiding tight clothes or tight belts; quitting smoking; losing weight if you are overweight. To hear lifestyle tips from community members with GERD and PF, please visit our FAQs here.
• Medications: Over the counter antacids such as Mylanta, Alka-Seltzer, Rolaids can help neutralize stomach acid, making it less painful when the acid comes up; proton pump inhibitors such as omeprazole reduce the amount of acid your stomach makes; acid blockers such as Pepcid which also decrease acid production; foaming agents such as Gaviscon which coat your stomach to prevent reflux; and other prescription medication to help empty your stomach faster and reduce acid reflux.
• Surgical options: These are used for more severe cases of GERD that do not respond to lifestyle changes and medications. A fundoplication procedure is when the top of your stomach is wrapped around the lower valve of your esophagus such that the muscle is tightened and prevents reflux. A Linx device is a ring of small magnetic beads which are wrapped around the area where the esophagus connects with the stomach to help prevent acid reflux.
  
  

For additional ideas on managing GERD if you have PF, please visit the following articles:

1. Deciding on treatment options
2. Accessing affordable prescription medications
3. Recordkeeping part 1 and part 2

Stay In Touch

PF Now! hosts a virtual support group on Zoom every month. Not only will you strengthen your network of connections but you’ll learn firsthand how those with PF best look after themselves. PF Now! also has a Facebook group whose active community shares their PF journey and their tips with others. New to online support groups? Download our free step-by-step guide for online advocacy here.

_{Never disregard professional medical advice or delay in seeking it because of any information received from us.}