What is your approach to evaluation and management of GERD in a patient with IPF?

When evaluating GERD in a patient with idiopathic pulmonary fibrosis (IPF), I prioritize obtaining a detailed history of GERD symptoms, as this aids in guiding both diagnostic and management decisions. Many IPF patients may not exhibit classic GERD symptoms like heartburn or regurgitation. Instead, they may present with atypical or subtle symptoms, or even silent reflux, which is prevalent in this population. Consequently, evaluation often includes objective testing such as 24-hour pH monitoring and esophageal manometry, especially in cases where symptoms are mild or absent. Recognizing even mild GERD symptoms is critical because microaspiration and acid reflux can exacerbate lung fibrosis and contribute to IPF progression (Raghu et al., PM...