Silent Damage by Micro-aspirations: Untangling the Connection of Gastroesophageal Reflux Disease (GERD) and Achalasia With Interstitial Lung Disease

Gastroesophageal reflux disease (GERD) frequently triggers respiratory conditions such as asthma and pneumonia. Inflammation occurs as a result of aspirated material, leading to symptoms such as cough, sputum production, chest discomfort from the involvement of the lower respiratory tract, and voice hoarseness owing to the involvement of the larynx. Repeated exposure to irritants can lead to fibrosis in the lungs. However, little is known about the association of achalasia with interstitial lung disease (ILD). We present a case of a patient with GERD who presented with cough and reflux for three months. Extensive testing confirmed the diagnosis of achalasia, and pneumatic dilation provided relief. The patient returned after two years with additional symptoms of shortness of breath. A CT scan of the chest showed worsening reticular changes and ground-glass opacity, indicative of ILD. An unremarkable toxin exposure history and a negative autoimmune panel led clinicians to explore the possible relationship between achalasia and ILD, highlighting the need for further exploration and research in this area.