OBJECTIVE: To systematically assess the prevalence of gastroesophageal reflux disease (GERD) in patients with idiopathic pulmonary fibrosis (IPF) and to provide evidence-based support for clinical assessment and future research. METHODS: Relevant studies published from database inception to January 1, 2026 were retrieved from PubMed, Embase, the Cochrane Library, Web of Science and Scopus. Two researchers independently conducted literature screening, data extraction and quality evaluation. Meta-analysis was performed using Stata 18.0 software. RESULTS: A total of 33 studies involving 35,807 IPF patients were included. Meta-analysis showed that the pooled prevalence of GERD in IPF patients was 47.0% 95%CI = 32.2%-62.0%. Subgroup analysis indicated that the prevalence of GERD was higher in cross-sectional studies than in cohort and case-control studies; similar in Europe and Asia and relatively lower in America and Oceania; lower in developing countries than in developed countries; the lowest in studies conducted during 2001-2010 and the highest in studies conducted after 2011. The prevalence estimated using 24-hour esophageal pH monitoring was higher than that estimated using clinical medical records or non-reflux monitoring methods. In addition, prevalence was higher in patients aged < 60 years than in those aged 60-69 years and ≥ 70 years, relatively higher in studies with a lower male proportion, higher in small-sample studies than in large-sample studies, and slightly higher in males than in females. Meta-regression suggested that study type, GERD diagnostic method, mean age and sample size were the main sources of heterogeneity. CONCLUSION: GERD appears to be common among patients with IPF, with apparent variations across study types, sample sizes, age groups and diagnostic methods. These findings may support greater clinical awareness and assessment of GERD in IPF patients. However, owing to the limitations of the number and quality of included studies, substantial heterogeneity and incomplete reporting of confounding factors, these conclusions should be interpreted cautiously and require further verification in high-quality studies.
Li et al. (Mon,) studied this question.