@clpc, Hello, you seem to be very aware and informed “up on this”. Thanks for all the good background. To answer your question, my best understanding of what my doctors have told me is there is a high rate of correlation for patients with Bx, MAC, and GERD, and studies indicate in some cases GERD may be the pathway through which Bx begins, esp. when we unknowingly aspirate particles from gut to lung at night. I have GERD, but my docs don’t believe that is why I developed Bx and eventually MAC. Mine is idiopathic, but probably related to childhood pneumonia(s). My understanding is I’ll never be rid of MAC now that it’s set up house in my lungs and sinuses, along with several other bad actors, all of whom are fighting for real estate. But my life is significantly better since diagnosis 5 years ago. My Rx is: regular airway clearance (vest + 7% saline nebulizer + postural drainage for lungs) + Gentamicin & Budesonide inhalants using my Navage device, + exercise + sleep + water. I haven't heard of anyone saying their Bx and MAC were mistaken for GERD. Best of luck & blessings to you, please keep us updated.