Does gastroesophageal reflux increase chronic obstructive pulmonary disease exacerbations?

Area of Science:

• Pulmonology
• Gastroenterology
• Medical Diagnostics

Background:

• Gastroesophageal reflux (GER) and chronic obstructive pulmonary disease (COPD) exacerbations have a less understood relationship compared to asthma.
• This study evaluates GER prevalence in COPD patients and its influence on exacerbation frequency.

Purpose of the Study:

• To assess the occurrence of GER in patients diagnosed with COPD.
• To determine the impact of GER on the frequency of COPD exacerbations.

Main Methods:

• Included 24 stable mild-moderate COPD patients and 19 controls.
• Utilized GERD symptom questionnaire, gastroscopy, manometry, and 24-h ambulatory pH-impedance monitoring.

Main Results:

• 73.9% of COPD patients exhibited acid reflux (DeMeester score > 14.7), significantly higher than controls (26.3%).
• Proximal reflux extension positively correlated with annual COPD exacerbations (r=0.448, p=0.03).
• Motility disorders were more prevalent in COPD patients (87.5%) versus controls (20%).

Conclusions:

• Gastroesophageal reflux is frequent in COPD patients, though typical symptoms are reported by only 20.8%.
• The proximal extent of reflux is a potential trigger for increased COPD exacerbations.