Chronic Obstructive Pulmonary Disease Exacerbations Are Influenced by Gastroesophageal Reflux Disease

• Published in: The American surgeon Vol. 84; no. 1; pp. 51 - 55
• Main Authors: Bigatao, Amilcar M., Herbella, Fernando A. M., Del Grande, Leonardo M., Nascimento, Oliver A., Jardim, Jose R., Patti, Marco G.
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.01.2018; SAGE PUBLICATIONS, INC
• Subjects: Age; Aged; Body mass; Body Mass Index; Body size; Chronic obstructive pulmonary disease; Correlation analysis; Esophageal pH Monitoring; Esophagus; Female; Females; Gastroesophageal reflux; Gastroesophageal Reflux - complications; Gastroesophageal Reflux - diagnosis; Gastroesophageal Reflux - physiopathology; Health risk assessment; Humans; Lung diseases; Male; Manometry; Middle Aged; Motility; Obstructive lung disease; Parameters; Patients; Pulmonary Disease, Chronic Obstructive - complications; Pulmonary Disease, Chronic Obstructive - diagnosis; Pulmonary Disease, Chronic Obstructive - physiopathology; Risk Factors; Severity of Illness Index; Smoking - adverse effects; Studies; Systematic review
• ISSN: 0003-1348; 1555-9823
• DOI: 10.1177/000313481808400122

Gastroesophageal reflux disease (GERD) is associated with different pulmonary diseases, including chronic obstructive pulmonary disease (COPD). Whether GERD is contributory to COPD severity remains unclear. This study aims to evaluate the contribution of GERD to the clinical manifestation of COPD based on ventilatory parameters and yearly clinical exacerbations. We studied 48 patients (56% females, age 66 years) with COPD. All patients underwent high-resolution manometry and esophageal pH monitoring. The patients were separated into two groups according to the presence of GERD. GERD was present in 21 (44%) patients. GERD + and GERD – groups did not differ in regard to gender, age, and body mass index. Pulmonary parameters were not different in the absence or presence of GERD. The number of yearly exacerbations was higher in patients GERD1. The severity of GERD (as measured by DeMeester score) correlated with the number of exacerbations. Our results show the following: 1) GERD does not influence pulmonary parameters and 2) GERD is associated with a higher number of annual clinical exacerbations. We believe GERD must be objectively tested in patients with COPD because the prevalence of GERD in these patients is underestimated when only symptoms are considered. GERD treatment might decrease the frequency of episodes of exacerbation.