Increased prevalence of gastroesophageal reflux symptoms in patients with COPD.
OBJECTIVE
To determine the prevalence of gastroesophageal reflux (GER) symptoms in patients with COPD and the association of GER symptoms with the severity of airways obstruction as assessed by pulmonary function tests (PFTs).


METHODS
Prospective questionnaire-based, cross-sectional analytic survey.


METHODS
Outpatient pulmonary and general medicine clinics at a Veterans Administration hospital.


METHODS
Patients with mild-to-severe COPD (n = 100) were defined based on American Thoracic Society criteria. The control group (n = 51) consisted of patients in the general medicine clinic without respiratory complaints or prior diagnosis of asthma or COPD.


METHODS
Both groups completed a modified version of the Mayo Clinic GER questionnaire.


RESULTS
Compared to control subjects, a greater proportion of COPD patients had significant GER symptoms defined as heartburn and/or regurgitation once or more per week (19% vs 0%, respectively; p < 0.001), chronic cough (32% vs 16%; p = 0.03), and dysphagia (17% vs 4%; p = 0.02). Among patients with COPD and significant GER symptoms, 26% reported respiratory symptoms associated with reflux events, whereas control subjects denied an association. Significant GER symptoms were more prevalent in COPD patients with FEV(1) < or %, as compared with patients with FEV(1) > 50% of predicted (23% vs 9%, respectively; p = 0.08). In contrast, PFT results were similar among COPD patients with and without GER symptoms. An increased number of patients with COPD utilized antireflux medications, compared to control subjects (50% vs 27%, respectively; p = 0.008).


CONCLUSIONS
The questionnaire demonstrated a higher prevalence of weekly GER symptoms in patients with COPD, as compared to control subjects. There was a trend toward higher prevalence of GER symptoms in patients with severe COPD; however, this difference did not reach statistical significance. We speculate that although GER may not worsen pulmonary function, greater expiratory airflow limitation may worsen GER symptoms in patients with COPD.
Mokhlesi
B
B
Division of Pulmonary and Critical Care, Northwestern University Medical School, Chicago, IL, USA. bmokhlesi@hotmail.com
Morris
A L
AL
Huang
C F
CF
Curcio
A J
AJ
Barrett
T A
TA
Kamp
D W
DW
D000368:Aged; D000863:Antacids / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D005541:Forced Expiratory Volume; D005764:Gastroesophageal Reflux / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D008173:Lung Diseases, Obstructive / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D008176:Lung Volume Measurements; D008875:Middle Aged; D011446:Prospective Studies; D013147:Spirometry; D011795:Surveys and Questionnaires
D000863:Antacids