Role of gastroesophageal reflux symptoms in exacerbations of COPD.
OBJECTIVE
The impact of gastroesophageal reflux disease (GERD) on exacerbations of COPD has never been evaluated. The aims of this investigation were to determine the prevalence of gastroesophageal reflux (GER) symptoms in COPD patients and the effect of GER on the rate of exacerbations of COPD per year.


METHODS
A questionnaire-based, cross sectional survey was performed. Subjects were recruited from the outpatient pulmonary clinics at the University of Florida Health Science Center/Jacksonville. Included patients had an established diagnosis of COPD. Exclusion criteria were respiratory disorders other than COPD, known esophageal disease, active peptic ulcer disease, Zollinger-Ellison syndrome, mastocytosis, scleroderma, and current alcohol abuse. Those meeting criteria and agreeing to participate were asked to complete the Mayo Clinic GERD questionnaire by either personal/telephone interview. Clinically significant reflux was defined as heartburn and/or acid regurgitation weekly. Other outcome measures noted were frequency and type of COPD exacerbations. Statistical analysis was performed using the Fisher exact test for categorical data and the independent t test for interval data.


RESULTS
Eighty-six patients were enrolled and interviewed (mean age, 67.5 years). Male patients accounted for 55% of the study group. Overall, 37% of patients reported GER symptoms. The mean FEV(1) percentage of predicted was similar in those with or without GER. The rate of exacerbations of COPD was twice as high in patients with GER symptoms compared to those without GER symptoms (3.2/yr vs 1.6/yr, p = 0.02).


CONCLUSIONS
The presence of GER symptoms appears to be associated with increased exacerbations of COPD.
Rascon-Aguilar
Ivan E
IE
University of Florida Health Science Center/Jacksonville, Division of Gastroenterology, 4555 Emerson Expressway, Suite 300, Jacksonville, FL 32207, USA.
Pamer
Mark
M
Wludyka
Peter
P
Cury
James
J
Coultas
David
D
Lambiase
Louis R
LR
Nahman
N Stanley
NS
Vega
Kenneth J
KJ
D000368:Aged; D000863:Antacids / Q000008:administration & dosage; D000897:Anti-Ulcer Agents / Q000008:administration & dosage; D015897:Comorbidity; D018450:Disease Progression; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D005764:Gastroesophageal Reflux / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology*; D006635:Histamine H2 Antagonists / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D054328:Proton Pump Inhibitors; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology* / Q000209:etiology*; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D013223:Statistics as Topic; D016896:Treatment Outcome
D000863:Antacids; D000897:Anti-Ulcer Agents; D006635:Histamine H2 Antagonists; D054328:Proton Pump Inhibitors