GASTRO ESOPHAGEAL REFLUX DISEASES IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE PATIENTS
AbstractBackground: There is an association of Gastroesophageal reflux disease (GERD) with chronic obstructive pulmonary disease (COPD). This study was designed to determine the frequency of GERD in COPD patients. Methods: This descriptive, cross-sectional study was conducted in the Pulmonology Unit Ayub Teaching Hospital Abbottabad. Patients more than 40 years of age of both genders presenting with features of COPD such as cough and breathlessness for more than 6 months and confirmed by spirometry were included in the study. A total of 118 consecutive patients were included in the study. Patients who had spirometry showing FEV1 <70% predicted & FEV1/FVC ratio <70% were included. Patients of asthma, with known oesophageal disease such as cancer, stricture, achalasia or active peptic ulcer disease, Pregnancy (precipitates GERD) and those patients who had used proton pump inhibitors (PPI) in the last 15 days were excluded. Results: The mean age of COPD patients was 65.25 years. Among COPD patients 89 (75.4%) were males. Fifty-five (46.6%) patients had moderate COPD (FEV1:50–69%). Frequency of smokers was 68.6% with mean duration of 12.5years and mean number of cigarettes smoke per day were 13.4. Thirty-five (29.75%) had GERD; 27% in males and 30% in females. Conclusion: Our study shows that a higher proportion of gastro oesophageal reflux (GERD) symptoms are present in COPD patients and it also shows that GERD is more common in severe COPD patients.Keywords: Gastroesophageal reflux disease, GERD; chronic obstructive pulmonary disease; COPD; spirometry; Proton Pump Inhibitors
Nielsen R, Johannessen A, Benediktsdottir B, Gislason T, Buist AS, Gulsvik A, et al. Present and future costs of COPD in Iceland and Norway: results from the BOLD study. Eur Respir J 2009;34(4):850–7.
Fletcher MJ, Upton J, Taylor-Fishwick J, Buist SA, Jenkins C, Hutton J, et al. COPD uncovered: an international survey on the impact of chronic obstructive pulmonary disease [COPD] on a working age population. BMC Public Health 2011;11:612.
Barnes N, Calverley PM, Kaplan A, Rabe KF. Chronic obstructive pulmonary disease and exacerbations: Patient insights from the global Hidden Depths of COPD survey. BMC Pulm Med 2013;13:54.
Vasankari TM, Impivaara O, Heliövaara M, Heistaro S, Liippo K, Puukka P, et al. No increase in the prevalence of COPD in two decades. Eur Respir J 2010;36(4):766–73.
Decramer M, Celli B, Kesten S, Lystig T, Mehra S, Tashkin DP. Effect of tiotropium on outcomes in patients with moderate chronic obstructive pulmonary disease (UPLIFT): a prespecified subgroup analysis of a randomised controlled trial. Lancet 2009;374(9696):1171–8.
Timms CJ, Yates DH, Thomas PS. Diagnosing GORD in respiratory medicine. Front Pharmacol 2011;2:40.
Takada K, Matsumoto S, Kojima E, Iwata S, Okachi S, Ninomiya K, et al. Prospective evaluation of the relationship between acute exacerbations of COPD and gastroesophageal reflux disease diagnosed by questionnaire. Respir Med 2011;105(10):1531–6.
Kamble NL, Khan NA, Kumar N, Nayak HK, Daga MK. Study of gastro-oesophageal reflux disease in patients with mild-to-moderate chronic obstructive pulmonary disease in India. Respirology 2013;18(3):463–7.
Gadel AA, Mostafa M, Younis A, Haleem M. Esophageal motility pattern and gastro-esophageal reflux in chronic obstructive pulmonary disease. Hepatogastroenterology 2012;59(120):2498–502.
Bor S, Kitapcioglu G, Solak ZA, Ertilav M, Erdinc M. Prevalence of gastroesophageal reflux disease in patients with asthma and chronic obstructive pulmonary disease. J Gastroenterol Hepatol 2010;25(2):309–13.
Takada K, Matsumoto S, Hiramatsu T, Kojima E, Iwata S, Shizu M, et al. Relationship between chronic obstructive pulmonary disease and gastroesophageal reflux disease defined by the frequency scale for the symptoms of gastroesophageal reflux disease. Nihon Kokyuki Gakkai Zasshi 2010;48(9):644–8.
Shimizu Y, Dobashi K, Kusano M, Mori M. Different gastoroesophageal reflux symptoms of middle-aged to elderly asthma and chronic obstructive pulmonary disease (COPD) patients. J Clin Biochem Nutr 2012;50(2):169–75.
Rogha M, Behravesh B, Pourmoghaddas Z. Association of gastroesophageal reflux disease symptoms with exacerbations of chronic obstructive pulmonary disease. J Gastrointestin Liver Dis 2010;19(3):253–6.
Buist AS, McBurnie MA, Vollmer WM, Gillespie S, Nurney P, Mannino DM, et al. International variation in the prevalence of COPD (the BOLD Study): a population-based prevalence study. Lancet 2007;370(9589):741–50.
Forey BA, Thornton AJ, Lee PN. Systematic review with meta-analysis of the epidemiological evidence relating smoking to COPD, chronic bronchitis and emphysema. BMC Pulm Med 2011;11:36.
Lindberg A, Eriksson B, Larsson LG, Rönmark E, Sandström T, Lundbäck B. Seven-year cumulative incidence of COPD in an age-stratified general population sample. Chest 2006;129(4):879–85.