Association of gastroesophageal reflux disease symptoms with exacerbations of chronic obstructive pulmonary disease.

BACKGROUND Symptoms of gastroesophageal reflux disease (GERD) are common in various chronic respiratory diseases, but little is known about GERD in the setting of chronic obstructive pulmonary disease (COPD). The aim of this study was to determine the effect of GERD symptoms on COPD exacerbations and subsequent hospitalization and drug usage. METHODS This retrospective study was conducted from December 2008 to February 2009 in the Pulmonary Clinic of Dr. Shariati University Hospital, Isfahan, Iran. Consecutive patients who were diagnosed with COPD based on clinical features and pulmonary function tests were included. Patients were categorized in GERD positive and GERD negative groups based on the Mayo GERD questionnaire. Exacerbation of COPD, hospitalization, and drug usage were compared between the two groups. RESULTS During the study period, 110 patients with COPD (mean age = 68.0 +/- 8.4 years, 87.3% male) were included; 59 (53.6%) patients were GERD positive. There was no significant difference between the GERD positive and GERD negative patients in age, gender, tobacco use, or body mass index. GERD positive patients experienced significantly more acute exacerbations of COPD than patients who were GERD negative (p < 0.001). The rate of hospitalization due to COPD exacerbations was significantly higher in GERD positive patients and they had a more severe COPD (p < 0.05) and more concurrent use of multiple therapies as compared with GERD negative patients (p < 0.05). CONCLUSION Patients with GERD symptoms have more COPD exacerbations and subsequent hospitalizations and drug usage. Clinical trials and preventive strategies for GERD in patients with COPD are warranted.