# GERD and Pulmonary Disease--Medscape



## overitnow (Nov 25, 2001)

GERD Symptoms Increase the Rate of COPD Exacerbations CMENews Author: Laurie Barclay, MDCME Author: Charles Vega, MD, FAAFPOctober 17, 2006 â€" The rate of chronic obstructive pulmonary disease (COPD) exacerbations in patients with gastroesophageal reflux (GERD) symptoms is twice as high as in those without GERD symptoms, according to the results of a cross-sectional survey published in the October issue of Chest."Microaspiration of gastric contents and/or vagal irritation from GER [gastroesophageal reflux] may constitute airway irritants and thus represent a potential pathogenic mechanism for acute exacerbations of COPD," write Ivan E. Rascon-Aguilar, MD, from the University of Florida Health Science Center in Jacksonville, and colleagues. "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."For this questionnaire-based, cross-sectional survey, 86 patients with an established diagnosis of COPD were recruited from outpatient pulmonary clinics and interviewed in person or by telephone. Patients with respiratory disorders other than COPD, known esophageal disease, active peptic ulcer disease, Zollinger-Ellison syndrome, mastocytosis, scleroderma, and current alcohol abuse were excluded. Clinically significant reflux was defined as weekly episodes of heartburn and/or acid regurgitation. Other endpoints were frequency and type of COPD exacerbations.Mean patient age was 67.5 years, 55% were men, and 37% reported GERD symptoms. The mean forced expiratory volume in 1 second (FEV1) percentage of predicted was similar in patients with or without GERD, but the rate of COPD exacerbations was twice as high in patients with GERD symptoms as in those without GERD symptoms (3.2 per year vs 1.6 per year; P = .02)."The presence of GER symptoms appears to be associated with increased exacerbations of COPD," the authors write. "We also conclude that COPD patients with weekly GER symptoms and COPD are twice as likely to be hospitalized, have an ED [emergency department] visit, or unscheduled clinic visit when compared with COPD patients with less frequent GER symptoms."Study limitations include inability to conclude whether the use of antireflux therapy was protective against exacerbations, inability to establish a cause-and-effect association from the cross-sectional data, possible recall bias, and limited sample size."The findings of this study suggest a possible modifiable risk factor in exacerbations of COPD," the authors conclude. "The implications of this link may not only be of clinical significance but also of economic significance, considering the cost of a single hospitalization, and taking into account that in the year 2000 there were 726,000 hospitalizations, 1.5 million ED visits, and 8 million office visits all due to exacerbations of COPD."The authors have disclosed no relevant financial relationships.


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## overitnow (Nov 25, 2001)

Since Chronic Pulmonary Disease is frequently related to Emphysema, I suppose this is for we (ex)smokers with GERD.If you haven't already done it, it would be best to quit today.Mark


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