CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Impact of gastro-oesophageal reflux disease symptoms on COPD exacerbation

K Terada¹, S Muro¹, S Sato¹, T Ohara¹, A Haruna¹, S Marumo¹, D Kinose¹, E Ogawa¹, Y Hoshino², A Niimi¹, T Terada³, M Mishima¹

¹ Department of Respiratory Medicine, Kyoto University, Japan
² Department of Experimental Therapeutics, Kyoto University Hospital, Japan
³ Terada Clinic, Respiratory Medicine and General Practice, Himeji City, Japan

Dr S Muro, Department of Respiratory Medicine, Kyoto University, 54, Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan; smuro{at}kuhp.kyoto-u.ac.jp

Background: The association between gastro-oesophageal reflux disease (GORD) and chronic obstructive pulmonary disease (COPD) exacerbation has so far remained unclear.

Objective: To prospectively establish the clinical significance of GORD symptoms on exacerbation.

Methods: 82 patients with COPD and 40 age matched controls were enrolled in this study. Symptoms were evaluated by a questionnaire using the Frequency Scale for the Symptoms of GORD (FSSG). Patients with COPD were prospectively surveyed for 6 months, and episodes of exacerbation were identified using a diary based on modified Anthonisen’s criteria. Exhaled breath condensate (EBC) pH was measured in both groups, and induced sputum was evaluated in patients with COPD.

Results: Positive GORD symptoms were reported in 22 (26.8%) patients with COPD and in five (12.5%) controls (p = 0.10). The frequency of exacerbations was significantly associated with the FSSG score (p = 0.03, r = 0.24, 95% CI 0.02 to 0.43). Multiple regression analysis revealed that GORD symptoms were significantly associated with the occurrence of exacerbations (p<0.01; relative risk 6.55, 95% CI 1.86 to 23.11). EBC pH was inversely correlated with FSSG score in both groups (p = 0.01, r = –0.37, 95% CI –0.55 to –0.14 in patients with COPD, and p<0.01, r = –0.45, 95% CI –0.67 to –0.16 in control subjects).

Conclusions: GORD symptoms were identified as an important factor associated with COPD exacerbation.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

Relevant Article

Airwaves

Wisia Wedzicha
Thorax 2008 63: i. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

• Maclay, J. D, Rabinovich, R. A, MacNee, W. (2009). Update in Chronic Obstructive Pulmonary Disease 2008. Am. J. Respir. Crit. Care Med. 179: 533-541 [Full Text]