Article Text

Download PDFPDF
Impact of gastro-oesophageal reflux disease symptoms on COPD exacerbation
  1. K Terada1,
  2. S Muro1,
  3. S Sato1,
  4. T Ohara1,
  5. A Haruna1,
  6. S Marumo1,
  7. D Kinose1,
  8. E Ogawa1,
  9. Y Hoshino2,
  10. A Niimi1,
  11. T Terada3,
  12. M Mishima1
  1. 1
    Department of Respiratory Medicine, Kyoto University, Japan
  2. 2
    Department of Experimental Therapeutics, Kyoto University Hospital, Japan
  3. 3
    Terada Clinic, Respiratory Medicine and General Practice, Himeji City, Japan
  1. Dr S Muro, Department of Respiratory Medicine, Kyoto University, 54, Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan; smuro{at}


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.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Funding: This work was supported in part by the Japan Society for the Promotion of Science Grant B 16390234.

  • Competing interests: None.

  • Ethics approval: The research protocol was approved by the ethics committee of Kyoto University.

Linked Articles

  • Airwaves
    Wisia Wedzicha