Frequency of GERD in subjects with COPD: an experience from PNS SHIFA

Abstract

Background—Gastro esophageal (GE) reflux is a known potential trigger ofasthma, and aggressive anti reflux therapy may improve asthma symptoms andpulmonary function in selected patients. The same has not been adequatelystudied in patients with chronic obstructive pulmonary disease (COPD).Objectives-1-To measure the frequency of gastro esophageal reflux disease (GERD) insubjects with chronic obstructive pulmonary disease (COPD) presenting at thedepartment of Pulmonology, PNS SHIFA.2-To compare the frequency of occurrence of COPD exacerbations in subjectswith and without GERD.Design- Cross-sectional study.Place and duration of study- This study was carried out between June-2006 toJune-2007 at department of Pulmonology, PNS SHIFA, Karachi.Subjects and methods- A total of 63 subjects with a diagnosis of COPD,confirmed through pulmonary function tests, were selected from a targetpopulation of patients attending PNS SHIFA out patient Pulmonologydepartment. These subjects were evaluated through GERD questionnaire forpresence of GERD as per the criteria of Shimoyama et al; they were thenfollowed up on two weekly basis for occurrence of COPD exacerbations.Main outcome measures-Presence of GERD, COPD exacerbationsResults- The frequency of occurrence of GERD in subjects with COPD was39.7%. COPD exacerbations, as defined by steroid use, antibiotics prescriptionsand hospital admissions was higher among COPD subjects with GERD incomparison with subjects who did not have GERD.Conclusion- The presence of GER symptoms appears to be associated withincreased exacerbations of COPD.