Purpose Chronic obstructive pulmonary disease (COPD) exacerbations have traditionally been attributed to infectious agents and pollutants, but little is known about other potential causes. The purpose of this investigation was to determine whether gastroesophageal reflux disease (GERD) is a risk factor for COPD exacerbations.
Methods We conducted a cross-sectional survey of patients with COPD seen at a pulmonary clinic of an urban academic health center. The diagnosis of COPD was confirmed by clinical history and mean forced expiratory volume in one second/forced vital capacity (FEV1/FVC) ratio of less than 70% of predicted on pulmonary function testing. The number of COPD exacerbations in the past year was determined by the need for antibiotics or prednisone use, unscheduled clinic visits, emergency room visits, or hospitalizations. The presence of GERD was determined by the use of a previously validated questionnaire (GERQ).
Results Of 49 patients enrolled, mean age was 67.6 ± 8.7 (mean ± SD) years with 62.5% males. Overall, 15 (30.6%) of patients reported GERD symptoms. The mean FEV1 % predicted was 40% ± 0.15% and did not differ significantly between the two groups. On average, patients with GERD symptoms reported a higher number of COPD exacerbations (4.4 ± 2.9/yr) compared to patients without GERD symptoms (1.9 ± 1.7/yr) (p = .001).
Conclusions These preliminary results suggest that the presence of GERD in COPD patients is associated with an increased risk for COPD exacerbations.