Sinem Iliaz1, Raim Iliaz2, Seda Tural Onur3, Serpil Arici4, Umit Akyuz5, Cetin Karaca6, Kadir Demir7, Fatih Besisik8, Sabahattin Kaymakoglu9, Filiz Akyuz10. 1. Koç University Hospital, Department of Pulmonology, Istanbul, Turkey. Electronic address: snmkaraosman@gmail.com. 2. Istanbul University, Istanbul Medical Faculty, Department of Gastroenterohepatology, Istanbul, Turkey. Electronic address: raimiliaz@gmail.com. 3. Yedikule Chest Diseases and Thoracic Surgery Education and Research Hospital, Department of Pulmonology, Istanbul, Turkey. Electronic address: sedatural@yahoo.com. 4. Istanbul University, Istanbul Medical Faculty, Department of Gastroenterohepatology, Istanbul, Turkey. Electronic address: aserpilarici@gmail.com. 5. Fatih Sultan Mehmet Educational and Research Center, Department of Gastroenterohepatology, Istanbul, Turkey. Electronic address: umitakyuz@yahoo.com. 6. Istanbul University, Istanbul Medical Faculty, Department of Gastroenterohepatology, Istanbul, Turkey. Electronic address: cetinkaraca@yahoo.com. 7. Istanbul University, Istanbul Medical Faculty, Department of Gastroenterohepatology, Istanbul, Turkey. Electronic address: kadirdmr@yahoo.com. 8. Istanbul University, Istanbul Medical Faculty, Department of Gastroenterohepatology, Istanbul, Turkey. Electronic address: besisiksef@yahoo.com. 9. Istanbul University, Istanbul Medical Faculty, Department of Gastroenterohepatology, Istanbul, Turkey. Electronic address: kaymakoglus@hotmail.com. 10. Istanbul University, Istanbul Medical Faculty, Department of Gastroenterohepatology, Istanbul, Turkey. Electronic address: filizakyuz@hotmail.com.
Abstract
BACKGROUND: The relationship between chronic obstructive pulmonary disease (COPD) exacerbations and gastroesophageal reflux (GER) has been investigated less than asthma-GER. We aimed to evaluate the presence of GER in patients with COPD and its impact on exacerbations. METHODS: We included 24 patients with stable mild-moderate stage COPD and 19 volunteers as the control group. We conducted a gastroesophageal reflux disease (GERD) symptom questionnaire, gastroscopy, manometry, and an ambulatory 24-h pH-impedance study. RESULTS: According to the GERD questionnaire, only 5 (20.8%) patients with COPD had typical GER symptoms. According to the 24-h pH-impedance study, the mean DeMeester score (DMS) was 38.1 ± 34.6 in the COPD group and 13.3 ± 16.8 in the control group (p = 0.01). The acid reflux (DMS > 14.7) rate was higher in patients with COPD than in controls (73.9% vs 26.3%, p = 0.01). The symptom association probability positivity rate was 17.4% (n = 4) in the COPD group, which was similar to the controls (p = 0.11). The mean proximal extension rate of reflux (Z 17 cm) was 26.4 ± 12.9% in the COPD group. The proximal extent of reflux was positively correlated with the number of COPD exacerbations per year (p = 0.03, r = 0.448). In the motility results, only 2 (20%) patients in the control group had a minor motility disorder. Seventeen (70.8%) patients in the COPD group had a minor motility disorder, and 4 (16.7%) had major motility disorders (p < 0.001). CONCLUSION: In our study, gastroesophageal reflux was frequent in patients with COPD, but only a quarter had typical reflux symptoms. The proximal extent of reflux may trigger frequent exacerbations of COPD.
BACKGROUND: The relationship between chronic obstructive pulmonary disease (COPD) exacerbations and gastroesophageal reflux (GER) has been investigated less than asthma-GER. We aimed to evaluate the presence of GER in patients with COPD and its impact on exacerbations. METHODS: We included 24 patients with stable mild-moderate stage COPD and 19 volunteers as the control group. We conducted a gastroesophageal reflux disease (GERD) symptom questionnaire, gastroscopy, manometry, and an ambulatory 24-h pH-impedance study. RESULTS: According to the GERD questionnaire, only 5 (20.8%) patients with COPD had typical GER symptoms. According to the 24-h pH-impedance study, the mean DeMeester score (DMS) was 38.1 ± 34.6 in the COPD group and 13.3 ± 16.8 in the control group (p = 0.01). The acid reflux (DMS > 14.7) rate was higher in patients with COPD than in controls (73.9% vs 26.3%, p = 0.01). The symptom association probability positivity rate was 17.4% (n = 4) in the COPD group, which was similar to the controls (p = 0.11). The mean proximal extension rate of reflux (Z 17 cm) was 26.4 ± 12.9% in the COPD group. The proximal extent of reflux was positively correlated with the number of COPD exacerbations per year (p = 0.03, r = 0.448). In the motility results, only 2 (20%) patients in the control group had a minor motility disorder. Seventeen (70.8%) patients in the COPD group had a minor motility disorder, and 4 (16.7%) had major motility disorders (p < 0.001). CONCLUSION: In our study, gastroesophageal reflux was frequent in patients with COPD, but only a quarter had typical reflux symptoms. The proximal extent of reflux may trigger frequent exacerbations of COPD.
Authors: Julia Sanchez; Desiree M Schumann; Meropi Karakioulaki; Eleni Papakonstantinou; Frank Rassouli; Matthias Frasnelli; Martin Brutsche; Michael Tamm; Daiana Stolz Journal: Respir Res Date: 2020-08-21
Authors: Hye Rin Kang; Ye Jin Lee; Ha Youn Lee; Tae Yun Park; Jung Kyu Lee; Eun Young Heo; Hee Soon Chung; Seung Ho Choi; Deog Kyeom Kim Journal: J Korean Med Sci Date: 2021-02-01 Impact factor: 2.153
Authors: David F Woods; Stephanie Flynn; Jose A Caparrós-Martín; Stephen M Stick; F Jerry Reen; Fergal O'Gara Journal: Antibiotics (Basel) Date: 2021-06-24