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COPD may predispose patients to reflux disease

Reuters Health • The Doctor's Channel Daily Newscast

NEW YORK (Reuters Health) – Patients with chronic obstructive pulmonary disease (COPD) may be at increased risk for gastroesophageal reflux disease (GERD), according to the results of a longitudinal study investigating the temporal relationship between the two conditions.

“Physicians should keep in mind that COPD patients may also be struggling with the symptoms of GERD,” treatment of which may improve their health-related quality of life, the research team states in the December issue of Chest.

Led by Dr. Luis A. Garcia Rodriguez, at the Spanish Centre for Pharmacoepidemiological Research in Madrid, the investigators conducted nested case-control analyses using data from the UK General Practice Research Database.

At baseline in 1996, the researchers followed 1628 patients with COPD but without GERD, along with 4391 patients with GERD but without COPD. The patients were all between the ages of 40 and 89 years old.

During the 5-year follow-up through 2001, the incidence of GERD per 1000 person-years was 21.5 in the COPD cohort and 14.9 in the control group (age- and sex-adjusted relative risk, 1.46).

In a similar analysis of 4391 patients with GERD and 5118 comparison subjects, the corresponding incidence was 6.8 and 6.0, respectively, a non-significant difference.

These results indicate that “COPD appears to predispose patients to GERD rather than vice versa,” Dr. Rodriguez and colleagues note, although the possibility exists, they add, that GERD may increase the frequency of COPD exacerbations.

They suggest using questionnaires to diagnose GERD in COPD patients “to ensure that they are managed appropriately.”

Reference:
Chest 2008;134:1223-1230.