Increased gastro-oesophageal reflux disease in patients with severe COPD

Casanova, Ciro; Baudet, J; Velasco, M. del Valle; Martin, Jessica; Aguirre‐Jaime, Armando; de-Torres, Juan P.; Celli, Bartolomé R.

doi:10.1183/09031936.04.00107004

Cited by 151 publications

(143 citation statements)

References 29 publications

(36 reference statements)

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“…33 Another cross sectional study found that decreases in oesophageal pH corresponded with drops in oxygen saturation among six of 15 patients with GORD and COPD. 31 …”

Section: Connective Tissue Diseasementioning

confidence: 99%

Gastro-oesophageal reflux and aspiration in patients with advanced lung disease

Sweet

Patti

Hoopes

et al. 2009

Thorax

125

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“…33 Another cross sectional study found that decreases in oesophageal pH corresponded with drops in oxygen saturation among six of 15 patients with GORD and COPD. 31 …”

Section: Connective Tissue Diseasementioning

confidence: 99%

Gastro-oesophageal reflux and aspiration in patients with advanced lung disease

Sweet

Patti

Hoopes

et al. 2009

Thorax

125

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“…Although our sample of subjects was small, the use of esophageal pH monitoring takes into account the broader profile of gastroesophageal reflux in bronchiectasis or COPD, for which both symptomatic and asymptomatic reflux have been described. 3,5,6,[36][37][38] In this study, the absence of a relationship between a diagnosis of gastroesophageal reflux and EBC pepsin con- centrations is contrary to the lower EBC pH and higher pepsin concentrations in patients with COPD and symptomatic reflux. 21 This may reflect the small number of subjects in this study meeting the criteria for gastroesophageal reflux, a limitation when including subjects irrespective of reflux symptoms.…”

Section: Discussionmentioning

confidence: 40%

Exhaled Breath Condensate Pepsin: Potential Noninvasive Test for Gastroesophageal Reflux in COPD and Bronchiectasis

et al. 2014

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BACKGROUND: Acid gastroesophageal reflux is a common problem in non-cystic fibrosis bronchiectasis and COPD. Invasive methods are used to diagnose gastroesophageal reflux, but the ability to detect pulmonary microaspiration of gastric contents using this method is unclear. A noninvasive option to detect pulmonary microaspiration is to measure pepsin in exhaled breath condensate (EBC), but this has not been related to esophageal pH monitoring in these lung conditions. This study aimed to measure pepsin concentrations and pH in EBC and to determine the relationship to gastroesophageal reflux in bronchiectasis or COPD. METHODS: Subjects with bronchiectasis (n ‫؍‬ 10) or COPD (n ‫؍‬ 10) and control subjects (n ‫؍‬ 10) completed 24-h esophageal pH monitoring for detection of acid gastroesophageal reflux, measuring the percentage of reflux time in the proximal esophagus and the DeMeester score (DMS). Concurrently, 3 samples of EBC were collected from each subject, and pH was measured and pepsin concentrations were analyzed by enzyme-linked immunosorbent assay. RESULTS: EBC pepsin was detected in subjects with bronchiectasis (44%) or COPD (56%) and in control subjects (10%). A diagnosis of gastroesophageal reflux was not associated with a higher concentration of EBC pepsin in bronchiectasis (P ‫؍‬ .21) or COPD (P ‫؍‬ .11). EBC pepsin concentration did not correlate with DMS (r s ‫؍‬ 0.36) or proximal reflux index (r s ‫؍‬ 0.25) in subjects with bronchiectasis or with DMS (r s ‫؍‬ 0.28) or proximal reflux index (r s ‫؍‬ 0.21) in patients with COPD. EBC and sputum pepsin concentrations were moderately correlated in bronchiectasis (r s ‫؍‬ 0.56) and in COPD (r s ‫؍‬ 0.43). CONCLUSIONS: Pepsin is detectable in EBC samples in bronchiectasis and COPD. Although no association was found between pepsin concentrations and a diagnosis of gastroesophageal reflux, a moderate relationship between sputum and EBC pepsin concentrations suggests that EBC pepsin may be a useful noninvasive marker of pulmonary microaspiration.

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“…(11) Although, GERD is usually confined to the lower oesophagus in some individuals, it may be associated with pulmonary microaspiration of gastric contents. Possible mechanisms that may contribute to GERD in COPD originate from gastro-oesophageal dysfunction including altered pressure in the lower oesophageal sphincter (which normally protect against GERD) and changes in oesophageal motility.…”

Section: Prevalence Of Gerdmentioning

confidence: 99%

Study of Prevalence of Gerd in Copd Patients

Singh¹,

Singh²,

Sharma³

et al. 2017

jemds

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BACKGROUNDThe association between gastro-oesophageal reflux symptoms and respiratory symptoms is well recognised in the setting of asthma. It has often been suggested that patients of COPD may experience symptoms of GERD. The purpose of this study is to calculate the prevalence of gastro-oesophageal reflux disease in COPD in Indian population. MATERIALS AND METHODSThe study was a descriptive study and patients were selected from OPD by convenient sampling and was conducted in postgraduate Department of Medicine, LLRM Medical College; 60 cases of COPD were selected and these subjects were subjected to thorough general and systemic examination, particularly with respect to respiratory and abdominal system including upper GI endoscopy. The study was conducted over a period of 6 months. The diagnosis of COPD was made on the basis of history and PFT. Diagnosis of GERD was made on the basis of history and endoscopic findings. All subjects were also evaluated for helicobacter pylori infection by biopsy urease test. Statistical Methods-Chi-square test was applied to see the association between COPD and GERD. P value was calculated to see the significance of association between GERD and severity of COPD, seropositivity for H. pylori and severity of COPD. RESULTS60 patients were enrolled (n= 60); out of 60, 40 were male subjects (m= 40, f= 20) and 20 were female. All subjects were subjected to PFT and FEV1 and FVC were recorded; 38.33% subjects had FEV1/FVC in range of 51% -60%, 35% subjects had FEV1/FVC in range of 41% -50%. Out of 60 cases of COPD 38 had symptoms of GERD, on endoscopic examination 6 more cases were diagnosed as GERD, hence out of 60 cases 44 had GERD (73%) which is a significant association (p value < 0.05%). On assessing the corelation of GERD symptoms with lung function impairment, it was found that 47.73% cases had FEV1/FVC < 50% and these patients had daily symptoms of heart burn, regurgitation and dysphagia and on statistical analysis the association is significant. All patients were subjected to gastroscopic urease test using biopsies from antrum; out of 60, 35 cases were positive for H. pylori (58%) and 25 were negative for H. pylori (42%) which is significant (58% vs 42%, p value < .05%). On comparison of prevalence of H. pylori in patients of COPD with or without GERD, out of 44 cases of COPD with GERD 35 cases were positive for H. pylori (79%) in comparison to 5 out of 16 cases without GERD (31.25%) which is statistically significant (79% vs 31.25%, p value < .05%). On assessing the severity of COPD in H. pylori positive and negative patients, out of 44 cases of GERD with COPD 35 were positive for H. pylori, out of which H. pylori positive status 18 (51.4%) had FEV1/FVC < 50% and among patients without GERD out of 16 cases of H. pylori only 5 (20%) had FEV1/FVC < 50%. This difference is statistically significant (51.4% vs 20%, p value < .05%). CONCLUSION 1. Prevalence of GERD is higher in COPD patients; 2. Severity of GERD increases with increase in severity of COPD; 3. H. pylori sero...

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Increased gastro-oesophageal reflux disease in patients with severe COPD

Cited by 151 publications

References 29 publications

Gastro-oesophageal reflux and aspiration in patients with advanced lung disease

Gastro-oesophageal reflux and aspiration in patients with advanced lung disease

Exhaled Breath Condensate Pepsin: Potential Noninvasive Test for Gastroesophageal Reflux in COPD and Bronchiectasis

Study of Prevalence of Gerd in Copd Patients

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