FREQUENCY OF GASTROESOPHAGEAL REFLUX DISEASE AMONG PATIENTS PRESENTING WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE
DOI:
https://doi.org/10.54112/pjicm.v5i02.99Keywords:
Gastroesophageal Reflux Disease, Chronic Obstructive Pulmonary Disease, Severity, PrevalenceAbstract
Background: Chronic obstructive pulmonary disease (COPD) is a prevalent and progressive respiratory condition frequently associated with comorbidities that complicate its management. Gastroesophageal reflux disease (GERD) is increasingly recognized as a common coexisting condition that can worsen respiratory symptoms and disease outcomes in COPD patients. Objective: To determine the frequency of gastroesophageal reflux disease (GERD) among patients presenting with chronic obstructive pulmonary disease (COPD). Study Design: Cross-sectional study. Setting: Conducted at a tertiary care hospital, the Department of Pulmonology, Mardan Medical Complex, Mardan, Pakistan. Duration of Study: 12 December 2024 to 12 May 2025. Methods: A total of 150 patients aged 30 to 70 years, of either gender, diagnosed with COPD, were enrolled in this study. Diagnosis of COPD was confirmed based on spirometric criteria (post-bronchodilator FEV₁/FVC ratio <0.70). GERD was diagnosed clinically based on the presence of retrosternal burning or acid regurgitation occurring at least twice weekly over the preceding month. Descriptive statistics were
used for analysis; results were expressed as mean ± standard deviation and percentages. Results: The mean age of participants was 54.21 ± 12.03
years. There were 94 males (62.7%) and 56 females (37.3%). COPD severity was classified as mild in 12 patients (8.0%), moderate in 66 (44.0%),
severe in 63 (42.0%), and very severe in 9 patients (6.0%). GERD was diagnosed in 78 patients, yielding a frequency of 52.0% among the COPD
cohort. The prevalence of GERD appeared to correlate with increasing COPD severity. Conclusion: GERD was identified in more than half of the COPD patients in this study, with a notable association between GERD frequency and COPD severity. These findings underscore the need for proactive GERD screening in the management of COPD to improve patient outcomes and quality of life.
References
Duffy SP, Criner GJ. Chronic Obstructive Pulmonary Disease: Evaluation and Management. Med Clin. 2019;103(3):453-61. https://doi.org/10.1016/S0140-6736(12)61728-0
Singh D, Agusti A, Anzueto A, Barnes PJ, Bourbeau J, Celli BR, et al. Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease: the GOLD science committee report 2019. Eur Respir J. 2019;53(5) https://doi.org/10.1183/13993003.00164-2019
Lange P, Celli B, Agustí A, Boje Jensen G, Divo M, Faner R, et al. Lung-function trajectories leading to chronic obstructive pulmonary disease. N Engl J Med. 2015;373(2):111-22. https://doi.org/10.1056/NEJMoa1411532
Global Initiative for Chronic Obstructive Lung Disease. Fontana: Global Initiative for Chronic Obstructive Lung Disease; 2022. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: 2022. https://doi.org/10.15326/jcopdf.2022.0296
Hurst JR, Vestbo J, Anzueto A, Locantore N, Müllerova H, Tal-Singer R, et al. Susceptibility to exacerbation in chronic obstructive pulmonary disease. N Engl J Med. 2010;363(12):1128-38. https://doi.org/10.1056/NEJMoa0909883
Ruvuna L, Sood A. Epidemiology of chronic obstructive pulmonary disease. Clin Chest Med. 2020;41(3):315-27. https://doi.org/10.1016/j.ccm.2020.05.002
Riley CM, Sciurba FC. Diagnosis and outpatient management of chronic obstructive pulmonary disease: a review. JAMA. 2019;321(8):786-97. https://doi.org/10.1001/jama.2019.0131
Fass R, Boeckxstaens GE, El-Serag H, Rosen R, Sifrim D, Vaezi MF. Gastro-oesophageal reflux disease. Nat Rev Dis Prim. 2021;7(1):55. nature.com/articles/s41572-021-00287-w
Nirwan JS, Hasan SS, Babar ZU, Conway BR, Ghori MU. Global prevalence and risk factors of gastro-oesophageal reflux disease (GORD): systematic review with meta-analysis. Sci Rep. 2020;10(1):5814. https://doi.org/10.1038/s41598-020-62795-1
Ustaoglu A, Woodland P. Sensory phenotype of the oesophageal mucosa in gastro-oesophageal reflux disease. Int J Molec Sci. 2023 ;24(3):2502. https://doi.org/10.3390/ijms24032502
Rubenstein JH, Chen JW. Epidemiology of gastroesophageal reflux disease. Gastroenterol Clin North Am. 2014;43(1):1-14. https://doi.org/10.1016/j.gtc.2013.11.006
Savarino E, Marabotto E, Bodini G, Pellegatta G, Coppo C, Giambruno E, et al. Epidemiology and natural history of gastroesophageal reflux disease. Minerva Gastroenterol Dietol. 2017 Sep;63(3):175-183. https://doi.org/10.23736/s1121-421x.17.02383-2
Gyawali CP, Yadlapati R, Fass R, Katzka D, Pandolfino J, Savarino E, et al. Updates to the modern diagnosis of GERD: Lyon consensus 2.0. Gut. 2024;73(2):361-371. https://doi.org/10.1136/gutjnl-2023-330616
Wahab A, Haq ZU, Ahmad W, Ashraf S, Farooqi R, Ullah R. Frequency of Gastroesophageal reflux disease in patients with Chronic Obstructive Pulmonary disease admitted to Pulmonology Ward Khyber Teaching Hospital. Pak J Chest Med. 2019;25(1):27-31. https://pjcm.net/index.php/pjcm/article/view/580
Kakar IA, Baqi A, Azim N, Ahmad W, Shaukat Z, Shahab K. Frequency of Gastroesophageal Reflux Disease in Chronic Obstructive Pulmonary Disease Patients. P J M H S. 2022;16(12):397-399. DOI: https://doi.org/10.53350/pjmhs20221612397
Usman U, Irfan M, Faisal M. Frequency of GERD in COPD Patients. Annals of Punjab Medical College. 2016;10(3):111-4. https://doi.org/10.29054/apmc/2016.272
Kiani RS, Munawar R, Bukhari SA, Quddus MA, Tahir R. Assessment of Gastroesophageal Reflux Frequency and Its Clinical Impact in Severe Chronic Obstructive Pulmonary Disease. Pak J Chest Med. 2024;30(01):51-58. https://pjcm.net/index.php/pjcm/article/view/945
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