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How Common Is GERD in COPD?

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Updated February 22, 2012

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Question: How Common Is GERD in COPD?
Dorothy Bateman, a COPD Forum member asks the following question:
I have suffered from COPD for 11 years. Recently I have also begun to suffer severe acid reflux. So far, tests have found nothing. I have heard that reflux is quite common in COPD sufferers. Is there anyone out there who can relate to this?
Answer: Gastroesophageal reflux disorder (GERD) is a common condition, affecting approximately 20% of the population. Often referred to as acid reflux, GERD is the result of the backward flow of stomach contacts into the esophagus.

Although more research is needed, studies suggest that people with COPD are more likely to have GERD compared to people who don't have COPD. In fact, evidence suggests that as many as 27% of all COPD patients may also have GERD.

What Are the Risk Factors For GERD?

Smoking, the number one risk factor for COPD, is also a common risk factor for GERD. Other important risk factors include:

  • obesity
  • pregnancy
  • drinking alcohol
  • eating certain foods (fried, fatty, spicy, acidic, citrus, or chocolate-based food)
  • having certain medical conditions (hiatal hernia, asthma, peptic ulcer, gastroparesis)

What Makes COPD Patients More at Risk for GERD?

Although more research is needed to clearly define the answer to this question, studies suggest that the severity of hyperinflation in the lungs and dyspnea play a part in why some COPD patients are more at risk for GERD.

What About GERD and COPD Exacerbation?

GERD appears to be closely associated with COPD exacerbation. It may even be a predictive factor for hospitalization due to acute exacerbation of COPD -- meaning that a patient who experiences GERD may be at risk for their COPD suddenly getting worse causing them to be hospitalized. Additionally, severe GERD symptoms may be linked to more frequent episodes of exacerbation in some COPD patients. Taking steps to reduce complications associated with GERD and prevent COPD exacerbation will help keep you out of the hospital.

Does Having GERD Worsen My COPD?

No. Studies suggest that having GERD does not worsen lung function or clinical outcomes in COPD. But, compared to those who are diagnosed with COPD alone, having poorly treated or unrecognized GERD can negatively impact your quality of life if you suffer from both illnesses.

How Do I Manage Both GERD and COPD?

Like COPD, obtaining an accurate diagnosis of GERD is the key to effective treatment. If you suspect that you have symptoms of GERD, make an appointment with your health care provider to undergo diagnostic testing. Furthermore, because GERD and COPD are two different conditions, it is important that they are medically treated as such. Read COPD Treatment Guidelines for more information about treatment for COPD.

How Is GERD Treated Medically?

Treatment for GERD typically starts with lifestyle changes like smoking cessation and dietary modifications (also important in the treatment of COPD). When lifestyle changes alone are ineffective, medications such as antacids, promotility agents, histamine receptor antagonists and proton pump inhibitors may also be added to the treatment plan. Finally, when lifestyle changes and medication provide little relief from GERD symptoms, surgery is also an option.

For more information, visit About.com's Heartburn and GERD Guidesite.

Sources:

Corinaldesi R. et. al. Gastroesophageal reflux disease: clinical and pathophysiological features (part I). Clin Ter. 2007 Jan-Feb;158(1):77-83.

Liang BM, Feng YL. Association of Gastroesophageal Reflux Disease Symptoms with Stable Chronic Obstructive Pulmonary Disease. Lung. 2012 Jan 19.

Rascon-Aguilar IE, Pamer M, Wludyka P, Cury J, Vega KJ. Poorly treated or unrecognized GERD reduces quality of life in patients with COPD. Dig Dis Sci. 2011 Jul;56(7):1976-80. Epub 2011 Jan 8.

Takada, K. et. al. Relationship between chronic obstructive pulmonary disease and gastroesophageal reflux disease defined by the Frequency Scale for the Symptoms of gastroesophageal reflux disease. Nihon Kokyuki Gakkai Zasshi. 2010 Sep;48(9):644-8.

Takada, K. et. al. Prospective evaluation of the relationship between acute exacerbations of COPD and gastroesophageal reflux disease diagnosed by questionnaire. Respir Med. 2011 Oct;105(10):1531-6. Epub 2011 Mar 30.

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