Chest
ORIGINAL RESEARCHCOPDHigh Prevalence of Proximal and Distal Gastroesophageal Reflux Disease in Advanced COPD
Section snippets
Materials and Methods
This study was approved by the University of Minnesota Institutional Review Board.
Results
A total of 51 COPD patients underwent screening for lung transplantation during the study period; of these, 42 patients (82%) underwent testing for gastroesophageal reflux. GERD assessment included manometry and 24-h esophageal pH monitoring in 41 patients and EGD in 1 patient. Four patients did not undergo testing due to early identification of a contraindication to transplantation, and one patient did not tolerate placement of the pH probe; the reason for no evaluation in the remaining four
Discussion
This series of patients with advanced COPD found a prevalence of GERD approximately five times that of the general population.19 A strikingly high proportion of patients had proximal reflux disease, often in the absence of pathologic amounts of distal reflux. The lack of association between reflux symptoms and the diagnosis of GERD, along with the small proportion of patients with GERD receiving acid blockers at the time of their referral, suggests there is a large burden of clinically silent
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2022, Respiratory MedicineCitation Excerpt :Psychological comorbidity is also very common in GERD patients and can play an important role in the process of GERD [30,31]. Another plausible causative mechanism why COPD patients have higher risk of developing GERD may be caused by increased intrathoracic pressure, diaphragmatic flattening, decreased in lower esophageal sphincter tonus caused by cough, beta-2-agonists and theophylline [32]. The strengths of our study include the extensive clinical and epidemiological characterization of the study cohort and long follow up duration in our one million population datasets.
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There was no external funding associated with this work.
No financial or other potential conflicts of interest exist for any of the authors.