Gastro-esophageal reflux disease and exacerbations in chronic obstructive pulmonary disease

Abstract

Background and objective We tested the hypothesis that gastro-esophageal reflux disease is a risk factor for exacerbations in individuals with chronic obstructive pulmonary disease (COPD). Methods Among 9622 participants in the Copenhagen City Heart Study, we identified 1259 individuals with COPD and information on gastro-esophageal reflux disease and the regular use of acid inhibitory treatment. These individuals were followed for 5 years with regard to medically treated COPD exacerbations, which we defined as a short course treatment with oral corticosteroids alone or in combination with antibiotics. We applied a multivariable Cox regression analysis with adjustment for well-established risk factors associated with COPD exacerbations or gastro-esophageal reflux disease, including COPD severity, and symptoms. Results Individuals with COPD and gastro-esophageal reflux disease had more chronic bronchitis (31 vs 21%, P-=-0.004), more breathlessness (39 vs 22%, P-