Poorly Treated or Unrecognized GERD Reduces Quality of Life in Patients with COPD

Abstract

The effect of gastroesophageal reflux disease (GERD) on health-related quality of life (HRQL) in COPD has never been assessed. To evaluate HRQL in patients with COPD alone compared with those with both COPD and continuing GERD symptoms. A questionnaire-based, cross-sectional survey was performed. Subjects were recruited from the outpatient pulmonary clinics at the University of Florida Health Science Center/Jacksonville. Included patients had an established diagnosis of COPD. Exclusion criteria were respiratory disorders other than COPD, known esophageal disease, active peptic ulcer disease, Zollinger–Ellison syndrome, mastocytosis, scleroderma, and current alcohol abuse. Those meeting the criteria and agreeing to participate were asked to complete the Mayo Clinic GERQ and SF-36 questionnaires, by either personal or telephone interview. Clinically significant reflux was defined as heartburn and/or acid regurgitation weekly. Study patients were divided into two groups for HRQL analysis based on the GERQ response: COPD+/GERD+ and COPD only. Statistical analysis was performed using the Mann–Whitney–Wilcoxon T test for unequal variables and linear regression was performed using ANOVA. All data are expressed as mean and standard deviation. Eighty-six patients completed both questionnaires. Males were 55% and COPD+/GERD+ patients comprised 37% of the study group. Compared with COPD only, HRQL was reduced across all measures for the COPD+ GERD+ patients and achieved significance for bodily pain (P < 0.02), mental health (P < 0.05), and physical component score (P < 0.05). Patients with COPD and continuing GERD symptoms have reduced HRQL in comparison with those with COPD alone.