COPD and Gastroesophageal Reflux Disease: A Double Blow

Chronic Obstructive Pulmonary Disease (COPD) is a chronic illness with a long clinical course characterised by episodes of worsening respiratory signs and symptoms due to acute exacerbations leading to increased usage of health care resources and much disability in later part of the life. Gastroesophageal reflux disease (GERD) is a common problem of the general population and has been seen by many researchers throughout the world as a potential risk factor for exacerbations in COPD due to micro aspiration of the gastric contents. It is observed that the incidence of GERD in COPD is much more than its incidence in the general population. This may be due to gastroesophageal dysfunction, leading to decreased tone and pressure in the lower oesophageal sphincter and oesophageal dysmotility. Many medications used by patients with COPD or changes in respiratory mechanics with increased lung hyperinflation may lead to this gastroesophageal dysfunction. GERD is amenable to treatment by both medical and surgical methods. This should help in reducing the exacerbations and improving the quality of life in patients with COPD. Hence further studies are needed to understand the cause-effect relationship.