GORD exacerbates COPD; antacids protect

Gastroesophageal reflux disease (GORD) almost triples the risk of exacerbations of chronic obstructive pulmonary disease (COPD) among patients not regularly taking acid suppressants, such as proton pump inhibitors. The study is 'the first prospective analyses' examining relationships between GORD, acid suppressants and COPD exacerbations in the general population.

Researchers followed 1259 COPD patients for five years. Significantly more patients with COPD and GORD showed chronic bronchitis (31% and 21%, respectively), breathlessness (39% and 22%, respectively) and histories of respiratory infections (6.8% and 1.4%, respectively) than COPD patients without GORD.

COPD patients with GORD who did not use acid inhibitors regularly (daily or almost daily) were 2.7 times more likely to have an exacerbation than those without GORD who did not regularly take acid suppressants. GORD patients using acid inhibitors regularly did not have a statistically increased risk of COPD exacerbations. Not taking acid suppressants regularly could account for approximately 31% of exacerbations among patients with COPD exacerbations and night time and daytime GORD. In addition, regularly taking medicines for arthritis was associated with a 1.7 fold increased risk of COPD exacerbations. NSAIDs can cause gastro-oesphageal reflux and damage gastrointestinal mucosa.