Study of gastroesophageal reflux disease in frequent exacerbations of chronic obstructive pulmonary disease

Comorbidity, especially cardiovascular diseases, in chronic obstructive pulmonary disease (COPD) is one of the main reasons of adverse outcomes in the exacerbation of COPD. So other concomitant pathologies require additional study. Objective: to study concomitant gastroesophageal reflux disease (GERD) in frequent exacerbations of COPD. Materials and methods: a retrospective analysis of 418 case records of patients hospitalized with COPD exacerbations for 4 years. 276 patients were hospitalized once (control group). 38 patients were hospitalized 2 times per year and 22 patients - 3 times (the main group). GERD was diagnosed using traditional clinical methods. Results: 5,8% of patients (16) in the control group had signs of GERD, while in the main group their number was 23,3% (14) (p<0.05). Among the hospitalized 3 times, the combination of GERD and COPD was higher (31,8%). Proton pump inhibitors (PPIs) were received in the hospital by 50% of patients in both groups. Only 20% of patients in the main group were prescribed to take the PPIs on an outpatient basis (50% in the control group). Patients with inadequate GERD therapy at the outpatient stage also used inhaled corticosteroids (ICS) 1,4 times less and had a higher frequency of COPD exacerbations. It was found that the presence of GERD increased the risk of repeated hospitalizations by 3 times (RR 3,1; 95% CI 1,95-4,95, p<0.05). Conclusions: GERD is a significant comorbid (23,3%) in patients with COPD with frequent exacerbations. Adequate treatment of GERD and COPD at the outpatient stage by taking PPIs and ICS may have an impact on reducing the frequency of exacerbations of COPD in this comorbidity.