Living With GERD and COPD

Having COPD increase your odds of developing GERD

A woman suffering from heartburn.
A woman suffering from heartburn. Patrick Heagney/Getty Images

Gastroesophageal reflux disorder (GERD) is a common condition which affects approximately 20 percent of the population. Often referred to as acid reflux, GERD occurs when the contents of your stomach move in the wrong direction―up the esophagus instead of down toward the small intestine.

Research shows that more than one-quarter of those with COPD also have GERD, making it more common in people with COPD than it is in people who don't have COPD.

Women who had been diagnosed with COPD are more likely to have GERD than men. Being older increases your risk of developing GERD as well. 

Risk Factors for Developing GERD

Smoking, the number one risk factor for COPD, is also a common risk factor for GERD. Other important risk factors include:

  • Obesity
  • Pregnancy
  • Drinking alcohol
  • Eating certain foods (fried, fatty, spicy, acidic, citrus, or chocolate-based food)
  • Having certain medical conditions (a hiatal hernia, asthma, peptic ulcer, gastroparesis)

Although more research is needed to determine why people with COPD have a higher risk of GERD, studies suggest that the severity of hyperinflation in the lungs and dyspnea (labored breathing) play a role. GERD also appears to be closely associated with COPD exacerbation. If you have GERD, you may even be at higher risk for hospitalization because your COPD suddenly gets worse.

Additionally, severe GERD symptoms may cause more frequent episodes of exacerbation if you have COPD.

Taking steps to reduce complications associated with GERD and prevent COPD exacerbation will help keep you out of the hospital.

There is some good news: Studies suggest that having GERD does not worsen lung function or clinical outcomes in COPD. But, compared to those who are diagnosed with COPD alone, having poorly treated or unrecognized GERD certainly can negatively impact your quality of life if you live with both illnesses.

Managing Both GERD and COPD

Because GERD and COPD are two different conditions, it is important that your doctors treat both of them. Like with COPD, getting an accurate GERD  diagnosis is the key to effective treatment.

If you suspect that you have symptoms of GERD, make an appointment with your health care provider. Your doctor may be able to diagnose you based on your symptoms, or they may ask you to undergo additional testing. This may include an endoscopy to look down your throat, an X-ray of your upper digestive system, or an ambulatory acid (pH) probe, a thin tube your wear down your nose and into your throat and measures the amount of acid present. 

Treating GERD

Treating GERD usually starts with lifestyle changes like smoking cessation and dietary modifications, which can also help treat COPD.

If lifestyle changes alone aren't enough, medications such as antacids, promotility agents, histamine receptor antagonists and proton pump inhibitors may also be added to the treatment plan. As a last resort, should lifestyle changes and medication provide little relief from GERD symptoms, surgery may be able to provide some relief. 

Sources:

Kim J et al. Association between chronic obstructive pulmonary disease and gastroesophageal reflux disease: a national cross-sectional cohort study. BMC Pulmonary Medicine. 2013 Aug 9;13:51.

Liang BM, Feng YL. Association of Gastroesophageal Reflux Disease Symptoms with Stable Chronic Obstructive Pulmonary Disease. Lung. 2012 Jan 19.

Rascon-Aguilar IE, Pamer M, Wludyka P, Cury J, Vega KJ. Poorly treated or unrecognized GERD reduces quality of life in patients with COPD. Dig Dis Sci. 2011 Jul;56(7):1976-80. Epub 2011 Jan 8.

Takada, K. et. al. Relationship between chronic obstructive pulmonary disease and gastroesophageal reflux disease defined by the Frequency Scale for the Symptoms of gastroesophageal reflux disease. Nihon Kokyuki Gakkai Zasshi. 2010 Sep;48(9):644-8.

Takada, K. et. al. Prospective evaluation of the relationship between acute exacerbations of COPD and gastroesophageal reflux disease diagnosed by questionnaire. Respir Med. 2011 Oct;105(10):1531-6.

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