Chest ACCP Career Connection
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Guest Access | Sign In via User Name/Password
First published online on March 30, 2007
Chest, doi:10.1378/chest.06-2264
doi:10.1378/chest.06-2264
(Chest. 2007; 131:1666-1671)
© 2007 American College of Chest Physicians
This Article
Right arrow Full Text Free
Right arrow Full Text (PDF) Free
Right arrow All Versions of this Article:
chest.06-2264v1
131/6/1666    most recent
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Article Archive
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via ISI Web of Science (3)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Kempainen, R. R.
Right arrow Articles by Billings, J. L.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Kempainen, R. R.
Right arrow Articles by Billings, J. L.

High Prevalence of Proximal and Distal Gastroesophageal Reflux Disease in Advanced COPD*

Robert R. Kempainen, MD; Kay Savik, MS; Timothy P. Whelan, MD; Jordan M. Dunitz, MD; Cynthia S. Herrington, MD and Joanne L. Billings, MD, MPH

* From the Division of Pulmonary, Allergy, and Critical Care (Drs. Kempainen, Whelan, Dunitz, and Billings), Department of Internal Medicine, School of Nursing (Ms. Savik), and Department of Surgery (Dr. Herrington), University of Minnesota School of Medicine, Minneapolis, MN.

Correspondence to: Robert R. Kempainen, MD, Division of Pulmonary, Allergy, and Critical Care, University of Minnesota School of Medicine, MMC 276, 420 Delaware St SE, Minneapolis, MN 55455; e-mail: kempa001{at}umn.edu

Abstract

Background: Gastroesophageal reflux disease (GERD) is common in a variety of chronic respiratory diseases, but little is known about GERD in the setting of COPD. The aims of this study were to determine the prevalence, presentation, and predictors of GERD based on proximal and distal esophageal pH monitoring in patients with severe COPD.

Methods: Forty-one COPD patients with a mean FEV1 of 24% of predicted underwent dual-probe 24-h esophageal pH monitoring, and 1 patient underwent esophagogastroduodenoscopy.

Results: The prevalence of GERD was 57%. Elevated distal and proximal reflux were present in 41% and 46% of patients undergoing esophageal pH studies, respectively. Fifteen percent of these patients had abnormal proximal reflux despite having normal distal probe results. Most patients with GERD were not receiving acid blockers at the time of their referral, and only one third reported heartburn and/or acid regurgitation during the pH study. Only higher body mass index was predictive of reflux on regression analysis (odds ratio, 1.2; 95% confidence interval, 1.0 to 1.5; p = 0.05).

Conclusions: GERD is common in advanced COPD. Patients are often asymptomatic and have a relatively high prevalence of isolated abnormal proximal reflux. Dual-probe monitoring is therefore well suited for detecting GERD in patients with advanced COPD.

Key Words: acid blockers • aspiration • COPD • gastroesophageal reflux disease






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2007 by the American College of Chest Physicians.