A possible pathological link among swallowing dysfunction, gastro-esophageal reflex, and sleep apnea in acute exacerbation in COPD patients

Teramoto, Shinji

doi:10.2147/copd.s99663

Cited by 11 publications

(3 citation statements)

References 17 publications

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“…However, it's not sufficient to draw the causal effect of GERD in exacerbations of COPD when we consider this issue in return. Sleep apnea, a common ailment existed in COPD patients, causes GER and non-acidic reflux [37]. Increased gastro-esophageal pressure gradient, recurrent coughing, diaphragmatic flattening in COPD patients are proposed to exacerbate reflux [13,38].…”

Section: Discussionmentioning

confidence: 99%

A systematic review with meta-analysis of gastroesophageal reflux disease and exacerbations of chronic obstructive pulmonary disease

2020

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Background: Gastroesophageal reflux disease (GERD) was suggested to be associated with exacerbations of chronic obstructive pulmonary disease (COPD) in recent years. The aim of this study was to examine the association between GERD and COPD exacerbation through a meta-analysis. Methods: Databases including EMBASE, MEDLINE, and the Cochrane Central Register of Controlled Trials were searched with a systematic searching strategy for original articles, published until Jan 2019, without language restriction. Results: A total of 13,245 patients from 10 observational articles were included in the meta-analysis. The metaanalysis indicated that GERD is associated with increased risk of COPD exacerbation (OR: 5.37; 95% CI 2.71-10.64). Patients with COPD and GERD had increased number of exacerbation (WMD: 0.48; 95% CI: 0.31 to 0.65). Conclusions: The meta-analysis showed that there was a significant correlation between GERD and COPD exacerbation.

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Section: Discussionmentioning

confidence: 99%

A systematic review with meta-analysis of gastroesophageal reflux disease and exacerbations of chronic obstructive pulmonary disease

2020

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“…In a recent systematic review on swallowing function and chronic respiratory disease [17], the outcome data indicate that chronic respiratory diseases increase the prevalence of oropharyngeal dysphagia in patients. Oesophageal dysphagia in the form of gastro-oesophageal reflux has also been reported as more common in patients with COPD [27] and associated with more frequent exacerbations; however, the exact prevalence of either oropharyngeal or oesophageal dysphagia in patients with COPD is not fully understood nor is the disease's impact on swallowing function and the patient's perception of this. Like COPD, the impact of dysphagia is considerable both from an epidemiological and an individual patient perspective; it can lead to aspiration, malnutrition, and a heavy burden on healthcare resources [28].…”

Section: Introductionmentioning

confidence: 99%

Subjective swallowing symptoms and related risk factors in COPD

et al. 2019

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ObjectivesThis study aimed to investigate the prevalence of subjective (i.e. self-reported) swallowing symptoms in a large cohort of patients with stable chronic obstructive pulmonary disease (COPD) and to identify potential related risk factors.MethodsA total of 571 patients with COPD, investigated in a stable phase, participated in this multicentre study (335 females, 236 males; mean age: 68.6 years (sd 7.7)). Data were derived from spirometry, a questionnaire and a 30-metre walking test.ResultsIn total, 33% (n=186) patients reported at least some degree of swallowing problem. The most frequently reported symptom was food lodging in the throat (23%). A significant relationship was found between swallowing symptoms and dyspnoea, assessed as modified Medical Research Council (mMRC) ≥2 compared with <2 (46% versus 22%; p<0.001) and health-related quality of life, assessed as the COPD Assessment Test (CAT) ≥10 (40% versus 19%; p<0.001). Swallowing problems were also related to lower physical capacity (p=0.02) but not to lung function (p>0.28).ConclusionSubjective swallowing symptoms seem to be a common problem in patients with stable COPD. This problem is seen in all stages of the disease, but is more common in symptomatic patients and in patients with lower physical capacity.

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“…Gastrointestinal disorders and sleep apnea were associated with symptoms and exacerbations (group B, stronger with group D). Both can lead to unwitnessed pulmonary aspiration [29,30] and pulmonary infections, and could, therefore, increase symptom burden and exacerbation rates. In line with findings on higher symptom burden and exacerbation rates in patients with Asthma-COPD overlap syndrome [31], we found asthma to be associated with groups B and D which might also be related to chronic airway inflammation.…”

Section: Symptoms Exacerbationsmentioning

confidence: 99%

The revised GOLD 2017 COPD categorization in relation to comorbidities

Kahnert

Alter

Young³

et al. 2018

Pneumologie

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Introduction:The COPD classification proposed by the Global Initiative for Obstructive Lung Disease was recently revised, and the A to D grouping is now based on symptoms and exacerbations only. Potential associations with comorbidities have not been assessed so far.Thus the aim of the present study was to determine the relationship between the revised (2017) GOLD groups A-D and major comorbidities. Methods: We used baseline data from the COPD cohort COSYCONET. Comorbidities were identified from patient self-reports and disease-specific medication: gastrointestinal disorders, asthma, sleep apnea, hyperuricemia, hyperlipidemia, diabetes, osteoporosis, mental disorders, heart failure, hypertension, coronary artery disease. The A-D groups were based on either the COPD Assessment Test or the modified Medical Research Council scale. Exacerbations were also categorized as per GOLD recommendations. Results: Data from 2228 patients were analyzed. Using GOLD group A as a reference, group D was associated with nearly all comorbidities, followed by group B and C. When groups A-D were dichotomized as AC vs. BD (symptoms) and AB vs. CD (exacerbations), all comorbidities correlated with symptoms and/or exacerbations. This was true for both mMRC-and CAT-based categorizations. Conclusions: These findings suggest that the recently modified GOLD categorization is clinically relevant beyond being purely an assessment of symptoms and exacerbations. As the A-D groups correlated with the risk of important comorbidities, with some differences in terms of the correlation with symptoms and exacerbations, the findings underline the importance of identifying comorbidities in COPD, particularly in non-responders to therapy who have high symptoms and/or exacerbation rates.

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A possible pathological link among swallowing dysfunction, gastro-esophageal reflex, and sleep apnea in acute exacerbation in COPD patients

Cited by 11 publications

References 17 publications

A systematic review with meta-analysis of gastroesophageal reflux disease and exacerbations of chronic obstructive pulmonary disease

A systematic review with meta-analysis of gastroesophageal reflux disease and exacerbations of chronic obstructive pulmonary disease

Subjective swallowing symptoms and related risk factors in COPD

The revised GOLD 2017 COPD categorization in relation to comorbidities

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