Incidence and treatment results of laryngopharyngeal reflux in chronic obstructive pulmonary disease

Abstract

Laryngopharyngeal reflux (LPR) is defined as the movement of gastric content towards the larynx and the pharynx and it may cause respiratory symptoms or difficulty in their control. We aimed to find the frequency of LPR in chronic obstructive pulmonary disease (COPD) patients and to investigate its effect on COPD symptoms and the results of its treatment. At baseline 30 (20 male, 10 female, mean age: 65 +/- 10 years) COPD patients completed LPR and COPD symptom questionnaires and 13 (44%) were diagnosed with LPR based on laryngeal examination. Patients with LPR were given 2 months of PPI treatment, after which LPR and COPD symptom questionnaires, laryngeal examinations and pulmonary function tests were repeated. Following the treatment, significant improvements in COPD symptom index, LPR symptom index and laryngeal examination findings were observed in patients with LPR (P < 0.01, P < 0.01, P < 0.0001, respectively). Treatment of LPR resulted in a significant improvement in the symptoms of COPD.

Exacerbations of COPD and symptoms of gastroesophageal reflux: a systematic review and meta-analysis

“…Of the 11 articles, 7 met the inclusion criteria and were included in the analysis (Figure 1). ( 4 , 19 , 44 - 48 ) The characteristics of the studies included in the meta-analysis are presented in Table 1. No unpublished or ongoing studies were included.…”

“…The major issues about the effect of GER in COPD exacerbations are how exacerbations are determined or defined and whether such determinations are carried out prospectively or retrospectively. Recent retrospective studies ( 47 , 48 ) suggested that GER symptoms were associated with exacerbations; however, in those studies, the subjects were asked to report the number of exacerbations that had occurred during the previous year, which was an approach that could result in a recall bias. To solve this type of problem, other studies ( 19 , 45 ) utilized a prospective questionnaire-based data collection system that allowed us to identify exacerbations according to a more reliable definition of COPD exacerbation, such as the modified criteria by Anthonisen et al ( 20 ) The prospective analyses of Terada et al ( 19 ) and Hurst et al ( 4 ) presented the most reliable information about exacerbations and were the most influential studies on the forest plots about the risk of COPD exacerbations associated with GER (Figure 5).…”

The clinical significance of laryngopharyngeal reflux in patients with chronic obstructive pulmonary disease

“…GERD is a well-known comorbidity of COPD, 12,15 and is negatively associated with symptoms, quality of life, and exacerbation of COPD. [16][17][18] However, the association between …”

Reflux gastro-œsophagien et pathologies respiratoires chroniques

“…La place du traitement anti-reflux n'est pas clairement établie : certaines études n'ont retrouvé aucun bénéfice quant à l'utilisation d'un traitement par IPP ou d'un antagoniste des récepteurs H2 [50,51] tandis que d'autres ont montré une amélioration des symptômes respiratoires [52] et une diminution des exacerbations [53] après instauration d'un IPP chez des patients BPCO. Il est vraisemblable que, tout comme dans l'asthme, les patients atteints de BPCO ayant un reflux symptomatique doivent recevoir un traitement anti-reflux, ce qui participera à l'amélioration significative de leur qualité de vie [54].…”