ISSN 2415-3060 (print), ISSN 2522-4972 (online)
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JMBS 2021, 6(4): 91–98
https://doi.org/10.26693/jmbs06.04.091
Clinical Medicine

Clinical Characteristics of the Combined Course of Chronic Obstructive Pulmonary Disease and Gastroesophagal Reflux Disease

Lіakh O. I., Tovt-Korshуnska M. I., Derbak M. A.
Abstract

The comorbid diseases can occur at any stage of bronchial obstruction, and, regardless of the severity or phase of chronic obstructive pulmonary disease, significantly affect disability, increase the frequency of hospitalizations, and increase the cost of medical care. The presence of concomitant gastroesophageal reflux disease in patients with chronic obstructive pulmonary disease is an independent aggravating risk factor for exacerbations and is associated with health deterioration of this group of patients. The purpose of the study was to study the features of the clinical course of chronic obstructive pulmonary disease in combination with gastroesophageal reflux disease. Materials and methods. Retrospective analysis of 138 patients who were treated in the pulmonology department for exacerbation of the disease and outpatient treatment by a gastroenterologist was carried out. 3 groups of patients were formed: 1 group (n=60) – patients with chronic obstructive pulmonary disease in combination with gastroesophageal reflux disease, 2 group (n=42) – patients with chronic obstructive pulmonary disease without signs of gastroesophageal reflux disease, who were treated in the pulmonology department for exacerbation of the disease and 3 group (n=36) – patients with gastroesophageal reflux disease who were treated on an outpatient basis. The patients were similar in age, stage of disease and duration of illness. The average age of the patients was 55±1.64. It should be noted, regarding the gender characteristics of the groups, that among the examined patients by gender, men predominated – 78.4% (80 out of 102). Results and discussion. The main clinical and anamnestic features of the combined pathology were studied. The significance of the assessment of functional changes in spirometry indexes in this category of patients is described. A significant decrease in external respiration function was revealed in the indicators of the external respiration function in patients of all groups. In the patients with chronic obstructive pulmonary disease in combination with gastroesophageal reflux disease the frequency of exacerbations increases. These exacerbations were associated with the presence and severity of gastrointestinal symptoms, namely increased heartburn, acid regurgitation causes worsening of respiratory symptoms, until the exacerbation of the disease with subsequent hospitalization. Also the length of stay in the hospital of the patients in this group increased by 1.5±0.4 days, which is associated with a severe exacerbation of chronic obstructive pulmonary disease and the need to use a double dose of glucocorticoids to control the symptoms of respiratory failure. Among the complaints of patients with combined pathology, extraesophageal manifestations of gastroesophageal reflux disease prevailed. Conclusion. The presence of concomitant gastroesophageal reflux disease in patients with chronic obstructive pulmonary disease expands and aggravates the clinical manifestations of the underlying disease

Keywords: chronic obstructive pulmonary disease, gastroesophageal reflux disease, external respiration function, extraesophageal manifestations

Full text: PDF (Eng) 288K

References
  1. Bobyk LR, Levynska NI, Piddubna AA, Vivsyannyk VV, Sazhyn NI. Metabolichni osoblyvosti erozyvno-vyrazkovykh urazhen shlunka ta dvanadtsyatypaloi kyshky u khvorykh na khronichne obstruktyvne zakhvoryuvannya lehen [The pathogenetic features of erosive-ulcerative damages of stomach and duodenum in patients with chronic obstructive lung’s disease]. Young Scientist. 2018; 11(63): 13-16. [Ukrainian]
  2. Shevchuk-Budz UI. Clinical and functional features of chronic bronchitis development admixed with a gastroesophageal reflux disease during an additional prescription of lecithine. Pharm Innovat J. 2018; 7(4): 488-489.
  3. Derbak MA, Boldizhar AA, Sirchak ES, Lazur YaV, Aleksandrova MYa. Kliniko-funktsionalnye osobennosti sochetanogo techeniya bronkhialnoy astmy i gastroezofagealnoy reflyuksnoyu bolezni i ikh korektsiya [Combined course of bronchial asthma and gastroesophageal reflux disease: its clinical, functional peculiarities, and mechanisms of its correction]. Georgian Med News. 2017 Nov; (272): 69-74. [Russian]
  4. Hashynova KYu. Khronichne obstruktyvne zakhvoryuvannya lehen: prohnozuvannya perebihu ta optymizatsiya terapiyi z urakhuvannyam lokalnoho urazhennya ta systemnykh proyaviv [Chronic obstructive pulmonary disease: forecasting the course and optimization of therapy taking into account local lesions and systematic manifestations]. Abstr. Dr. Sci. (Med.). Dnipropetrovsk; 2017. 360 p. [Ukrainian]
  5. Shevchuk-Budz UI. The study of clinical and pathogenetic characteristics of the chronic bronchitis course on the background of the aggravating concomitant gastroesophageal reflux. Pharm Innovat J. 2018; 7(10): 59-61.
  6. Lin YH, Tsai CL, Tsao LI, Jeng C. Acute exacerbations of chronic obstructive pulmonary disease (COPD) experiences among COPD patients with comorbid gastrooesophageal reflux disease. J Clin Nurs. 2019 May; 28(9-10): 1925-1935. https://www.ncbi.nlm.nih.gov/pubmed/30698890. https://doi.org/10.1111/jocn.14814
  7. Makarova HV, Rekalova OM. Osoblyvosti perebihu khronichnoho bronkhitu u khvorykh z suputnoyu hastroezofahalnoyu reflyuksnoyu khvoroboyu [Features of the course of chronic bronchitis in patients with concomitant gastroesophageal reflux disease]. Astma y allerhyya. 2019; (4): 37–42. [Ukrainian]
  8. Francis DO. Chronic cough and gastroesophageal reflux disease. Gastroenterol Hepatol (NY). 2016; 12(1): 64-6. https://www.ncbi.nlm.nih.gov/pubmed/27330507. https://www.ncbi.nlm.nih.gov/pmc/articles/4865789
  9. Khalil AM, Trofimov VI, Bibikova AA. Osobennosti techeniya khronicheskoy obstruktivnoy bolezni legkikh v sochetanii s gastroezofagalnoy reflyuksnoy boleznyu [Clinical picture of chronic obstructive pulmonary disease combined with gastroesophagenal reflux disease]. Uchenye zapiski SPbGMU im IP Pavlova. 2012; 19(1): 78-80. [Russian]
  10. Khalil AM. Otyagoshchenie techeniya khronicheskoy obstruktivnoy bolezni legkikh (KhOBL) gastroezofagalnoy reflyuksnoy boleznyu (GERB) [The burden of the flow of chronic obstructive pulmonary disease (COPD) gastroesophaginal reflux disease (GERD)]. Vrach-provizor-patsient. 2011; (1): 17. [Russian]
  11. Kryvenko VI, Hrinenko TYu, Pakhomova SP. Funktsionalni rozlady shlunkovo-kyshkovoho traktu u praktytsi likarya zahalnoi praktyky - simeynoi medytsyny [Functional disorders of the gastrointestinal tract in practice of general practitioner - family medicine]. Navch posibnik. Zaporizhzhya; 2015. 89 p. [Ukrainian]
  12. Dent J, El-Serag HB, Wallander M, Johansson S. Epidemiology of gastro-oesophageal reflux disease: a systematic review. Gut. 2005; 54(5): 710-7. https://doi.org/10.1136/gut.2004.051821. https://www.ncbi.nlm.nih.gov/pubmed/15831922. https://www.ncbi.nlm.nih.gov/pmc/articles/1774487
  13. Boyko TV. Suchasni aspekty diahnostyky hastroezofahealnoi reflyuksnoi khvoroby [Modern aspects of diagnosis of gastroesophageal reflux disease]. Zdobutky klinichnoi i eksperymentalnoi medytsyny. 2017; 2: 8-12. [Ukrainian]
  14. Kozub DD. Osoblyvosti perebihu bronkhialnoi astmy u poyednanni z hastroezofahealnoyu reflyuksnoyu khvoroboyu [Features of bronchial asthma in combination with gastroesophageal reflux disease]. Sumy; 2016. Available from: https://essuir.sumdu.edu.ua/handle/123456789/44651 [Ukrainian]