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Laryngopharyngeal reflux COPD to uncover reflux and columnar lined esophagus

Authors Kristo I, Riegler M, Schoppmann SF

Received 4 August 2015

Accepted for publication 12 August 2015

Published 30 September 2015 Volume 2015:10(1) Pages 2095—2096

DOI https://doi.org/10.2147/COPD.S93711

Checked for plagiarism Yes

Editor who approved publication: Dr Richard Russell

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Ivan Kristo, Martin Riegler, Sebastian F Schoppmann

Upper-GI-Service, Gastroesophageal Tumor Unit, Department of Surgery, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria

With interest we read the article by Jung et al1 published in the recent issue of the International Journal of Chronic Obstructive Pulmonary Disease. An important finding of the study was the positive correlation between symptoms of gastroesophageal reflux disease (GERD), endoscopic signs for laryngopharyngeal reflux (LPR), and COPD.1 COPD represents an increasing health burden.2,3 Owing to the symptoms, COPD impairs the productivity and life quality of those affected.2,3 Frequently, COPD requires chronic administration of cortisone therapy, which itself produces side effects impairing well being.4,5 The finding that COPD associates with LPR and GERD opens the trail for additional diagnostic and therapeutic considerations.


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Dear editor

With interest we read the article by Jung et al1 published in the recent issue of the International Journal of Chronic Obstructive Pulmonary Disease. An important finding of the study was the positive correlation between symptoms of gastroesophageal reflux disease (GERD), endoscopic signs for laryngopharyngeal reflux (LPR), and COPD.1 COPD represents an increasing health burden.2,3 Owing to the symptoms, COPD impairs the productivity and life quality of those affected.2,3 Frequently, COPD requires chronic administration of cortisone therapy, which itself produces side effects impairing well being.4,5 The finding that COPD associates with LPR and GERD opens the trail for additional diagnostic and therapeutic considerations.

If GERD is suspected, one may want to define the amount, characteristics, and components of GERD. Thus, endoscopy and histopathology of esophageal biopsies help to assess the morphologic manifestation of GERD, ie, hiatal hernia, esophagitis, and columnar lined esophagus in the distal or proximal portion of the esophagus.6 Presence of Barrett’s esophagus defines increased cancer risk and may be managed by surveillance or, in cases of increased cancer risk (dysplasia), by elimination of Barrett’s esophagus tissue by endoscopic radiofrequency ablation (± endoscopic mucosal resection).6 Furthermore, esophageal manometry and reflux monitoring characterize reflux, that causes symptoms, ie, aggravates COPD and LPR.5,6 In summary, the orchestration of diagnostic findings offers the path for a tailored therapy, ie, medical, nutrition or, in cases of advanced GERD, resolution of reflux by laparoscopic anti reflux surgery.5,6 Going in line with the considerations of Jung et al1 we think that LPR-positive COPD patients should be offered the above algorithm to attenuate the progression of the disease and the need for cortisone therapy.2,4 We kindly ask the authors to address the above suggestions.

Disclosure

The authors report no conflicts of interest in this communication.


References

1.

Jung YH, Lee DY, Kim DW, et al. Clinical significance of laryngopharyngeal reflux in patients with chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis. 2015;10:1343–1351.

2.

Ajmera M, Raval AD, Shecn C, Sambamoorthi U. Explaining the increased health care expenditures associated with gastroesophageal reflux disease among elderly Medicare beneficiaries with chronic obstructive pulmonary disease: a cost-decomposition analysis. Int J Chron Obstruct Pulmon Dis. 2014;9:339–348.

3.

Landis SH, Muellerova H, Mannino DM, et al. Continuing to Confront COPD International Patient Survey: methods, COPD prevalence, and disease burden in 2012–2013. Int J Chron Obstruct Pulmon Dis. 2014;9:597–611.

4.

Woods JA, Wheeler JS, Finch CK, Pinner NA. Corticosteroids in the treatment of acute exacerbations of chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis. 2014;9:421–430.

5.

Promberger R, Spitzer A, Ott J, et al. Quality of life in type 2 diabetics with gastroesophageal reflux disease: a case control study. Eur Surg. 2013;45:194–199.

6.

Subramanian CR, Triadafilopoulos G. Radiofrequency-based treatments for esophageal disease. Eur Surg. 2014;46:12–20.

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