Correlation between gastroesophageal reflux disease (GERD) and the risk of acute exacerbation of chronic obstructive pulmonary disease (COPD), A cross-sectional study in Syrian Patients

Background: Gastroesophageal reflux disease (GERD) and chronic obstructive pulmonary disease (COPD) are prevalent chronic conditions associated with significant morbidity and mortality worldwide. While GERD affects 10-20% of adults in Western countries, COPD affects approximately 10% of adults over 40 years old. The coexistence of GERD and COPD is increasingly recognized, with evidence suggesting a bidirectional relationship between the two conditions. Methods: A cross-sectional study was conducted on a sample of residents from various provinces in Syria (Damascus, Al-Suwayda, Raqqa, Deir ez-Zor, Daraa), with informed consent obtained from all participants. The inclusion criteria encompassed all participants who responded to the questionnaire within the period from February 1st to March 25th, 2024. Results: The survey involved 100 COPD patients from various Syrian regions, mostly Damascus (82%), with 76% male and 24% female, averaging 64.5 years. 75% lacked education, 63% were employed in diverse fields. Smoking rate was 89%, with 98% married and 3 children on average. 50% had high blood pressure, 28% previously diagnosed with COPD. 86% struggled to quit smoking. 60% had three meals daily. Conclusions: The study assessed 100 participants with COPD from various Syrian regions, predominantly Damascus (82%). It found 48% had normal BMI, while 68% were male smokers, despite awareness campaigns. Elderly participants (aged 70-61) were prevalent, potentially experiencing comorbidities such as hypertension and cardiac disorders. 40% reported acid reflux, correlated with dietary neglect. There was no significant gender correlation with GERD, but age showed a weak association. Smoking exacerbated COPD symptoms, with increased consumption leading to worsened prognosis. Male gender potentially protected against severe exacerbations. Participants within the normal weight range (48%) faced increased hospitalization risks due to severe exacerbations. Studies emphasized weight gain and obesity's protective role against exacerbations and morbidity rates among COPD patients.