Volume 119, Issue 4, Pages 1043-1048 (April 2001) Increased Prevalence of Gastroesophageal Reflux Symptoms in Patients With COPD  Mokhlesi Babak , MD, Morris Aaron L. , RRT, Huang Cheng-Fang , MS, Curcio Anthony J. , Barrett Terrence A. , MD, Kamp David W. , MD, FCCP  CHEST  Volume 119, Issue 4, Pages 1043-1048 (April 2001) DOI: 10.1378/chest.119.4.1043 Copyright © 2001 The American College of Chest Physicians Terms and Conditions

Figure 1 Higher prevalence of significant GER symptoms in patients with COPD. The prevalence of significant GER symptoms (heartburn and/or regurgitation once or more per week), chronic cough, and dysphagia in patients with COPD (gray bars) are compared to control subjects (open bars). GER symptoms were assessed by a modified version of the Mayo Clinic GER questionnaire (see “Materials and Methods” section). *p < 0.05 COPD patients vs control subjects. CHEST 2001 119, 1043-1048DOI: (10.1378/chest.119.4.1043) Copyright © 2001 The American College of Chest Physicians Terms and Conditions

Figure 2 Higher prevalence of significant GER symptoms in patients with severe COPD. Patients with severe COPD based on FEV1 ≤≤ 50% of predicted (gray bars) had a higher prevalence of significant GER symptoms (heartburn and/or regurgitation once or more per week) compared with less severe COPD based on FEV1 > 50% (striped bars) and control subjects (open bars). *p < 0.05 FEV1 ≤≤ 50% vs control subjects;** p < 0.05 FEV1 > 50% vs control subjects. CHEST 2001 119, 1043-1048DOI: (10.1378/chest.119.4.1043) Copyright © 2001 The American College of Chest Physicians Terms and Conditions

Figure 3 Proportion of COPD patients with significant GER symptoms who reported increased respiratory symptoms associated with reflux events. A total of 19 patients with COPD reported significant GER symptoms on the modified version of the Mayo Clinic GER questionnaire (see “Materials and Methods” section). Five of these patients (26%) reported increased respiratory symptoms, such as wheezing, shortness of breath, and/or cough associated with reflux events. CHEST 2001 119, 1043-1048DOI: (10.1378/chest.119.4.1043) Copyright © 2001 The American College of Chest Physicians Terms and Conditions

Figure 4 Higher use of antireflux medications by COPD patients. The proportion of patients with COPD (gray bars) compared to control subjects (open bars) receiving over-the-counter antacids once or more per week, daily H2-RAs, or PPI therapy is indicated. Some patients were receiving multiple therapeutic regimens (eg, antacids and other prescription strength antireflux medications). *p < 0.05 COPD patients vs control subjects. CHEST 2001 119, 1043-1048DOI: (10.1378/chest.119.4.1043) Copyright © 2001 The American College of Chest Physicians Terms and Conditions