Diagnostic particularities of gastroesophageal reflux disease associated with chronic obstructive pulmonary disease

Abstract

Background. Studies show that 40–60% of patients with GERD present respiratory manifestations suggestive of COPD. The two conditions influence each other through inflammatory mechanisms and vago-neurogenic reflexes, contributing to the exacerbation of symptoms, complicating diagnosis and therapeutic conduct. Objective(s). To highlight the diagnostic particularities of Gastroesophageal Reflux Disease and COPD and the role of paraclinical investigations in optimizing the management of these associated conditions. Materials and methods. This research was based on literature sources analyzed via PubMed, NCIB, and Mendeley using the keywords “GERD,” “COPD,” “investigations,” “clinical picture,” “diagnosis,” and their combinations, published between 2023 and 2025. Relevant studies addressing GERD diagnosis in the context of COPD were selected, with emphasis on paraclinical methods. Results. Chronic Obstructive Pulmonary Disease diagnosis in Gastroesophageal Reflux Disease patients included spirometry with reversibility testing to assess obstruction, and thoracic CT scans that revealed bronchiectasis and chronic inflammation due to microaspiration. GERD was confirmed by esophagitis signs on upper endoscopy and barium radiography indicating high-level reflux. Twenty-four-hour pH monitoring and esophageal impedance testing identified episodes of both acid and non-acid reflux associated with coughing, involved in persistent respiratory symptoms or unexplained exacerbations, highlighting the clinical link between the two conditions. Conclusion(s). The clinical picture in GERD and COPD is complex, with overlapping symptoms. The presence of persistent respiratory manifestations (cough, shortness of breath, etc.) requires detailed evaluation. Correct diagnosis prevents underdiagnosis, optimizes therapy, and avoids deterioration of lung function.