Association of Bile Acid and Pepsin Micro-aspiration with Chronic Obstructive Pulmonary Disease Exacerbation

BACKGROUND: Chronic Obstructive Pulmonary Disease (COPD) is one of the most common chronic diseases all around the world. One of suggested risk factors for COPD is Gastroesophageal Reflux Disease (GERD). The aim of this study was investigation of the association between micro-aspiration of bile acid and pepsin with exacerbation attacks in COPD patients. MATERIALS AND METHODS: The present study was a descriptive cross-sectional study. Fifty-two COPD patients were selected by simple sampling from patients referring to the Bessat Lung Clinic. Participants were divided into two groups of with and without COPD exacerbation history in the past year. The severity of the disease was determined based on the GOLD criteria (mild, moderate, severe and very severe). Then, all patients underwent bronchoscopy and the concentrations of bile acid and pepsin were compared in Broncho-Alveolar Lavage Fluid (BALF) of two groups. RESULTS: The mean of bile acids in the group without COPD exacerbations was lower (27.38±3.26 μmol/Lit) than the group with COPD exacerbations (32.31±5.35 μmol/Lit) and this difference was not significant (P=0.436). The mean of pepsin in the first group was higher (118.46 ±15.44 ng/ml) than the second group (107.88±10.7 ng/ml) and this difference was also not significant (P=0.577). CONCLUSION: According to the results of this study, there is no association between disease severity and number of exacerbations with micro-aspiration of bile acid and pepsin in COPD patients.