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Chronic obstructive pulmonary disease is associated with a higher risk of functional gastrointestinal disorders - 11/05/22

Doi : 10.1016/j.rmed.2022.106833 
Yu-Chi Chiu a, b, 1, Wei-Pin Chang c, 1, Gau-Jun Tang d, Tzuo-Yun Lan d, , Kang-Yun Lee e, f, Vincent Yi-Fong Su g, h, i,
a Department of Internal Medicine, Tao Yuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan 
b Department of Healthcare Management, Yuanpei University of Medical Technology, Hsinchu, Taiwan 
c School of Health Care Administration, Taipei Medical University, Taipei, Taiwan 
d Institute of Hospital & Health Care Administration, National Yang Ming Chiao Tung University, Taipei, Taiwan 
e Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan 
f Division of Thoracic Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan 
g Department of Internal Medicine, Taipei City Hospital, Taipei City Government, Taipei, Taiwan 
h Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan 
i Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan 

Corresponding author. Department of Internal Medicine, Taipei City Hospital, Taipei City Government, Taipei, Taiwan.Department of Internal MedicineTaipei City HospitalTaipei City GovernmentTaipeiTaiwan∗∗Corresponding author. Institute of Hospital & Health Care Administration, National Yang Ming Chiao Tung University, Taipei, Taiwan.Institute of Hospital & Health Care AdministrationNational Yang Ming Chiao Tung UniversityTaipeiTaiwan

Abstract

Rationale

The association between chronic obstructive pulmonary disease (COPD) and functional gastrointestinal disorders (FGIDs) remains unclear.

Methods

Using Taiwan's National Health Insurance Research Database, we conducted a nationwide population-based study to explore the relationship of COPD and future FGIDs development. The COPD cohort consisted of 4107 patients with COPD between 2000 and 2005. For a comparison cohort, 12,321 age- and gender-matched patients without COPD were randomly selected. The two cohorts were tracked for 5 year and observed for occurrence of FGIDs. The operational definition of COPD in the Korean Health Insurance Review and Assessment Service database was used to validate the results. The validation study confirmed the accuracy of definitions of COPD (83.5% sensitivity).

Results

The adjusted hazard ratios (aHR) of FGIDs in patients with COPD was higher (aHR: 1.63; 95% confidence interval (CI): 1.45–1.83; P < .001) than that of the comparison patients. In our secondary analysis in which FGIDs was divided into gastroesophageal reflux disease, irritable bowel syndrome and functional dyspepsia. Patients with COPD also had higher risk for all three subtypes of FGIDs: irritable bowel syndrome (aHR: 1.55; 95% confidence interval (CI): 1.27–1.90; P < .001), gastroesophageal reflux disease (aHR: 2.10; 95% confidence interval (CI): 1.76–2.49; P < .001), and functional dyspepsia (aHR: 1.34; 95% confidence interval (CI): 1.11–1.62; P = .003). The results in validated COPD group were consistent with those in unvalidated COPD group.

Conclusion

Patients with COPD appeared to be at higher risk for future FGIDs.

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Highlights

COPD patients had higher risk for all three subtypes of FGIDs: irritable bowel syndrome, gastroesophageal reflux disease, and functional dyspepsia.
The validation study confirmed the accuracy of definitions of COPD.
The results in validated COPD group were consistent with those in unvalidated COPD group.

Le texte complet de cet article est disponible en PDF.

Keywords : COPD, Functional gastrointestinal disorders, Gastroesophageal reflux disease, Irritable bowel syndrome and functional dyspepsia

Abbreviations : COPD, WHO, FGID, NHI, LHID, NHIRD, ICD-9-CM, HIRA, SPSS, HR, CI, GERD, FEV1


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Vol 197

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