Lung disease and reduced pulmonary function are known comorbidities of obesity. A group of anti-reflux drugs called proton pump inhibitors (PPIs), which reduce the production of stomach acid, may improve lung function in people with bronchiectasis and high body mass index (BMI), according to a study published in the Korean Journal of Gastroenterology.
Researchers from Seoul National University in South Korea, led by Dr. Nayoung Kim, reviewed the clinical records (2003–15) of 257 patients, ages 24 to 92, who had bronchiectasis with gastro-esophageal reflux disease (GERD). Patients went through an initial lung function test and those who had GERD were treated with the anti-reflux drug.
The study, “Effect of Proton Pump Inhibitors in Bronchiectatic Patients with Gastroesophageal Reflux Disease,” suggests that the drug had no significant positive effect on lung function as measured by forced vital capacity (FVC) and forced expiratory volume in one second (FEV1). However, when researchers analyzed the association of lung function and BMI, they saw that anti-reflux drug treatment significantly improved FVC and FEV1 in obese patients, those with a high BMI. The drug’s effect correlated with the severity of the obesity.
In people with high BMI, medical anti-reflux therapy could be an option to anti-reflux surgery, which is currently one of the treatment options for bronchiectasis patients with GERD as supported by previous research.
The authors speculate that the reason anti-reflux drugs are efficient in obese people but not in those with a low BMI “could be because obesity causes increased esophageal acid exposure time.” To determine the exact effect of anti-reflux drugs in obese patients with bronchiectasis and GERD, randomized studies on a larger number of patients are needed.
It is estimated that more than 4 in every 100,000 people ages 18 to 34 have bronchiectasis in the U.S. This number dramatically rises to almost 272 people out of 100,000 for those over 75 years old. The disease is made worse by GERD. due to involuntary constriction of the airways controlled by the vagus nerve, and micro aspiration.
PPIs are potent inhibitors of acid secretion from the stomach. They are used to treat a variety of medical conditions, such as indigestion, stomach ulcers, and GERD.