GERD: A risk factor for nontuberculous mycobacterial lung disease


Dr JS Rajkumar, Chairman & Chief Surgeon, Lifeline Hospitals, Chennai    25 February 2023

Patients with gastroesophageal reflux disease (GERD) are at risk of developing nontuberculous mycobacteria pulmonary disease, suggests a new study published in the journal Chest.1


Through this study, Korean researchers aimed to find out the association between GERD and nontuberculous mycobacteria pulmonary disease. For this they retrospectively analysed data from the Korean National Health Insurance Service National Sample Cohort between 2002 and 2015. A total of 17,424 patients with GERD were included in the study and each patient with GERD was matched exactly to four control subjects who did not have GERD based on age, sex, type of insurance and Charlson Comorbidity Index (CCI).


During a follow-up period of 5.1 years (median), it was found that the incidence of nontuberculous mycobacteria pulmonary disease was significantly higher in patients with GERD compared to matched controls without GERD; 34.8 per 100,000 person-years vs 10.5 per 100,000 person-years, respectively with roughly 3.4 fold increased risk of nontuberculous mycobacteria pulmonary disease among patient with GERD than in those without.


Among patients with GERD, the risk increased nearly 4 times in patients aged ≥60 years with adjusted hazard ratio (aHR) of 3.57, while in those with bronchiectasis, the risk was found to increase by 18-folds with aHR of 18.69. Patients with nontuberculous mycobacteria pulmonary disease showed higher all-cause (13,321 person years vs 5,932 person years) and respiratory disease-related (5,403 vs 801) visits to ER or hospitalizations.


This is the first study, note the authors, to show that GERD is associated with increased risk of nontuberculous mycobacteria pulmonary disease, which led to more hospital visits and healthcare utilization. Among GERD patients, older age and bronchiectasis were identified as risk factors. Hence, GERD patients should be assessed for nontuberculous mycobacteria pulmonary disease if they develop new respiratory symptoms.




  1. Kim Y, et al. Gastroesophageal reflux disease increases susceptibility to nontuberculous mycobacterial pulmonary disease. Chest. 2023 Feb;163(2):270-280. doi: 10.1016/j.chest.2022.08.2228.

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