Association of gastro-oesophageal reflux disease and quality of life in patients with chronic rhinosinusitis

Yang, Xu; Yang, Wen; Song, Yao; Cheng, Danni; Cao, Min; Huang, Jingyue; Ren, Jianjun; Lee, Jong Wook; Hueniken, Katrina; Chen, Yao; Brown, Catherine; Zhang, Yuke; Qiu, Ke; Xu, Wei; Zhao, Yu; Liu, Geoffrey

doi:10.14639/0392-100x-n1491

Cited by 6 publications

(4 citation statements)

References 25 publications

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“…There were some literatures suggesting that treatment of RS was helpful in improving the symptoms of acid and after FESS, and the results showed that compared with CRS patients without GERD, GERD patients with CRS had worse quality of life, and after FESS, Quality of life improved in these GERD patients with CRS [27]. In this study, as shown in Table 2, we saw that the risk of GERD rised with CRS occurrence in the IVW method.…”

Section: Discussionsupporting

confidence: 55%

Causal relationships between rhinosiusitis and gastroesophageal reflux disease： a bidirectional two-sample Mendelian randomization study

Chen,

Zhang,

Xie

et al. 2023

Preprint

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Background Gastroesophageal reflux disease (GERD) is associated with acute and chronic rhinosinusitis (ARS/CRS), although the causal relationship between them is not clear. Methods We conducted a bidirectional two-sample Mendelian randomized study to investigate the causal effects between GERD and rhinosinusitis (RS). The data for GERD and RS were obtained from large sample size genome-wide association studies (GWAS). Single-nucleotide polymorphisms (SNPs) associated with each exposure were considered instrumental variables in this study. We conducted a causal effect analysis using the inverse-variance weighted (IVW)，Weighted median，MR Egger，Simple mode and Weighted mode methods. The inverse-variance weighted and MR - Egger methods were used for the heterogeneity analysis. The MR - Egger model method was adopted for Pleiotropic effects. Results MR analysis showed that GERD had a statistically significant causal effect on ARS (IVW, OR = 1.324, 95% CI 1.177-1.490, p <0.001) and CRS (IVW, OR = 1.365, 95% CI 1.185-1.572, p <0.001).MR analysis showed that CRS had a statistically significant causal effect on GERD (IVW, OR = 1.033, 95% CI 1.009-1.056, p =0.006). However, the MR-Egger model revealed the evidence of horizontal pleiotropy for the causal effect of CRS on GERD (Egger-intercept=0.007, p=0.032). In addition，we did not observe a causal effect of ARS on GERD (IVW, OR = 1.019, 95% CI 0.986-1.053, p=0.269). Conclusions We confirmed the causal effect of GRED on RS, while no causal effect of RS on GERD was found. These studies are expected to provide high-quality causal evidence for the pathogenesis of RS and GERD, and additional ideas for their primary prevention and treatment.

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Section: Discussionsupporting

confidence: 55%

Causal relationships between rhinosiusitis and gastroesophageal reflux disease： a bidirectional two-sample Mendelian randomization study

Chen,

Zhang,

Xie

et al. 2023

Preprint

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“…Additionally, we have contributed supplementary evidence substantiating the beneficial impact of PPIs on the outcomes of CRS patients. This benefit is observed whether PPIs are administered as standalone treatment or subsequent to FESS, as demonstrated by Anzic et al 34 and Nanda et al 33 These findings serve to underscore the role of GERD in hindering the successful resolution of CRS through medical or surgical interventions, a facet not definitively ascertained by Leason et al 50 It's important to note, however, that the presence of GERD did not exert any noticeable impact on the outcomes of FESS, as reported by Xu et al 35 and Verim et al 38 Furthermore, our research introduces additional supporting evidence that highlights elevated levels of pepsin in CRS patients when compared to control groups, a fact established by the studies of Ren et al 29 and Wang et al 30 This phenomenon is particularly prominent in the subgroup of CRS patients with LPR, as opposed to those without, as demonstrated by Azis et al 19 Our systematic review encountered several limitations. Firstly, due to language constraints, we only accessed studies that were published in English.…”

Section: Discussionmentioning

confidence: 75%

Association Between Chronic Rhinosinusitis and Reflux Diseases in Adults: A Systematic Review and Meta-Analysis

Aldajani,

Alhussain,

Mesallam

et al. 2023

Am J Rhinol�Allergy

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Background Over the last few decades, reflux diseases, such as laryngopharyngeal reflux (LPR) and gastroesophageal reflux disease (GERD), have been identified as significant contributors to inflammatory upper aerodigestive tract diseases. Establishing a direct relationship between reflux disease and chronic rhinosinusitis (CRS) is challenging due to the high prevalence of both diseases and their potential for independent coexistence. Objective The purpose of this study is to review the existing literature and evaluate the evidence of an association between reflux diseases and CRS. Methods A comprehensive electronic search was conducted across multiple databases to identify all studies that investigated the relationship between LPR, GERD, and CRS from January 1, 1950, to June 16, 2022. Only studies with English manuscripts involving adult populations were included, while case series, case reports, and in vitro studies were excluded. The risk of bias was evaluated using The Newcastle-Ottawa Scale for case-control studies and the NIH quality assessment tool for observational cohort and cross-sectional studies. Results The search strategy yielded a total of 427 articles, out of which 25 studies examined the correlation between reflux diseases and CRS. The meta-analysis indicated a significant association between the presence of GERD and CRS compared to control groups ( P < .001; CI 3.56 [2.25, 5.65]), as well as significantly higher pH values and pepsin detection in CRS patients when compared to healthy individuals ( P = .003). Furthermore, all studies that evaluated proton pump inhibitor (PPI) therapy in CRS patients reported positive outcomes, with 93% of CRS patients showing improvement on PPIs. Conclusion The existing literature provides suggestive evidence of an association between reflux diseases and CRS, with regards to both prevalence and treatment. Nonetheless, further studies are required to confirm this relationship.

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“…It is controversial whether GERD affects the outcomes of CRS treatment [9]. Some studies have shown greater improvement in QoL after FESS in CRS patients with GERD compared to those without GERD, although CRS patients with GERD have lower preoperative QoL scores [8]. CRS patients with comorbid GERD have higher 22-item Sino-Nasal Outcome test scores and lower QoL scores [4].…”

Section: Discussionmentioning

confidence: 99%

“…Patients with both CRS and GERD are more likely to develop atopic diseases and asthma than those without GERD [7]. Acid reflux affects nasal symptoms and quality of life (QoL) in CRS patients [8]. However, the link between RS and GERD has not been fully understood.…”

Section: Introductionmentioning

confidence: 99%

Gastroesophageal Reflux Disease and Rhinosinusitis: A Bidirectional Mendelian Randomization Study

Chen,

Lv,

Lai

et al. 2023

Int Arch Allergy Immunol

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Introduction: Comorbidities, such as gastroesophageal reflux disease (GERD), are common in patients with rhinosinusitis (RS). However, the link between RS and GERD has not been fully understood. This study aimed to investigate the causal relationship between GERD and acute (ARS) or chronic RS (CRS), providing references for the pathogenesis and management of RS. Methods: The data were obtained from the Integrative Epidemiology Unit Open GWAS project and FinnGen. A total of 972,838 individuals were included. The inverse variance-weighted (IVW) method was applied to obtain the primary results of the study. Weighted median, MR-Egger, and mode-based methods were used to determine the robustness of the results. Cochran’s Q statistic and MR-Egger method were applied to detect heterogeneity and pleiotrophy in instrumental variables (IVs). Other sensitivity analyses included MR-PRESSO and leave-one-out analysis. Results: The MR study showed that GERD was associated with an increased risk of CRS (OR: 1.36, 95% CI: 1.18–1.57, p < 0.001). The results of other analysis methods were broadly consistent with the IVW estimate. No heterogeneity was detected by Cochran’s Q test (p = 0.061) and MR-PRESSO (p = 0.074). No horizontal pleiotropy was shown in IVs (p = 0.700). GERD was also associated with an increased risk of ARS (OR: 1.31, 95% CI: 1.17–1.48, p < 0.001). Some analytical results were inconsistent with the IVW estimate. No heterogeneity and pleiotropy were observed. There was no sufficient evidence for a reverse causal effect of RS on GERD. Conclusion: Our study supported that GERD promoted the risk of CRS and may be a potential risk factor for ARS. This provides additional support for further investigation into the mechanisms of GERD on RS.

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Association of gastro-oesophageal reflux disease and quality of life in patients with chronic rhinosinusitis

Cited by 6 publications

References 25 publications

Causal relationships between rhinosiusitis and gastroesophageal reflux disease： a bidirectional two-sample Mendelian randomization study

Causal relationships between rhinosiusitis and gastroesophageal reflux disease： a bidirectional two-sample Mendelian randomization study

Association Between Chronic Rhinosinusitis and Reflux Diseases in Adults: A Systematic Review and Meta-Analysis

Gastroesophageal Reflux Disease and Rhinosinusitis: A Bidirectional Mendelian Randomization Study

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