Correlation between Allergic Rhinitis and Laryngopharyngeal Reflux

Abstract

Background and Objectives Laryngopharyngeal reflux (LPR) exhibits nonspecific clinical presentations, and these symptoms may be associated with other conditions such as allergies, including allergic rhinitis and laryngitis. However, there is a gap in the literature regarding the correlation of laryngopharyngeal reflux with allergic rhinitis/laryngitis. Hence, the aim of this study is to explore the correlation between these two conditions. Patients and Methods A total of 126 patients with suggestive manifestations of laryngopharyngeal reflux were included in this study. Patients were classified into LPR positive and negative groups based on the results of a 24-hour oropharyngeal pH monitoring system while allergic rhinitis status was assessed with the score for allergic rhinitis (SFAR). The results of the two groups were compared regarding the SFAR score. Correlation between the pH results and SFAR score was explored. Results The LPR positive group demonstrated significantly higher SFAR scores compared to the negative LPR group (p < 0.0001). In addition, the Ryan score was significantly correlated with the SFAR total score and its symptomatology-related items (r ranged between 0.35 and 0.5). Conclusion. It seems that laryngopharyngeal reflux increases patients' self-rating of allergic manifestations. It appears that there is an association between laryngopharyngeal reflux and allergic rhinitis/laryngitis.

Allergic rhinitis, asthma and gastro-esophageal reflux disease: a cross-sectional study on their reciprocal relations

“…A causal link between GORD and AR was not established and only a few studies indicated a correlation [42]. We found in our study that LPR and AR occurred simultaneously more frequently as having LPR increased the incidence for AR by more than two folds which is similar to other studies [17,18]. Having asthma increased the correlation, but the correlation persisted even when excluding asthma which concurs with another study [18].…”

“…GORD in addition to Rhinitis in general are among the main causes of chronic cough, and their role has been discussed in several studies; increased reoccurrence of the cough with reflux symptom has also been reported in more than a few patients with GORD and in those with rhinitis who do not have symptoms of GORD, indicating that other factors contribute to the development of chronic cough. In addition, the coexistence of GORD and chronic rhinosinusitis (CRS) were reported by multiple studies [17,18,41,42,45,46]. One theory explaining this phenomena is that Helicobacter pylori, which is usually found in the gastric mucosa and promotes heartburning, can exist in the sinonasal cavity [47].…”

“…However, one study suggested that GORD would only worsen nasal symptom scores but did not cause chronic rhinosinusitis [46]. Studies data are conflicting in role of PPI in LPR as some studies found a higher response when using PPI suggesting complex patterns of LPR, while others did not show additional relief of symptoms compared with placebo [49] although a positive correlation was found between pH Ryan score and total SFAR score in another study which could be related to LPR [17]. RSI score in our study increased in responders with positive AR symptoms, suggesting that having AR increased the symptoms of LPR and vice versa, SFAR score increased with positive LPR symptoms, suggesting that having LPR increased symptoms of AR.…”

“…AR has a wide variety of symptoms including sneezing, a sore throat, globus pharyngeus, rhinorrhoea and congestion, and postnasal drip [15,16]. As AR and LPR have many symptoms in common resulting from irritation to the aerodigestive tract, they may have a correlation as suggested in many studies regardless of having asthma [17,18]. In this study we used a validated reflux symptom index (RSI) in Arabic [5,[19][20][21][22] to assess LPR and an Arabic version of the score for allergic rhinitis (SFAR) [23,24] to assess AR in Syria and to find if such a correlation exists.…”

Laryngopharyngeal Reflux: An Update

“…Many GERD patients experience dysmotility and prolonged acidity when the lower esophageal sphincter malfunctions, thereby allowing stomach acid to move up the esophagus, causing heartburn [12,18]. LPR is associated with a failure of the upper sphincters, which allows the acid to move up to the throat and even into the nose or middle ears [7][8][9]12]. LPR patients commonly present tissue damage of the laryngopharyngeal epithelium [12,19].…”