Nasal Pepsin Assay and pH Monitoring in Chronic Rhinosinusitis

Özmen, Süay; Yücel, Ömer Taşkın; Sinici, Incilkay; Özmen, Özlem; Süslü, Ahmet Emre; Öǧretmenoǧlu, Oğuz; Önerci, Metin

doi:10.1097/mlg.0b013e318165e324

Cited by 85 publications

(85 citation statements)

References 26 publications

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“…However, a higher frequency of LPR determined by means of dual-channel 24-hour pH monitoring was found in a group of patients with CRS who had persistent CRS symptoms despite endoscopic sinus surgery 50 and a similarly higher frequency of LPR by pH monitoring and fluorometric pepsin assay of nasal secretions was found in a population of patients with CRS undergoing sinus surgery compared with a control group. 51 However, there are no controlled studies demonstrating improvement of CRS by means of antireflux therapy.…”

Section: Humoral or Innate Immune Deficiencymentioning

confidence: 99%

Chronic rhinosinusitis: Epidemiology and medical management

Hamilos

2011

Journal of Allergy and Clinical Immunology

360

296

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Section: Humoral or Innate Immune Deficiencymentioning

confidence: 99%

Chronic rhinosinusitis: Epidemiology and medical management

Hamilos

2011

Journal of Allergy and Clinical Immunology

360

296

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“…Neither the Pincus et al 412 nor the DiBaise et al 413 study had a control group. Ozmen et al 414 showed a higher prevalence of pharyngeal reflux events (29/33) and positive nasal pepsin assay (26/33) in medically refractory CRS patients, as compared to controls (11/20 for each). Loehrl et al 415 found positive pharyngeal pH probes in 19 of 20 surgically refractory CRS patients, and positive nasal pepsin assays were found in all 5 patients tested.…”

Section: S55mentioning

confidence: 99%

International Consensus Statement on Allergy and Rhinology: Rhinosinusitis

Orlandi

Kingdom

Hwang

et al. 2016

Int Forum Allergy Rhinol

557

888

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Background:The body of knowledge regarding rhinosinusitis (RS) continues to expand, with rapid growth in number of publications, yet substantial variability in the quality of those presentations. In an effort to both consolidate and critically appraise this information, rhinologic experts from around the world have produced the International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR:RS). Methods:Evidence-based reviews with recommendations (EBRRs) were developed for scores of topics, using previously reported methodology. Where existing evidence was insufficient for an EBRR, an evidence-based review (EBR) was produced. The sections were then synthesized and the entire manuscript was then reviewed by all authors for consensus. Results:The resulting ICAR:RS document addresses multiple topics in RS, including acute RS (ARS), chronic RS (CRS) with and without nasal polyps (CRSwNP and CRSsNP), recurrent acute RS (RARS), acute exacerbation of CRS (AE-CRS), and pediatric RS. Conclusion:As a critical review of the RS literature, ICAR:RS provides a thorough review of pathophysiology and evidence-based recommendations for medical and surgical treatment. It also demonstrates the significant gaps in our understanding of the pathophysiology and optimal management of RS. Too o en the foundation upon which these recommendations are based is comprised of lowerlevel evidence. It is our hope that this summary of the evidence in RS will point out where additional research efforts may be directed. C 2016 ARS-AAOA, LLC. Key Words:rhinosinusitis; chronic rhinosinusitis; acute rhinosinusitis; recurrent acute rhinosinusitis; evidence-based medicine; systematic review; endoscopic sinus surgery List of Abbreviations Used

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“…The authors concluded that salivary pepsin assay might be a non-invasive method to assess for proximal reflux. While, Ozmen et al found 100% sensitivity and 92.3% specificity for pepsin assay in nasal lavage fluid in chronic rhinosinusitis patients [94], Printza et al did not demonstrate any peptic activity in 93 LPR patients' saliva samples [95]. Employing western blot technique for sputum and salivary pepsin samples in patients with extraesophageal reflux, Kim et al reported sensitivity and specificity of 89 and 68%, respectively based on the pH monitoring results [96].…”

Section: Diagnostic Considerationmentioning

confidence: 96%

Extra-esophageal gastroesophageal reflux disease and asthma: understanding this interplay

Naik

Vaezi²

2015

Expert Review of Gastroenterology & Hepatology

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Gastroesophageal reflux disease (GERD) is a condition that develops when there is reflux of stomach contents, which typically manifests as heartburn and regurgitation. These esophageal symptoms are well recognized; however, there are extra-esophageal manifestations of GERD, which include asthma, chronic cough, laryngitis and sinusitis. With the rising incidence of asthma, there is increasing interest in identifying how GERD impacts asthma development and therapy. Due to the poor sensitivity of endoscopy and pH monitoring, empiric therapy with proton pump inhibitors (PPIs) is now considered the initial diagnostic step in patients suspected of having GERD-related symptoms. If unresponsive, diagnostic testing with pH monitoring off therapy and/or impedance/pH monitoring on therapy, may be reasonable in order to assess for baseline presence of reflux with the former and exclude continued acid or weakly acid reflux with the latter tests. PPI-unresponsive asthmatics, without overt regurgitation, usually have either no reflux or causes other than GERD. In this group, PPI therapy should be discontinued. In those with GERD as a contributing factor acid suppressive therapy should be continued as well as optimally treating other etiologies requiring concomitant treatment. Surgical fundoplication is rarely needed but in those with a large hiatal hernia, moderate-to-severe reflux by pH monitoring surgery might be helpful in eliminating the need for high-dose acid suppressive therapy.

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Nasal Pepsin Assay and pH Monitoring in Chronic Rhinosinusitis

Cited by 85 publications

References 26 publications

Chronic rhinosinusitis: Epidemiology and medical management

Chronic rhinosinusitis: Epidemiology and medical management

International Consensus Statement on Allergy and Rhinology: Rhinosinusitis

Extra-esophageal gastroesophageal reflux disease and asthma: understanding this interplay

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