Relation between chronic rhinosinusitis and gastroesophageal reflux in adults: systematic review

Abstract

There seems to be relative prevalence of reflux with intractable CRS. There is still a lack of controlled studies with a significant number of patients to confirm this hypothesis. Few studies specifically assess the impact of treatment of reflux on symptom improvement in patients with CRS.

Intranasal Helicobacter pylori infection in patients with chronic rhinosinusitis with polyposis

“…The presence of H pylori in patients with chronic rhinosinusitis with polyposis could be linked to pathological reflux of the upper airway. It has been suggested that gastroesophageal reflux might play a role in the pathogenesis of chronic rhinosinusitis 25 , 26 . Our study shows a high prevalence of laryngopharyngeal reflux related symptoms and signs among H pylori positive patients (mainly patients with chronic rhinosinusitis with polyposis) and H pylori negative patients (equal numbers of patients with chronic rhinosinusitis with polyposis and controls).…”

“…Additionally, perhaps not all patients had intragastric H pylori that could be transmitted to the upper airway 28 . Furthermore, nasopharyngeal reflux is more commonly severely refractory to treatment in chronic rhinosinusitis patients 26 , 29 . Unfortunately, in our study we did not use objective 24-hour pH-metry or multichannel impedancometry to prove the laryngopharyngeal reflux diagnosis or to estimate the character of reflux episodes in the upper airway.…”

Prevention of chronic rhinosinusitis

“…The relationship between gastroesophageal reflux disease (GERD) and upper and lower airway diseases has been debated in the past . However, recent epidemiologic studies using electronic health registries and systematic reviews report that GERD and CRS often coexist (10,52) . Wong et al describe a possible vagal reflex existing between the oesophagus and the paranasal sinuses (53) .…”

Upper digestive tract abnormalities in dogs with chronic idiopathic lymphoplasmacytic rhinitis

“…9 Many studies have postulated a relationship between CILPR and gastrointestinal clinical signs such as those related to gastroesophageal reflux disease (GERD). [10][11][12] However, it is difficult to establish a direct relationship between CILPR and GERD, because both entities are highly prevalent, which makes it likely for them to coexist independently. 13 Gastroesophageal reflux disease can affect the nasal cavity directly by introduction of acid, pepsin, and gastric contents into the nasal cavity, or indirectly by stimulating the autonomic nervous system.…”