Association of gastro-oesophageal reflux and chronic rhinosinusitis: systematic review and meta-analysis

Abstract

Introduction: Gastro-oesophageal reflux disease (GORD) has been implicated in the development of chronic rhinosinusitis (CRS).The association of GORD with CRS is systematically assessed from the medical literature.Methodology: Embase and MEDLINE were searched using a comprehensive strategy limited to English language and Human subjects. Any study with original data on the experimental, diagnostic, treatment or prognostic association of CRS with GORD was included. Studies without a control group, case reports and review articles were excluded. Results:The search returned 958 records, with an additional 10 found from bibliographic lists; this produced 32 studies. The included studies (n=32) consisted of studies reporting pathogenic factors (n=20), epidemiological association (n=8), prognostic interactions (n=3), and a combination of these outcomes (n=1). Potential pathogenic roles for GORD in CRS were supported; CRS subjects had greater prevalence of intranasal Helicobacter pylori and acid reflux than subjects without CRS. CRS is more prevalent in GORD sufferers than those without GORD. Evidence is conflicting for GORD as a factor in CRS treatment failure. Conclusion:The results support a significant association of GORD with CRS. Physicians should be cognizant of the potential for acid and non-acid reflux as a driving factor in CRS.

Gastroesophageal reflux disease in patients with various comorbidal pathology

“…Otolaryngological symptoms are manifested by laryngitis, hoarseness, granulomas, ulcers, vocal cord polyps, otalgia, rhinitis, otitis media. The results of a meta-analysis confirm a significant association of GERD with chronic rhinosinusitis, with both acid and non-acid reflux being risk factors for this pathology [25]. Dental symptoms include tooth decay, tooth enamel erosion, periodontal disease, and aphthous stomatitis.…”

Association between laryngopharyngeal reflux, gastroesophageal reflux and recalcitrant chronic rhinosinusitis: A systematic review

“…Importantly, note that the present systematic review focused on recalcitrant CRS and considered the methodology used to establish the LPR diagnosis, which are both differences with the previous review of Leason et al who investigated the relationship between CRS and reflux. 9…”

“…7 In the present review, we included studies with recalcitrant CRS patients, and we paid a particular attention on the reflux detection method, which differs from the past reviews that investigated the association between GERD and CRS. 9,48 In practice, most patients with LPR and nasopharyngeal reflux events have no GERD, while patients with GERD may have no pharyngeal reflux event. 7 The long period of time between the earliest and latest papers is a limitation of the present paper because the recalcitrant CRS and GERD/LPR definitions, diagnosis approaches and management have changed.…”

“…[4][5][6] Over the last decades, laryngopharyngeal reflux (LPR) and gastroesophageal reflux disease (GERD) have been proposed as important contributing factors to a myriad of inflammatory upper aerodigestive tract diseases, including benign lesions of the vocal folds, otitis media and chronic rhinosinusitis. [7][8][9] The prevalence of CRS has been shown to be higher in patients with LPR compared with controls, 10 and at the same time, CRS subjects have been shown to have higher rates of reflux disease when compared to those without CRS. 9 It has been proposed that CRS patients with reflux may be more recalcitrant to medical and surgical interventions.…”

“…[7][8][9] The prevalence of CRS has been shown to be higher in patients with LPR compared with controls, 10 and at the same time, CRS subjects have been shown to have higher rates of reflux disease when compared to those without CRS. 9 It has been proposed that CRS patients with reflux may be more recalcitrant to medical and surgical interventions. 6,8,11 In this systematic review, we aimed to investigate the relationship between LPR, GERD and CRS recalcitrant to medical or surgical treatment.…”