Gastroesophageal reflux and chronic rhinosinusitis

Hanna, Brendan; Wormald, Peter John

doi:10.1097/moo.0b013e32834e8f11

Cited by 36 publications

(35 citation statements)

References 19 publications

(10 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…CRS symptoms improved or settled with LPR treatment in almost all cases, which suggests that LPR was a significant contributor to CRS symptoms. This is in direct contrast to a prior review of GORD and chronic rhino‐sinusitis (CRS), where it was claimed that direct reflux into the nasopharynx is a rare event . A good correlation was found between the amplitude of supine LPR on scintigraphy and reflux into the nasopharynx and sinuses with many patients experiencing worsening of their nasal symptoms and coughing after lying down at night.…”

Section: Discussioncontrasting

confidence: 69%

“…This is in direct contrast to a prior review of GORD and chronic rhino-sinusitis (CRS), where it was claimed that direct reflux into the nasopharynx is a rare event. 68 A good correlation was found between the amplitude of supine LPR on scintigraphy and reflux into the nasopharynx and sinuses with many patients experiencing worsening of their nasal symptoms and coughing after lying down at night. Savarino et al showed that alginate-containing antacids (ACA) reduce supine acid reflux and retard the proximal extent of supine reflux.…”

Section: Discussionmentioning

confidence: 92%

See 1 more Smart Citation

Observational cohort study: Getting to the bottom of laryngopharyngeal reflux—It’s a motility disorder and not just about the acid

et al. 2019

View full text Add to dashboard Cite

Summary Background Laryngopharyngeal reflux (LPR) has been linked with irritable bowel syndrome (IBS). Functional colonic, upper gastrointestinal (GI) and LPR symptoms often coexist and all improve with osmotic laxative therapy. Reflux scintigraphy demonstrates direct contamination of the airway by refluxate. Aims Evaluate the clinical utility of reflux scintigraphy in managing LPR. Assess the effect of osmotic laxatives combined with acid suppression on both functional GI and LPR symptoms. Methods Forty consecutive patients referred over 6 months with functional colonic symptoms and significant LPR with a reflux symptom index (RSI)> 13 were followed prospectively. All patients underwent pre‐treatment reflux scintigraphy and gastroscopy with assessment of their reflux finding score (RFS). RSI and RFS were reassessed at ENT follow‐up at a median of 5 months. Functional GI symptoms and RSI were reassessed at a median of 17 months. Results Thirty‐nine of 40 (97.5%) demonstrated reflux into their oropharynx on reflux scintigraphy. The majority had minimal typical reflux symptoms (55%) and their LPR was refractory to acid suppression alone (62.5%). Short‐term combination therapy reduced both the RSI (22.6‐17.2, P < .01) and RFS (12.3‐7.7, P < .01). Longer term treatment reduced the RSI further (22.6‐9.2, P < .01) correlating strongly with improvement in functional GI symptoms. Conclusions LPR occurs frequently amongst IBS patients without typical reflux symptoms. Reflux scintigraphy is useful to both diagnose and optimise treatment of LPR. Reducing colonic distension with osmotic laxatives improves both functional GI and LPR symptoms.

show abstract

Section: Discussioncontrasting

confidence: 69%

Section: Discussionmentioning

confidence: 92%

Observational cohort study: Getting to the bottom of laryngopharyngeal reflux—It’s a motility disorder and not just about the acid

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Proton-pump inhibitors might be therapeutically effective [153] because gastroesophageal reflux is discussed as possible origin of chronic rhinosinusitis [154]. However, to date, it was only shown that the application of proton-pump inhibitors may reduce postnasal secretion [155], whereas an effect on other symptoms of chronic rhinosinusitis was not identified [28]. …”

Section: Types and Therapies Of Rhinosinusitismentioning

confidence: 99%

Evidence and evidence gaps in therapies of nasal obstruction and rhinosinusitis

Rotter¹

2016

GMS Current Topics in Otorhinolaryngology - Head and Neck Surgery; 15:Doc06

View full text Add to dashboard Cite

“…In addition, various studies have failed to consistently show the presence of pH changes or pepsinogen within the nasopharynx or nasal cavity to stimulate the inflammatory responses of CRS. (35, 46) Future research should evaluate the association of GERD with eosinophilic esophagitis, which has histologic, and possibly etiologic, parallels to CRS.…”

Section: Gastroesophageal Reflux Disease: How Does It Affect the Uppementioning

confidence: 99%

The association of premorbid diseases with chronic rhinosinusitis with and without polyps

Lam

Hirsch

Tan

2014

Current Opinion in Otolaryngology & Head and Neck Surgery

View full text Add to dashboard Cite

Purpose of review This article reviews recent insights regarding the epidemiology of adult chronic rhinosinusitis (CRS) with particular attention to its association with other premorbid conditions. Identifying premorbid disease associations establishes potential risk factors for developing CRS and helps corroborate current postulates of the various pathophysiologic mechanisms involved with the development and persistence of paranasal sinus inflammation. Recent findings Recent findings demonstrate that the diagnosis of CRS is associated with a higher premorbid prevalence of upper airway diseases, lower airway diseases, gastroesophageal reflux disease, diseases of epithelial tissues, autoimmune disorders, and psychiatric conditions. While some of these conditions have long been associated with CRS, improvements in study design and future studies in the general population will more accurately estimate the relative strengths of associations, clinical relevance and temporal relationship of these various conditions in relation to the development of CRS. Summary The predisposing patterns of premorbid illnesses may provide valuable information regarding the underlying causes of CRS and allow for both therapeutic and preventive interventions. There remains conflicting evidence within the literature regarding the association of CRS with some medical conditions, signifying the need for continued research on the subject. Limitations of current studies include small sample sizes, lack of prospective longitudinal or interventional studies that help establish causality, and variable criteria for diagnosis of CRS in the outpatient setting.

show abstract

Gastroesophageal reflux and chronic rhinosinusitis

Abstract: Recent evidence suggests that GERD does not play a causative role in CRS. However, there is evidence of an oesophageal-nasal reflex, particularly in regard to mucus secretion and symptoms of postnasal drip. The presence of GERD would, therefore, be expected to worsen nasal symptom scores.

Cited by 36 publications

References 19 publications

Observational cohort study: Getting to the bottom of laryngopharyngeal reflux—It’s a motility disorder and not just about the acid

Observational cohort study: Getting to the bottom of laryngopharyngeal reflux—It’s a motility disorder and not just about the acid

Evidence and evidence gaps in therapies of nasal obstruction and rhinosinusitis

The association of premorbid diseases with chronic rhinosinusitis with and without polyps

Contact Info

Product

Resources

About