Gastroesophageal reflux and chronic rhinosinusitis

Brendan Hanna, Peter Wormald

    Research output: Contribution to journalReview articlepeer-review

    24 Citations (Scopus)


    Purpose of review: Chronic rhinosinusitis (CRS) and gastroesophageal reflux disease (GERD) are two common conditions which have been reported to occur together more frequently than expected. It has, therefore, been proposed that GERD may have an aetiologic role in CRS. This study reviews the results of research into the possible reflux and reflex mechanisms that may link CRS and GERD. Recent findings: Robust assessment of gastric reflux into the nasopharynx using circumferential pH probes which are less subject to artefact have demonstrated that direct reflux into the nasopharynx is a rare event. Pepsinogen has only been found in the nasal cavity in one study which had unexpected results, raising doubts about the validity of the methodology. A reflex increase in nasal congestion and mucus secretion has been demonstrated experimentally, but in a small number of patients, which precluded statistical significance. The relationship between reflux and mucus secretion is supported, though, by randomized controlled trials showing decreased postnasal drip with proton-pump inhibitor therapy. Summary: 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.

    Original languageEnglish
    Pages (from-to)15-18
    Number of pages4
    JournalCurrent Opinion in Otolaryngology and Head and Neck Surgery
    Issue number1
    Publication statusPublished - Feb 2012


    • chronic rhinosinusitis
    • gastroesophageal reflux disease
    • postnasal drip


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