Chronic sinusitis and GERD
chronic sinusitis is a common clinical condition. There is increasing evidence from observational studies that both paediatric and adult patients with chronic sinusitis frequently have associated GORD and EOR and that these patients may benefit from medical antireflux therapy. GORD and EOR may contribute to the pathogenesis of chronic sinusitis by causing sinonasal congestion, compromised sinus drainage, and inflammation.29 Otitis media Otitis media with effusion (OME) is a prevalent condition and the most common cause of hearing loss in childhood. Recently, Tasker et al reported high concentrations (up to a 1000-fold greater than serum levels) of pepsin/pepsinogen in 59 of 65 middle ear effusion samples from children with OME. The authors concluded that reflux of gastric juice into the middle ear may be the primary factor in the initiation of OME in children. Using upper gastrointestinal endoscopy and 24 hour pH monitoring, we prospectively assessed the coexistence of GORD in consecutive adult patients with chronic secretory otitis media (CSOM) or with a chronic refractory feeling of pressure in the ear(s) (CRFP). All patients with CSOM and most patients with CRFP had evidence of GORD (oesophagitis and/or abnormal pH metry). Medical antireflux therapy with open label PPI led to cessation of middle ear drainage and CRFP after, on average, 11 weeks and four weeks, respectively. These studies indicate that GORD may directly cause or contribute to chronic ear problems, both in children and in adults. RCTs evaluating the effect of antireflux therapy are lacking. Excessive throat phlegm and postnasal drip It has been suggested that unexplained excessive throat phlegm may also be a manifestation of GOR but formal .( Chang A,et al ,2005)
so if any one suffering from chronic sinusitis with no response to treatment we should consider gerd as main cause if there are any digestive trouble or if the patient is on medical treatment for reflux.