Chronic sinusitis and GERD or extraesophageal reflux disease

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.