Chronic Rhinosinusitis Patients with Gastroesophageal Reflux Disease Have Significantly Higher Prevalence of Atopic Conditions
Monday, March 7, 2016: 2:30 PM
Theatre, Room 411 (Convention Center)
Erica L. Palmisano, MD, , , , , , , , ,
Rationale: Chronic rhinosinusitis (CRS) is characterized by chronic inflammation in the nasal and paranasal sinus mucosal membranes and is associated with increased risk of gastroesophageal reflux disease (GERD).  However the mechanism underlying the link between CRS and GERD and the risk factors for GERD in patients with CRS are unknown.

Methods: We investigated the diagnosis of GERD in a large cohort of patients with CRS between 2005-2015.  The diagnosis of GERD was based on positive symptoms of heartburn/regurgitation plus response to empiric therapy with PPI. Cases with possible diagnosis without evidence for treatment or positive GI diagnostic results were excluded.  Charts were then evaluated for presence or absence of asthma, allergic rhinitis, eczema and food allergy. Comparisons between groups were assessed by using logistic regression; all analyses were adjusted for age, gender and BMI.

Results: Our cohort included 1005 patients with documented diagnosis of CRS; 211(20.9%) had GERD. Patients with CRS and GERD were predominantly female, and had higher BMI and age compared to CRS without GERD.  CRS and GERD patients had higher prevalence of asthma (47.4% vs. 26.6%, p<0.05), food allergy (21.8% vs. 10%, p<0.05), allergic rhinitis (36% vs. 28.8%,p<0.05) and eczema (11.4% vs. 6.4%,p<0.05) as compared to CRS patients without GERD.  GERD in CRS patients was not associated with nasal polyps, loss of smell, need for increased surgical treatment or Lund-MacKay-score.

Conclusions: CRS patients with GERD are more likely to have atopic conditions.  This may indicate that comorbid GERD and atopic disease are risk factors for development of CRS.