Gastroesophageal reflux and chronic rhinosinusitis : Current Opinion in Otolaryngology & Head and Neck Surgery

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Gastroesophageal reflux and chronic rhinosinusitis

Hanna, Brendan C.; Wormald, Peter J.

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Current Opinion in Otolaryngology & Head and Neck Surgery 20(1):p 15-18, February 2012. | DOI: 10.1097/MOO.0b013e32834e8f11


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.


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.

© 2012 Lippincott Williams & Wilkins, Inc.

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