Possible relationship of gastroesophagopharyngeal acid reflux with pathogenesis of chronic sinusitis. Am J Rhinol 1999;13(3):197-202
Date
07/07/1999Pubmed ID
10392238DOI
10.2500/105065899781389777Scopus ID
2-s2.0-0033128514 (requires institutional sign-in at Scopus site) 120 CitationsAbstract
UNLABELLED: Gastroesophagopharyngeal reflux (GEPR) has been suggested as a cause of pediatric sinusitis. However, its contribution to the pathogenesis of chronic sinusitis in adults has not been systematically investigated. We evaluated the prevalence of GEPR in 11 CT confirmed chronic sinusitis patients (51 +/- 4 years) who had not responded to conventional therapy, and 11 normal healthy controls (44 +/- 7 years). A 3-site ambulatory esophagopharyngeal pH monitoring technique (probe location: 2 cm proximal, 3-4 cm distal to UES and 5 cm proximal to LES high pressure zones) was used. A pharyngeal pH drop was accepted as a true reflux event only if it was coincident with or preceded by esophageal pH declines of a similar or larger magnitude. Studies were performed while subjects were on a uniform 2500 calorie diet (provided).
RESULTS: Ambulatory pH monitoring documented GEPR in seven of 11 patients (1-12 episodes) and two of 11 normal volunteers (1,2 episodes) (p < 0.05). A total of 34 nonbelch related pharyngeal acid reflux events were identified in patients, but none was associated with coughing. In both groups, all pharyngeal acid events occurred in the upright position. Compared to normal controls prevalence of pharyngeal reflux of gastric acid is significantly higher in patients with chronic sinusitis unresponsive to conventional therapy and suggests a different esophagopharyngeal distribution pattern of gastric refluxate in this patient group; these findings suggest that GEPR may contribute to the pathogenesis of chronic sinusitis in some adult patients.
Author List
Ulualp SO, Toohill RJ, Hoffmann R, Shaker RAuthor
Reza Shaker MD Assoc Provost, Sr Assoc Dean, Ctr Dir, Chief, Prof in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultAged
Barium Sulfate
Chronic Disease
Esophagus
Gastric Acidity Determination
Gastroesophageal Reflux
Humans
Middle Aged
Monitoring, Physiologic
Sinusitis
Tomography, X-Ray Computed