We are all well aware that both chronic rhinosinusitis and reflux are prevalent in our populations. This meta-analysis looked at 25 studies investigating the association between GERD, LPR and CRS, therefore evaluating more than 117,000 patients. The results are fascinating – CRS patients are 11.5 times more likely to have elevated pH and pepsin levels when compared to healthy individuals as measured by levels in nasophayngeal tissues, and CRS patients frequently had pH levels less than five. PPI treatment was shown to be beneficial in treating the symptoms of CRS in over 90% of patients in one study, 81% in another, and an improvement in at least one symptom of CRS in 45% after three months. The meta-analysis found some conflicting results from studies assessing outcomes from FESS in association with pre-existing GERD, with some studies finding greater benefit from FESS but some the converse. Certainly, there is evidence to support a beneficial impact of treatment with PPI on patients with CRS, whether as a standalone treatment or following FESS. Ultimately, this supports a link between GERD and CRS, although not all the studies examined confirmed this. As both conditions are so prevalent, this is certainly worthy of more research to try to establish the degree of association and, therefore, benefit to treating the two conditions simultaneously.
Is GERD linked to CRS?
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