Abstract
Gastroesophageal reflux disease (GERD) can cause several upper airway symptoms and alter the physiology of nasopharyngeal mucosa, while upper airway diseases in turn might also exacerbate GERD symptoms. For a long time, asthma was considered a risk factor of GERD in the literature. Asthma and allergic rhinitis (AR) are usually identified as united airway disease according to similar epidemiology and pathophysiology; however, the association between AR and GERD is less elucidated. We aimed to evaluate whether AR would increase the development of GERD. Patients diagnosed as AR were identified from the National Health Insurance Research Database between January 1, 2000 and December 31, 2005 without prior history of gastroesophageal reflux disease. The outcome of interest was new-onset GERD. Cox regression models were applied to calculate the hazard ratio (HR) of GERD. We analyzed the data of 193,810 AR patients aged 18 years or older and being free of AR at baseline. The AR cohort (n = 96,905) had a significantly increased risk of GERD over a non-AR cohort (n = 96905) (adjusted HR (aHR) 1.94; 95% CI = 1.88–1.99, p < 0.001). AR may have stronger correlation with GERD than does asthma, although asthma might increase GERD risk by means of certain pathways shared with AR.
Highlights
Gastroesophageal reflux disease (GERD) can cause several upper airway symptoms and alter the physiology of nasopharyngeal mucosa, while upper airway diseases in turn might exacerbate GERD symptoms
The pathophysiology of GERD is not fully understood and many mechanisms have been proposed to explain the development of GERD, inclusive of obesity, transient lower-esophageal sphincter relaxations (TLESRs), hiatus hernia, acid pockets, visceral hypersensitivity, impaired esophageal mucosal integrity, poor esophageal clearance, and delayed gastric emptying[3,4,5]
The overall cumulative hazard rate of new onset GERD events followed by time was greater in the allergic rhinitis (AR) cohort than in the non-AR cohort (p < 0.001) (Fig. 1)
Summary
Gastroesophageal reflux disease (GERD) can cause several upper airway symptoms and alter the physiology of nasopharyngeal mucosa, while upper airway diseases in turn might exacerbate GERD symptoms. Gastro-esophageal reflux disease (GERD) is one of the most prevalent gastrointestinal diseases and its prevalence is increasing worldwide[1]. It is defined by its troublesome symptoms and/or complications caused by the refluxed contents from the stomach, creating a great adverse impact on health and quality of life as well as consuming financial resources in medical insurance[2]. Asthma and allergic rhinitis (AR) are common airway diseases and are viewed as a united airway disease They frequently occur together and share similar physiological traits, including heightened reactivity to a variety of stimuli and heightened bronchial hyper-responsiveness[10]
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