Abstract
BackgroundGastroesophageal reflux disease (GERD) has been reported to be significantly associated with chronic rhinosinusitis, but the strength of the association is still debated.AimsTo evaluate the strength of the association between gastritis/GERD and non-allergic rhinitis (NAR)/allergic rhinitis (AR)/sinusitis.MethodsWe investigated 2887 subjects aged 20–84 years, who underwent a clinical visit in seven Italian centres (Ancona, Palermo, Pavia, Terni, Sassari, Torino, Verona) within the study on Gene Environment Interactions in Respiratory Diseases, a population-based multicase-control study between 2008 and 2014. Subjects were asked if they had doctor-diagnosed “gastritis or stomach ulcer (confirmed by gastroscopy)” or “gastroesophageal reflux disease, hiatal hernia or esophagitis”. The association between NAR/AR/sinusitis and either gastritis or GERD was evaluated through relative risk ratios (RRR) by multinomial logistic regression.ResultsThe prevalence of gastritis/GERD increased from subjects without nasal disturbances (22.8% = 323/1414) to subjects with AR (25.8% = 152/590) and further to subjects with NAR (36.7% = 69/188) or sinusitis (39.9% = 276/691). When adjusting for centre, sex, age, education level, BMI, smoking habits and alcohol intake, the combination of gastritis and GERD was associated with a four-fold increase in the risk of NAR (RRR = 3.80, 95% CI 2.56–5.62) and sinusitis (RRR = 3.70, 2.62–5.23) with respect to controls, and with a much smaller increase in the risk of AR (RRR = 1.79, 1.37–2.35)..ConclusionThe study confirmed the association between gastritis/GERD and nasal disturbances, which is stronger for NAR and sinusitis than for AR.
Highlights
Gastroesophageal reflux disease (GERD) has been reported to be significantly associated with chronic rhinosinusitis, but the strength of the association is still debated
The present study aimed to investigate the relation between gastritis/GERD and allergic and non-allergic rhinitis in a large population-based case–control study
Description of controls and cases of allergic rhinitis (AR)/non-allergic rhinitis (NAR)/sinusitis, as a function of main risk factors 2887 subjects participated in the clinical visit and they had a mean age (SD) of 50.1 (13.2) years
Summary
Gastroesophageal reflux disease (GERD) has been reported to be significantly associated with chronic rhinosinusitis, but the strength of the association is still debated. The two major classifications are allergic (AR) and nonallergic rhinitis (NAR) [1]. NAR occurs when obstruction and rhinorrhea are related to non-allergic, non-infectious triggers such as a change in the weather, exposure. Gastro-esophageal reflux disease (GERD) is a worldwide prevalent condition, which is on the rise in Europe and North America [5]. Esophageal and extraesophageal diseases associated with GERD are expected to increase. Some of the well-established extraesophageal manifestations are reflux-induced cough, laryngitis, asthma and dental erosion. Other manifestations, such as sinusitis, pharyngitis, idiopathic pulmonary fibrosis, and recurrent otitis media, are proposed but not established as it is unclear whether GERD is a significant causal or exacerbating factor [6]
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