TY - JOUR
T1 - Possible relationship of gastroesophagopharyngeal acid reflux with pathogenesis of chronic sinusitis
AU - Ulualp, Seckin O.
AU - Toohill, Robert J.
AU - Hoffmann, Raymond
AU - Shaker, Reza
PY - 1999
Y1 - 1999
N2 - Gastroesophagopharyngeal reflux (GEPR) has been suggested as a cause of pédiatrie sinusitis. However, its contribution to the pathogenesis of chronic sinusitis in adults has not been systematically investigated. We evaluated the prevalence of GEPR in II CT confirmed chronic sinusitis patients (51 ± 4 years) who had not responded to conventional therapy, and II 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.
AB - Gastroesophagopharyngeal reflux (GEPR) has been suggested as a cause of pédiatrie sinusitis. However, its contribution to the pathogenesis of chronic sinusitis in adults has not been systematically investigated. We evaluated the prevalence of GEPR in II CT confirmed chronic sinusitis patients (51 ± 4 years) who had not responded to conventional therapy, and II 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.
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U2 - 10.2500/105065899781389777
DO - 10.2500/105065899781389777
M3 - Article
C2 - 10392238
AN - SCOPUS:0033128514
SN - 1050-6586
VL - 13
SP - 197
EP - 202
JO - American Journal of Rhinology
JF - American Journal of Rhinology
IS - 3
ER -