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Gastroesophageal reflux disease and chronic sinusitis: In search of an esophageal-nasal reflex

Wong, Ian W. Y.; Rees, Guy; Greiff, Lennart LU ; Myers, Jennifer C.; Jamieson, Glyn G. and Wormald, Peter-John (2010) In American Journal of Rhinology & Allergy 24(4). p.255-259
Abstract
Background: This study was performed to explore whether or not a neural reflex linking the esophagus and the nasal airway exists, as a pathogenic mechanism accounting for the association between gastroesophageal reflux (GER) disease and chronic rhinosinusitis (CRS). A prospective trial of healthy human volunteers was performed. Methods: Ten healthy volunteers without GER or sinonasal disease were investigated using an acid infusion challenge test. Normal saline and hydrochloric acid were infused into the lower esophagus through an esophageal manometry catheter. Nasal responses in symptom score, nasal inspiratory peak flow, and mucus production were analyzed after the esophageal challenge. Results: A tendency for an increase in nasal mucus... (More)
Background: This study was performed to explore whether or not a neural reflex linking the esophagus and the nasal airway exists, as a pathogenic mechanism accounting for the association between gastroesophageal reflux (GER) disease and chronic rhinosinusitis (CRS). A prospective trial of healthy human volunteers was performed. Methods: Ten healthy volunteers without GER or sinonasal disease were investigated using an acid infusion challenge test. Normal saline and hydrochloric acid were infused into the lower esophagus through an esophageal manometry catheter. Nasal responses in symptom score, nasal inspiratory peak flow, and mucus production were analyzed after the esophageal challenge. Results: A tendency for an increase in nasal mucus production was observed after esophageal stimulation with both normal saline and HCl. This returned to baseline level 45 minutes after the acid infusion. A similar trend was also observed with the measurements of nasal symptom scores and, to a lesser extent, nasal inspiratory peak flow. Conclusion: These results support the possibility that a neural reflex exists between the esophagus and the paranasal sinuses via the vagus nerve. If indeed present, the reflex-mediated rhinitis derived from this neuropathic inflammation may contribute to the development of CRS in patients with GER. Further study is required to define the relationship between GER and CRS. (Am J Rhinol Allergy 24, 255-259, 2010; doi: 10.2500/ajra.2010.24.3490) (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
vagus, rhinitis, reflex-mediated, neuropathic inflammation, neural reflex, reflux, gastroesophageal, Chronic rhinosinusitis, esophageal-nasal reflex
in
American Journal of Rhinology & Allergy
volume
24
issue
4
pages
255 - 259
publisher
Ocean Side Publications Inc.
external identifiers
  • wos:000281294900003
  • scopus:77955649291
ISSN
1945-8924
DOI
10.2500/ajra.2010.24.3490
language
English
LU publication?
yes
id
9726477a-6965-4436-bc65-2d5abfcea5e2 (old id 1673499)
date added to LUP
2010-09-23 10:56:34
date last changed
2018-05-29 11:40:04
@article{9726477a-6965-4436-bc65-2d5abfcea5e2,
  abstract     = {Background: This study was performed to explore whether or not a neural reflex linking the esophagus and the nasal airway exists, as a pathogenic mechanism accounting for the association between gastroesophageal reflux (GER) disease and chronic rhinosinusitis (CRS). A prospective trial of healthy human volunteers was performed. Methods: Ten healthy volunteers without GER or sinonasal disease were investigated using an acid infusion challenge test. Normal saline and hydrochloric acid were infused into the lower esophagus through an esophageal manometry catheter. Nasal responses in symptom score, nasal inspiratory peak flow, and mucus production were analyzed after the esophageal challenge. Results: A tendency for an increase in nasal mucus production was observed after esophageal stimulation with both normal saline and HCl. This returned to baseline level 45 minutes after the acid infusion. A similar trend was also observed with the measurements of nasal symptom scores and, to a lesser extent, nasal inspiratory peak flow. Conclusion: These results support the possibility that a neural reflex exists between the esophagus and the paranasal sinuses via the vagus nerve. If indeed present, the reflex-mediated rhinitis derived from this neuropathic inflammation may contribute to the development of CRS in patients with GER. Further study is required to define the relationship between GER and CRS. (Am J Rhinol Allergy 24, 255-259, 2010; doi: 10.2500/ajra.2010.24.3490)},
  author       = {Wong, Ian W. Y. and Rees, Guy and Greiff, Lennart and Myers, Jennifer C. and Jamieson, Glyn G. and Wormald, Peter-John},
  issn         = {1945-8924},
  keyword      = {vagus,rhinitis,reflex-mediated,neuropathic inflammation,neural reflex,reflux,gastroesophageal,Chronic rhinosinusitis,esophageal-nasal reflex},
  language     = {eng},
  number       = {4},
  pages        = {255--259},
  publisher    = {Ocean Side Publications Inc.},
  series       = {American Journal of Rhinology & Allergy},
  title        = {Gastroesophageal reflux disease and chronic sinusitis: In search of an esophageal-nasal reflex},
  url          = {http://dx.doi.org/10.2500/ajra.2010.24.3490},
  volume       = {24},
  year         = {2010},
}