title: Nocturnal GERD - a risk factor for rhinitis/rhinosinusitis: the RHINE study.
abstract: BACKGROUND
  It has been suggested that gastroesophageal reflux disease (GERD) is a risk factor for developing rhinitis/rhinosinusitis, but data are lacking. This is a prospective 10-year follow-up study of a large multicenter cohort from Northern Europe, evaluating the relationship between nocturnal GERD and noninfectious rhinitis (NIR).
  
  
  METHODS
  The study comprised 5417 subjects born between 1945 and 1973, who answered a questionnaire in 1999-2001 and again in 2010-2012. Noninfectious rhinitis was defined as having nasal obstruction, secretion, and/or sneezing without having the common cold. Odds ratios for developing NIR in relation to age, gender, BMI, smoking, asthma, and nocturnal GERD were calculated.
  
  
  RESULTS
  During the 10-year observation period, 1034 subjects (19.1%) developed NIR. Subjects reporting nocturnal gastroesophageal reflux in both 1999 and 2010 had more NIR in 2010 (2.8% vs 1.2%, P < 0.001). There was a significant dose-response relationship between the number of reflux episodes/week in 1999 and the risk of having NIR in 2010, P = 0.02. In the multiple regression adjusted for age, gender, BMI, tobacco smoke, and asthma, those with nocturnal GERD in 1999 (≥3 episodes of nocturnal gastroesophageal reflux symptoms per week) had an OR of 1.6 (95% CI 1.0-2.5, P = 0.03) to develop NIR in 2010. Smoking was associated both with an increased risk of developing NIR (30.7% vs 24.0%, P < 0.001) and with the development of nocturnal GERD.
  
  
  CONCLUSIONS
  This large, population-based, 10-year study indicates that nocturnal GERD was a risk factor for noninfectious rhinitis/rhinosinusitis. GERD should therefore be considered in patients with rhinitis of known and unknown origin.
authors: Section of Occupational and Environmental Medicine, University of Gothenburg, Gothenburg, Sweden.
authors: L
authors: L
authors: Schiöler
authors: Departmet of ENT, Head and Neck Surgery, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.
authors: M
authors: M
authors: Ruth
authors: Lung Clinic, Tartu University Hospital, Tartu, Estonia.
authors: R
authors: R
authors: Jõgi
authors: Faculty of Medicine, Department of Respiratory Medicine and Sleep, Landspitali University Hospital, University of Iceland, Reykjavik, Iceland.
authors: T
authors: T
authors: Gislason
authors: Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway.
authors: T
authors: T
authors: Storaas
authors: Department of Medical Sciences: Respiratory Medicine and Allergology, Uppsala University, Akademiska sjukhuset, Uppsala, Sweden.
authors: C
authors: C
authors: Janson
authors: Division of Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
authors: B
authors: B
authors: Forsberg
authors: Department of Public Health Section for Environment Occupation and Health, Aarhus University, Aarhus, Denmark.
authors: T
authors: T
authors: Sigsgaard
authors: Section of Occupational and Environmental Medicine, University of Gothenburg, Gothenburg, Sweden.
authors: K
authors: K
authors: Torén
authors: Departmet of ENT, Head and Neck Surgery, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.
authors: J
authors: J
authors: Hellgren
mesh_terms: D000328:Adult; D001249:Asthma / Q000453:epidemiology; D003718:Denmark / Q000453:epidemiology; D004957:Estonia / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D005764:Gastroesophageal Reflux / Q000453:epidemiology*; D006801:Humans; D007055:Iceland / Q000453:epidemiology; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009664:Norway / Q000453:epidemiology; D016017:Odds Ratio; D011446:Prospective Studies; D012220:Rhinitis / Q000453:epidemiology*; D012307:Risk Factors; D012852:Sinusitis / Q000453:epidemiology*; D012907:Smoking / Q000453:epidemiology; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology
keywords: gastroesophageal reflux disease; multicenter; noninfectious rhinitis; population; upper airway inflammation