title: Association of gastro-oesophageal reflux and chronic rhinosinusitis: systematic review and meta-analysis.
abstract: Gastro-oesophageal reflux disease (GORD) has been implicated in the development of chronic rhinosinusitis (CRS). The association of GORD with CRS is systematically assessed from the medical literature.
  
  
  
  Embase and MEDLINE were searched using a comprehensive strategy limited to English language and Human subjects. Any study with original data on the experimental, diagnostic, treatment or prognostic association of CRS with GORD was included. Studies without a control group, case reports and review articles were excluded.
  
  
  
  The search returned 958 records, with an additional 10 found from bibliographic lists; this produced 32 studies. The included studies (n=32) consisted of studies reporting pathogenic factors (n=20), epidemiological association (n=8), prognostic interactions (n=3), and a combination of these outcomes (n=1). Potential pathogenic roles for GORD in CRS were supported; CRS subjects had greater prevalence of intranasal Helicobacter pylori and acid reflux than subjects without CRS. CRS is more prevalent in GORD sufferers than those without GORD. Evidence is conflicting for GORD as a factor in CRS treatment failure.
  
  
  
  The results support a significant association of GORD with CRS. Physicians should be cognizant of the potential for acid and non-acid reflux as a driving factor in CRS.
authors.affiliation: Rhinology and Skull Base Research Group, St Vincents Centre for Applied Medical Research, University of New South Wales, Sydney, Australia.
authors.forename: S R
authors.initials: SR
authors.lastname: Leason
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, Louisiana State University, New Orleans, LO, USA.
authors.forename: H P
authors.initials: HP
authors.lastname: Barham
authors.affiliation: Rhinology and Skull Base Research Group, St Vincents Centre for Applied Medical Research, University of New South Wales, Sydney, Australia.
authors.forename: G
authors.initials: G
authors.lastname: Oakley
authors.affiliation: St Vincents Clinic, St Vincents Hospital, Sydney, Australia.
authors.forename: J
authors.initials: J
authors.lastname: Rimmer
authors.affiliation: Division of Rhinology and Sinus Surgery, Department of Otolaryngology, Emory University School of Medicine, Atlanta, GA, USA.
authors.forename: J M
authors.initials: JM
authors.lastname: DelGaudio
authors.affiliation: Rhinology and Skull Base Research Group, St Vincents Centre for Applied Medical Research, University of New South Wales, Sydney, Australia.
authors.forename: J M
authors.initials: JM
authors.lastname: Christensen
authors.affiliation: Rhinology and Skull Base Research Group, St Vincents Centre for Applied Medical Research, University of New South Wales, Sydney, Australia.
authors.forename: R
authors.initials: R
authors.lastname: Sacks
authors.affiliation: Rhinology and Skull Base Research Group, St Vincents Centre for Applied Medical Research, University of New South Wales, Sydney, Australia.
authors.forename: R J
authors.initials: RJ
authors.lastname: Harvey
mesh_terms: D002908:Chronic Disease; D015897:Comorbidity; D005764:Gastroesophageal Reflux / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D015995:Prevalence; D011379:Prognosis; D012220:Rhinitis / Q000150:complications* / Q000453:epidemiology / Q000209:etiology; D012852:Sinusitis / Q000150:complications* / Q000453:epidemiology / Q000209:etiology