Nocturnal GERD - a risk factor for rhinitis/rhinosinusitis: the RHINE study

Allergy. 2015 Jun;70(6):697-702. doi: 10.1111/all.12615. Epub 2015 Apr 6.

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.

Conclusion: 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.

Keywords: gastroesophageal reflux disease; multicenter; noninfectious rhinitis; population; upper airway inflammation.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Asthma / epidemiology
  • Denmark / epidemiology
  • Estonia / epidemiology
  • Female
  • Follow-Up Studies
  • Gastroesophageal Reflux / epidemiology*
  • Humans
  • Iceland / epidemiology
  • Logistic Models
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Norway / epidemiology
  • Odds Ratio
  • Prospective Studies
  • Rhinitis / epidemiology*
  • Risk Factors
  • Sinusitis / epidemiology*
  • Smoking / epidemiology
  • Surveys and Questionnaires
  • Sweden / epidemiology