Recent scientific research indicates that acid reflux into the throat (pharynx) plays a role in the development of sinusitis in both children and adults. Although acid reflux usually does not reach all the way to the sinuses, it could induce inflammation of the sensitive nasal mucous membranes, thus blocking the sinuses.
Patients with GERD or LPRD are also less likely to get relief from sinus surgery if their reflux is not addressed.
Unfortunately, the exact cause-and-effect mechanism of acid reflux and sinusitis has not yet been established. For example, postnasal drip can occur from inflammation of the nose by the stomach acids or it can be caused by chronic sinusitis. We also know that when postnasal drip lines the throat and the esophagus, it can cause reflux to worsen. I believe that this is secondary to the gag reflex but also that it may occur as a result of stimulation to the autonomic nervous system. Furthermore, older people often complain that when they eat, their nose runs. This is further evidence that there is a connection between the stomach and the nose. I believe that this is also via the autonomic nervous system. Last, when infection in the sinuses drips into the stomach, the infecting bacteria and fungus upset the normal balance of stomach organisms. The stomach reacts to this imbalance and this can potentially cause the reflux to act up.
Symptoms of LPRD, especially in children, can be difficult to diagnose. For sufferers with chronic sinusitis, the symptom of postnasal drip
can make them feel the same way as those that suffer from LPRD. Or the symptoms can occur because of a combination of the two disease processes. For all of these reasons, I believe that GERD/LPRD is intimately related with sinus disease, and thus I include it within the definition of CAID.
As you start to understand each, you will also be able to decipher exactly what is acting up at all times and often can tell which came first. For example, when your sinuses are acting up, you can feel your nose get congested, and you begin to suffer from the usual sinus symptoms - postnasal drip, nasal discharge, cough, hoarseness, pressure, and headaches. When your GERD/LPRD is acting up by itself you can feel mild heartburn or begin to belch, expel gas, cough, or have a feeling of fullness in the throat. When they are both acting up, you can feel both sets of symptoms. Sometimes your sinuses can be the first to start, and you feel the postnasal drip and instinctively start swallowing and clearing your throat. Then you can find yourself belching, clearing your throat more, coughing, and your voice can become hoarse. When this occurs, you might want to jump out of your skin, especially when you are in public. It is impossible to attribute a cause for every symptom. In these cases, treatments should be focused toward both your sinuses and your stomach.
My patient Sandra ate a dinner of pasta with a glass or two of wine. About 20 minutes into the meal she began to feel congested. Her sinuses seemed to have acted up in response to both the carbohydrates and the alcohol. She began to feel postnasal drip in the back of her throat. When this happens, Sandra usually can’t clear her throat, and she begins to cough. Her reflux also starts. Sandra notes that she will start belching and coughing and feel a slight heaviness in her chest. This description is consistent with someone experiencing fullblown GERD/LPRD caused by a sinus flare-up. Both the sinus flare - up and the GERD/LPRD appear to be related to carbohydrate and alcohol consumption. In other words, this becomes a vicious cycle, with the reflux causing more postnasal drip, creating more congestion
and inflammation with more drip causing more reflux. However, once the sinus problem and the GERD/LPRD are treated, Sandra will return to normal.
It is interesting that another patient, Dane, a GERD sufferer, told me that he didn’t realize his GERD was connected to sinus problems. He had been treated for years by various physicians and no one mentioned it. Dane told me that he went online and found a massive amount of literature on the connection between sinus disease and GERD. He was surprised that many people don’t make a connection between these disorders. Unfortunately, the people who know best are the ones who suffer from these disease processes.