Gastritis and gastroesophageal reflux disease are strongly associated with non-allergic nasal disorders

BACKGROUND: Gastroesophageal reflux disease (GERD) has been reported to be significantly associated with chronic rhinosinusitis, but the strength of the association is still debated.AIMS: To evaluate the strength of the association between gastritis/GERD and non-allergic rhinitis (NAR)/allergic rhinitis (AR)/sinusitis.METHODS: We investigated 2887 subjects aged 20-84years, who underwent a clinical visit in seven Italian centres (Ancona, Palermo, Pavia, Terni, Sassari, Torino, Verona) within the study on Gene Environment Interactions in Respiratory Diseases, a population-based multicase-control study between 2008 and 2014. Subjects were asked if they had doctor-diagnosed "gastritis or stomach ulcer (confirmed by gastroscopy)" or "gastroesophageal reflux disease, hiatal hernia or esophagitis". The association between NAR/AR/sinusitis and either gastritis or GERD was evaluated through relative risk ratios (RRR) by multinomial logistic regression.RESULTS: The prevalence of gastritis/GERD increased from subjects without nasal disturbances (22.8%=323/1414) to subjects with AR (25.8%=152/590) and further to subjects with NAR (36.7%=69/188) or sinusitis (39.9%=276/691). When adjusting for centre, sex, age, education level, BMI, smoking habits and alcohol intake, the combination of gastritis and GERD was associated with a four-fold increase in the risk of NAR (RRR=3.80, 95% CI 2.56-5.62) and sinusitis (RRR=3.70, 2.62-5.23) with respect to controls, and with a much smaller increase in the risk of AR (RRR=1.79, 1.37-2.35)..CONCLUSION: The study confirmed the association between gastritis/GERD and nasal disturbances, which is stronger for NAR and sinusitis than for AR.