The Relationship Between Gastroesophageal Reflux and Pediatric Rhinitis: Significance of Pale/Blue Colored Turbinate

Summary

Gastroesophageal(GERD) reflux disease is a very common problem among pediatric population and has be proved to contribute in numerous otolaryngological manifestations. Trails of empirical treatment of antireflux medications is often used as a diagnostic test. However, the investigators believe GERD can cause rhinitis and nasal obstruction. Nasonex is considered as first line treatment for nasal obstruction. Hence, the proposed study aims to define the relationship between GERD and rhinitis using randomize control trial where one group of patients will receive nasonex and placebo, while the other group will receive nasonex and antireflux medications.

Timeline

Start

2015-01

Primary completion

2016-01

Completion

2017-01

Publications

• Background Vandenplas Y, Rudolph CD, Di Lorenzo C, Hassall E, Liptak G, Mazur L, Sondheimer J, Staiano A, Thomson M, Veereman-Wauters G, Wenzl TG, North American Society for Pediatric Gastroenterology Hepatology and Nutrition, European Society for Pediatric Gastroenterology Hepatology and Nutrition. Pediatric gastroesophageal reflux clinical practice guidelines: joint recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN). J Pediatr Gastroenterol Nutr. 2009 Oct;49(4):498-547. doi: 10.1097/MPG.0b013e3181b7f563.
• Background Zalzal GH, Tran LP. Pediatric gastroesophageal reflux and laryngopharyngeal reflux. Otolaryngol Clin North Am. 2000 Feb;33(1):151-61. doi: 10.1016/s0030-6665(05)70212-7.
• Background Ali Mel-S. Laryngopharyngeal reflux: diagnosis and treatment of a controversial disease. Curr Opin Allergy Clin Immunol. 2008 Feb;8(1):28-33. doi: 10.1097/ACI.0b013e3282f3f44f.
• Background Karkos PD, Leong SC, Apostolidou MT, Apostolidis T. Laryngeal manifestations and pediatric laryngopharyngeal reflux. Am J Otolaryngol. 2006 May-Jun;27(3):200-3. doi: 10.1016/j.amjoto.2005.09.004.
• Background Al-Saab F, Manoukian JJ, Al-Sabah B, Almot S, Nguyen LH, Tewfik TL, Daniel SJ, Schloss MD, Hamid QA. Linking laryngopharyngeal reflux to otitis media with effusion: pepsinogen study of adenoid tissue and middle ear fluid. J Otolaryngol Head Neck Surg. 2008 Aug;37(4):565-71.
• Background Contencin P, Maurage C, Ployet MJ, Seid AB, Sinaasappel M. Gastroesophageal reflux and ENT disorders in childhood. Int J Pediatr Otorhinolaryngol. 1995 Jun;32 Suppl:S135-44. doi: 10.1016/0165-5876(94)01157-s.
• Background El-Serag HB, Gilger M, Kuebeler M, Rabeneck L. Extraesophageal associations of gastroesophageal reflux disease in children without neurologic defects. Gastroenterology. 2001 Dec;121(6):1294-9. doi: 10.1053/gast.2001.29545.
• Background Yuksel F, Dogan M, Karatas D, Yuce S, Senturk M, Kulahli I. Gastroesophageal reflux disease in children with chronic otitis media with effusion. J Craniofac Surg. 2013 Mar;24(2):380-3. doi: 10.1097/SCS.0b013e31827feb08.
• Background Nair S, Kumar M, Nair P. Role of GERD in children with otitis media with effusion. Indian J Pediatr. 2012 Oct;79(10):1328-32. doi: 10.1007/s12098-011-0671-y. Epub 2012 Jan 7.
• Background Benninger MS, Ferguson BJ, Hadley JA, Hamilos DL, Jacobs M, Kennedy DW, Lanza DC, Marple BF, Osguthorpe JD, Stankiewicz JA, Anon J, Denneny J, Emanuel I, Levine H. Adult chronic rhinosinusitis: definitions, diagnosis, epidemiology, and pathophysiology. Otolaryngol Head Neck Surg. 2003 Sep;129(3 Suppl):S1-32. doi: 10.1016/s0194-5998(03)01397-4. No abstract available.
• Background Phipps CD, Wood WE, Gibson WS, Cochran WJ. Gastroesophageal reflux contributing to chronic sinus disease in children: a prospective analysis. Arch Otolaryngol Head Neck Surg. 2000 Jul;126(7):831-6. doi: 10.1001/archotol.126.7.831.
• Background Lupa M, DelGaudio JM. Evidence-based practice: reflux in sinusitis. Otolaryngol Clin North Am. 2012 Oct;45(5):983-92. doi: 10.1016/j.otc.2012.06.004. Epub 2012 Aug 9.
• Background Loehrl TA, Smith TL, Darling RJ, Torrico L, Prieto TE, Shaker R, Toohill RJ, Jaradeh SS. Autonomic dysfunction, vasomotor rhinitis, and extraesophageal manifestations of gastroesophageal reflux. Otolaryngol Head Neck Surg. 2002 Apr;126(4):382-7. doi: 10.1067/mhn.2002.123857.

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