Evaluation of Chronic Rhinosinusitis and Its Correlation with Gastroesophageal Reflux Disease (GERD)

Background: Chronic rhinosinusitis (CRS) is a persistent inflammatory disorder of the paranasal sinuses that significantly impairs quality of life. Gastroesophageal reflux disease (GERD) is a common gastrointestinal disorder increasingly recognized for its extraesophageal manifestations, including upper airway conditions. The potential relationship between CRS and GERD remains under investigation, with overlapping symptoms complicating diagnosis and management. Objective: To evaluate the prevalence of GERD among patients with CRS and to assess the correlation between CRS severity and reflux symptom burden. Methods: A cross-sectional study was conducted from March 2024 to March 2025 at two tertiary care centers in Punjab, Pakistan. A total of 120 adult patients fulfilling the EPOS 2020 diagnostic criteria for CRS were enrolled. Patients were divided into two groups: Group A (CRS with GERD, n = 48) and Group B (CRS without GERD, n = 72). GERD was identified using the Reflux Symptom Index (RSI > 13), and in selected cases, 24-hour pH monitoring was performed. All participants underwent demographic profiling, clinical assessment, and rigid nasal endoscopy. Data were analyzed using SPSS version 26.0. Results: GERD was present in 40% of CRS patients. Group A patients were more often overweight/obese and reported significantly higher rates of nasal obstruction (91.7% vs. 77.8%, p = 0.04), postnasal drip (81.3% vs. 70.8%, p = 0.03), and chronic cough (54.2% vs. 33.3%, p = 0.01) compared to Group B. Endoscopy showed increased mucosal edema (70.8% vs. 52.8%, p = 0.03) and posterior nasal discharge (68.8% vs. 45.8%, p = 0.01) in CRS with GERD. Correlation analysis revealed a moderate positive association between CRS severity and RSI scores (r = 0.39, p < 0.001). Conclusion: GERD is a significant comorbidity in CRS and appears to exacerbate sinonasal symptoms and mucosal findings. Routine screening for GERD in CRS patients, especially those with persistent cough and postnasal drip, may enhance clinical outcomes through integrated management.