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Article Type

Article

Abstract

Background and Objectives: Gastro esophageal reflux disease (GERD) is believed to be important contributing factor in many disorders of upper respiratory and alimentary tracts namely rhino-sinusitis nasal polyps , adenoid enlargement , chronic tonsillitis , chronic pharyngitis , chronic esophagitis , esophageal strictures , chronic laryngitis , otitis media , and chronic chest infections . It has been reported that GERD and Helicobacter pylori (HBP) infection may be interrelated phenomenon. Although there are many theories tried to explain the pathogenesis of GERD but still Helicobacter pylori based theory is considered as strong theory via which the GERD pathophysiological mechanism factor can be presented. The successful eradication of Helicobacter pylori infection was shown to be significantly related to improvement of the symptomatology in patients with chronic upper air way and alimentary tract related disorders. Therefore this study was conducted prospectively to confirm this concept specifically in relation to the incidence as well as the management of chronic sinusitis.

Patients and Methods: 235 patients aged 5-85 years with already confirmed GERD at different grades according to (Savary- Millar or Savary- Monnier 1989) grading system on bases of diagnostic upper gastrointestinal tract fibrooptic endoscopic evaluating examination presented at internal medicine department and ENT department, Althwora-hospital, Elbedya- Libya with varieties of upper aero-digestive related symptoms at period from September 2005 up to March 2009 were studied as prospective study .All patients were investigated for H.pylori infection by using of ELISA as serological test to demonstrate anti-helicobacter pylori antibodies titer before the starting of the recommended medication and compared with results at the end of the course by 4-6 months. The results were correlated with the clinical presentations of the patients. Results:

208 patients (89%) of the total number showed positive Helicobacter pylori and 203 cases (98%) were improved after medical eradicative course against Helicobacter pylori . on the other hand only 27 patients (11%) with either upper air way or alimentary tract related disorders in association with chronic infective rhino-sinusitis were found to be with a negative Helicobacter pylori results .

Conclusion: The Para nasal sinus disease is considered as one of ENT related common presentation in GERD. I.e. GERD can be described as one of predisposing factors of sinopathy. It is well known that, there is strong correlation between GERD pathogenesis and HBP infection. In the same time there is well –established significant relationship between GERD and Para nasal sinus disease. Therefore, as it was confirmed in this presenting study that the HBP infection may act as main predisposing factor for sinus pathology among patients with GERD.

Keywords: GERD, HELICOBACTER PYLORI, chronic rhino-sinusitis.

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