Otitis media in adults as a symptom of gastroesophageal reflux

Abstract

OBJECTIVE: To investigate the clinical relationship between gastroesophageal reflux (GER) and otitis media with effusion (OME) in adults.

STUDY DESIGN AND SETTING: Sixty patients with OME with unknown causes were asked to answer a new questionnaire specific for the diagnosis of GER disease; pepsinogen (PG) levels in their middle-ear effusions (MEEs) were measured.

RESULTS: The percentage of patients with high PG concentrations in their MEEs was significantly higher in those with questionnaire-positive GER than in those with questionnaire-negative GER. OME was present bilaterally in a significantly higher percentage of patients with questionnaire-positive GER. The PG levels decreased in some of the patients after receiving proton pump inhibitors, which also decreased the symptoms of GER.

CONCLUSION: The presence of PG in MEEs supports the existence of GER; treatment for GER should be considered in patients with ear complaints, especially in those who have GER-related symptoms.

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References

Vaezi

. Gastroesophageal reflux disease and the larynx. J Clin Gastroenterol 2003;36:198–203. (Grade D)

Dibaise

Olusola

Huerter

. Role of GERD in chronic resistant sinusitis: a prospective, open label, pilot trial. Am J Gastroenterol 2002;97:843–50. (Grade B)

Weaver

. Association between gastroesophageal reflux and sinusitis, otitis media, and laryngeal malignancy: a systematic review of the evidence. Am J Med 2003;115:81S–9S. (Grade B)

Gaynor

. Gastroesophageal reflux as an etiologic factor in laryngeal complications of intubation. Laryngoscope 1988;98:972–9. (Grade B)

White

Heavner

Hardy

. Gastroesophageal reflux and eustachian tube dysfunction in an animal model. Laryngoscope 2002;112:955–61. (Grade A)

Tasker

Dettmar

Panetti

. Is gastric reflux a cause of otitis media with effusion in children? Laryngoscope 2002;112:1930–4. (Grade C)

Tasker

Dettmar

Panetti

. Reflux of gastric juice and glue ear in children. Lancet 2002;359:493. (Grade C)

Lieu

JEC

Muthappan

Uppaluri

. Association of reflux with otitis media in children. Otolaryngol Head Neck Surg 2005;133:357–61. (Grade C)

Shimoyama

Kusano

Sugimoto

. Diagnosis of gastro-esophageal reflux disease using a new questionnaire. J Gastroenterol Hepatol 2005;20:643–7. (Grade B)

10.

Rudolph

. Supraesophageal complications of gastroesophageal reflux in children: challenges in diagnosis and treatment. Am J Med 2003;115:150S–6S. (Grade D)

11.

Velepic

Starcevic

. Gastroesophageal reflux and sequelae of chronic tubotympanal disorders in children. Acta Otolaryngol 2004;124:914–7. (Grade C)

12.

Poelmans

Tack

Feenstra

. Prospective study on the incidence of chronic ear complications related to gastroesophageal reflux and on the outcome of antireflux therapy. Ann Otol Rhinol Laryngol 2002;111:933–8. (Grade C)

13.

Potluri

Friedenberg

Parkman

. Comparison of a salivary sputum pepsin assay with 24-hour esophageal PH monitoring for detection of gastroesophageal reflux into the proximal esophagus, oropharynx, and lung. Diges Dis Sci 2003;48:1813–7. (Grade B)