Results of a small, preliminary study suggest that some people with chronic sinus trouble may benefit from treatment with acid-reducing medication normally prescribed to treat acid reflux.
Symptoms of sinusitis include nasal congestion and drainage, facial pain and malaise. The condition is considered chronic when it lasts longer than 6 weeks.
Previously, UNMC’s John K. DiBaise, M.D., and colleagues found that a significant portion of people with hard-to-treat chronic sinusitis also have symptoms of acid reflux, formally known as gastroesophageal reflux disease (GERD). Symptoms of GERD, which occurs when acid from the stomach backs up into the esophagus, include heartburn and chest pain.
In the present study, Dr. DiBaise’s group set out to see whether the acid-blocking drug omeprazole (Prilosec), which is used to treat GERD, might also improve sinus symptoms.
The researchers compared two groups of patients: 11 people with chronic sinusitis that persisted after treatment with antibiotics and sinus surgery, and 19 people with GERD.
Eight of the patients with sinusitis experienced heartburn at least once a week and nine had levels of acid in the esophagus comparable to the GERD patients, the report indicates. For 3 months, all sinusitis patients, regardless of whether they had GERD symptoms, took omeprazole before breakfast and supper each day.
The approach appears promising, according to a report in a recent issue of the American Journal of Gastroenterology. Read the report here.
“Most chronic resistant sinusitis patients noted a modest improvement in one or more sinus symptoms and global satisfaction,” Dr. DiBaise and his colleagues report. After about 8 weeks of treatment with omeprazole, improvement in symptoms seemed to peak, according to the report.
Despite the improvements in symptoms, however, sinusitis symptoms rarely disappeared. Also, the results of diagnostic tests performed to evaluate GERD at the beginning and end of the study did not show major changes, although the researchers point out that the study might have been too short to detect such physical changes.
Dr. DiBaise and his colleagues say the findings need to be confirmed in a larger, randomized study in which patients do not know whether they are taking omeprazole or an inactive pill called a placebo. Still, they conclude that “it might be prudent” to consider GERD in cases of chronic sinusitis that do not improve after standard treatment.