Chronic rhinosinusitis, asthma, and gastroesophageal reflux: Epidemiology, pathophysiology, and comorbidity

Chronic rhinosinusitis (CRS) is a persistent inflammatory condition affecting the mucosa of nasal cavity and paranasal sinus, often stemming from untreated or recurrent acute sinusitis. Asthma is characterized by airway inflammation, intermittent bronchospasm, and symptoms such as wheezing and dyspnea. These two conditions frequently coexist, sharing overlapping pathogenic mechanisms and inflammatory pathways. Gastroesophageal reflux disease (GERD), a condition where stomach contents reflux into the esophagus, is another prevalent comorbidity associated with asthma and CRS. Notably, GERD is more common in CRS patients, suggesting the intricate and potentially bidirectional relationship among CRS, asthma, and GERD. Despite this complexity, a comprehensive understanding of these interconnections remains elusive in the literature. This review synthesizes findings from the past decade, focusing on the epidemiology, pathophysiology, and comorbidity mechanisms linking these three conditions. By addressing current knowledge gaps, it aims to provide insights into their shared mechanisms and implications for integrated clinical management.