You think you have acid reflux but you may have sinusitis; or, you’re convinced you have sinusitis but it just might be GERD!
The symptoms of GERD or acid reflux and sinusitis, do indeed overlap, and one condition is often mistaken for the other by sufferers as well as physicians.
“GERD is technically the wrong term; it actually is laryngopharyngeal reflux (LPR),” says Jamie A. Koufman, MD, Director of the Voice Institute of New York and a leading authority on reflux disease.
“GERD refers to reflux into the esophagus, but not all forms of acid reflux disease.
“When the air passages are involved, medical specialists usually call it LPR, also often called silent reflux.”
So if you want to know how to tell GERD symptoms from sinusitis, the better question is:
How do laryngopharyngeal reflux symptoms compare to those of sinusitis?
Dr. Koufman explains, “Reflux can cause post-nasal drip and too much throat mucus, as can sinusitis; but more importantly, reflux can actually be the cause of sinusitis.
“LPR is called ‘silent reflux’ because the reflux can occur during the night; and when this occurs, the stomach contents (enzymes and acid) actually make it all the way up into the back of the nose, where they can cause problems with the sinuses.”
Can a person have LPR and sinusitis, but with both conditions independent of each other, rather than one causing the other?
Dr. Koufman explains, “A person can have both conditions.
“However, reflux is more likely to cause sinus disease than sinus disease to cause reflux.
“As doctors become more aware that reflux can cause disease anywhere in the airway, including the sinuses, more people will receive treatment, which can prevent sinusitis.
“In other words, many reflux patients on long-tern anti-reflux treatment report that their sinus troubles vanish, too.”
How often is GERD misdiagnosed as sinusitis?
“LPR/GERD is often misdiagnosed as sinusitis, simply because of the post-nasal drip,” says Dr. Koufman.
“Too much throat mucus is one of the most common symptoms of LPR.”
What is the function of mucus? It creates a protective barrier for the nasal membranes, as well as the membranes that line the throat.
“When irritation is present from reflux, generally more mucus is produced, almost as if the body was trying to better protect itself,” says Dr. Koufman.
About half of Dr. Koufman’s patients, who have been diagnosed with sinus disease by other doctors, don’t have sinusitis.
She adds, “Unfortunately, sometimes I see such patients after they’ve had unsuccessful and ineffective sinus surgery.”
Why is GERD so often misdiagnosed as sinusitis?
“Reflux is misdiagnosed as sinusitis, even when special X-rays are obtained,” says Dr. Koufman.
“Thick lining inside the sinuses is actually not ‘sinusitis,’ but can be associated with reflux or even allergies.
“True sinusitis will show complete opacification of the sinus or even an air-fluid level.” Opacification means non-transparency.
The truth is, continues Dr. Koufman, that “many physicians assume that nasal/sinus symptoms are due to sinusitis simply because they are still unaware of silent reflux.
“After all, if a person doesn’t have heartburn or indigestion, it’s easy (easier) to overlook the diagnosis of LPR.”
So how is a diagnosis of LPR made?
One must make an appointment with an ENT (ear, nose and throat) doctor for a complete throat and nose exam.
Dr. Koufman adds that there is now a special test called pharyngeal pH-monitoring that detects acid in the upper area of the throat.
If you have symptoms that seem to be GERD or sinusitis, don’t try to self-diagnose; make an appointment with an ENT physician.