The relationship between adenoid hypertrophy and gastroesophageal reflux disease: A meta-analysis

BACKGROUND: Gastroesophageal reflux disease (GERD) is believed to be associated with various manifestations in the otorhinolaryngology and has been found to be an additional risk factor for adenoid hypertrophy, but the causal relation between them is under controversial. We thus performed a meta-analysis to grade the strength of evidence and systematically explore whether adenoid hypertrophy correlates with GERD in the literature. METHODS: A systematic literature search was performed using Medline via PubMed, Embase, CNKI, and Web of Science. Studies reporting the adenoid hypertrophy and GERD were identified for inclusion. RESULTS: There were 6 studies that matched the selection criteria, and the total sample size of these studies was 548 cases. We identified a significant relationship between adenoid hypertrophy and GERD, with a pooled odds ratio of 4.12 (95% confidence interval [CI]: 1.32–12.93; P < .001). The results was significant in 24-hour pH monitoring subgroup analysis, with a corresponding value of 8.62 (95% CI: 4.06–18.27, P > .05) under the fixed-effects model. And the results was significant in Helicobacter pylori subgroup analysis, with a corresponding value of 2.39 (95% CI: 0.39–14.55, P < .05) under the random-effects model. Begg tests (P = .73) and Egger tests (P = .76) showed there were no obvious evidence to support publication bias in our study. CONCLUSION: This meta-analysis provided a strong correlation between adenoid hypertrophy and GERD, the children with adenoid hypertrophy had a higher incidence of GERD than healthy children, but the pathogenesis of GERD in adenoid hypertrophy awaits more investigations and suggests that we should not overlook GERD in clinical practice and an appropriate evaluation for GERD may be needed.