Association between Helicobacterpylori, reflux and chronic rhinosinusitis: a systematic review

Lechien J.R. Ragrag K. Kasongo J. Favier V. Mayo-Yanez M. Chiesa-Estomba C.M. Iannella G. Cammaroto G. Saibene A.M. Vaira L.A. Carsuzaa F. Sagandykova K. Fieux M. Lisan Q. Hans S. Maniaci A.
January 2026 Springer Science and Business Media Deutschland GmbH

European Archives of Oto-Rhino-Laryngology
2026 #283 Issue 1 609 - 619 pp.

Background: The prevalence, role, and clinical relevance of Helicobacter Pylori (HP) in sinonasal tissues of patients with chronic rhinosinusitis remain unclear. Objective: To investigate the prevalence and clinical relevance of Helicobacter Pylori (HP) in chronic rhinosinusitis (CRS) with nasal polyps (CRSwNP) and without nasal polyps (CRSSNP). Methods: Three investigators conducted a PubMed, Scopus, and Cochrane Library systematic review of the prevalence and clinical relevance of HP infection in CRS patients through the PRISMA framework. A bias analysis was conducted to identify potential heterogeneity and biases across studies. Results: Of the 42 identified studies, 20 met the inclusion criteria, accounting for 741 CRS patients and 368 controls. HP was detected in 37.1% (n = 127/342) of polyps of CRSwNP patients with the polymerase chain reaction (PCR) and 32.7% (n = 37/113) of polyp tissue with the immunohistochemistry (IHC). Controls reported a nasal PCR and IHC detection rates of 14.8% (n = 36/243) and 3.6% (n = 3/84), respectively. The HP rate did not differ between CRSwNP and CRSsNP. Among patients with CRS, the enzyme-linked immunosorbent assay testing detected blood HP antigens in 48.7% (n = 74/152) of CRS patients and 41.6% (n = 37/89) of controls. The detection of HP in polyps was associated with the severity of gastroesophageal reflux disease (GERD). There was an important heterogeneity between studies for the inclusion criteria, methods of HP detection, and reflux outcomes. Conclusion: Helicobacter Pylori can be detected in one-third of sinonasal tissues from patients with CRS and can be considered a biomarker of GERD. The potential role of HP in the development of CRS remains unclear. The heterogeneity between studies limits the drawing of valid conclusions.

Chronic Rhinosinusitis , Gastroesophageal , Helicobacter Pylori , Laryngopharyngeal , Otolaryngology , Otorhinolaryngology , Polyp , Reflux

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Department of Surgery, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium
Department of Otolaryngology-Head Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France
Research Committee, Young Otolaryngologists of the International Federation of Otorhinolaryngological Societies, Paris, France
Department of Otolaryngology-Head and Neck Surgery, CHU de Montpellier, Montpellier, France
Otorhinolaryngology-Head and Neck Surgery Department, Complexo Hospitalario Universitario A Coruña (CHUAC), A Coruña, Galicia, Spain
Department of Otorhinolaryngology—Head & Neck Surgery, Hospital Universitario Donostia, San Sebastian, Spain
Organi di Senso Department, Sapienza University of Rome, Viale del Policlinico 151, Rome, 00161, Italy
Head-Neck, and Oral Surgery Unit, Department of Head-Neck Surgery, Otolaryngology, Morgagni Pierantoni Hospital, Forlì, 47121, Italy
Otolaryngology Unit, Santi Paolo e Carlo Hospital, Department of Health Sciences, Università degli Studi di Milano, Milan, 20121, Italy
Maxillofacial Surgery Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, 07100, Italy
PhD School of Biomedical Science, Biomedical Sciences Department, University of Sassari, Sassari, Italy
Department of Otolaryngology-Head and Neck Surgery, CHU de Poitiers, Poitiers, France
Department of Otorhinolaryngology, NpJSC “Astana Medical University”, Astana, 010000, Kazakhstan
Hospices Civils de Lyon, Hôpital Lyon Sud, Service d’ORL, d’otoneurochirurgie et de Chirurgie Cervico-Faciale, Pierre Bénite, 69310, France
Université de Lyon, Université Lyon 1, Lyon, 69003, France
UMR 5305, Laboratoire de Biologie Tissulaire et d’Ingénierie Thérapeutique, Institut de Biologie et Chimie des Protéines, CNRS/Université Claude Bernard Lyon 1, 7 Passage du Vercors, CEDEX 07, Lyon, 69003, France
Faculty of Medicine and Surgery, University of Enna Kore, Enna, 94100, Italy
Department of Surgery, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, Avenue du Champ de Mars, 6, Mons, B7000, Belgium

Department of Surgery
Department of Otolaryngology-Head Neck Surgery
Research Committee
Department of Otolaryngology-Head and Neck Surgery
Otorhinolaryngology-Head and Neck Surgery Department
Department of Otorhinolaryngology—Head & Neck Surgery
Organi di Senso Department
Head-Neck
Otolaryngology Unit
Maxillofacial Surgery Unit
PhD School of Biomedical Science
Department of Otolaryngology-Head and Neck Surgery
Department of Otorhinolaryngology
Hospices Civils de Lyon
Université de Lyon
UMR 5305
Faculty of Medicine and Surgery
Department of Surgery

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