Fact-checked for medical accuracy: April 2026

Acid Reflux and Sinus Congestion – The Connection Explained

sinus lpr acid reflux

The short answer: Yes, there’s a strong connection between acid reflux (especially LPR/silent reflux) and sinus congestion, postnasal drip, and rhinosinusitis. When acid and pepsin from your stomach reflux upward beyond your esophagus, they can reach your nasopharynx and sinuses, triggering inflammation, congestion, and mucus production.

The mechanism isn’t just direct acid damage—research shows that even at neutral pH, pepsin can be reactivated in your sinuses and cause ongoing cellular damage. Additionally, reflux triggers a vagal reflex that increases nasal mucus secretion, explaining why so many people with LPR experience persistent sinus symptoms that don’t respond to antihistamines or decongestants.

For those with chronic rhinosinusitis or unexplained postnasal drip, reflux-based treatment (diet changes, medication, and the alkaline nasal spray technique) often works better than traditional sinus interventions.

Key Takeaways

  • LPR and sinus congestion are directly linked—reflux reaching the nasopharynx causes 65-95% of laryngeal findings in certain patient groups, with sinusitis and postnasal drip being common manifestations
  • Pepsin damage occurs even at neutral pH—inactivated pepsin enters cells and is reactivated later, causing ongoing mitochondrial and cellular damage independent of acid exposure
  • Postnasal drip is often misdiagnosed—many people treated for allergies or sinus infections actually have reflux-induced PND that requires reflux management, not antihistamines
  • An esophageal-nasal reflex exists—reflux triggers a vagal reflex arc that increases nasal mucus secretion, explaining why congestion persists despite normal sinus imaging
  • LPR is comorbid with sinusitis in 65-95% of cases—depending on the laryngeal findings, the majority of patients have concurrent sinus and reflux issues
  • Alkaline nasal sprays neutralize pepsin—pH >8 deactivates pepsin permanently, providing relief that acid-suppressing medications alone cannot
  • Dietary changes reduce sinus symptoms—a low-acid diet (pH ≥5) prevents pepsin reactivation in the sinuses and addresses the root cause
  • PPIs improve sinus symptoms in reflux patients—multiple randomized trials show that acid-suppressing therapy reduces postnasal drip and nasal congestion in those with proven LPR

The Direct Pathway: How Acid and Pepsin Reach Your Sinuses

To understand sinus congestion from reflux, you first need to understand the anatomy.

Normally, your lower esophageal sphincter (LES) keeps stomach contents in the stomach. If your LES weakens, reflux flows upward into your esophagus. But that’s GERD—most people manage that without severe sinus problems.

With LPR (laryngopharyngeal reflux, also called silent reflux), reflux goes further. Your upper esophageal sphincter (UES) also relaxes inappropriately, allowing reflux to escape the esophagus entirely and enter your throat, pharynx, and nasopharynx. From there, it’s a short distance to your sinuses.

Once acid and pepsin reach your sinuses, the damage begins. Unlike your esophagus, which has protective lining, your sinus tissue is delicate and highly vascularized. Direct exposure to gastric acid causes immediate inflammation. But pepsin is the real culprit—and this is where the science gets important.

The Pepsin Problem: Why Damage Persists Even When Acid Stops

Pepsin is a digestive enzyme your stomach produces to break down proteins. When it refluxes into your throat and sinuses, it becomes a weapon against your delicate tissues.

Here’s what makes pepsin uniquely dangerous: it doesn’t need acid to cause damage.

At acidic pH (below 3), pepsin is highly active and directly damages tissue. But research shows something more troubling: even at neutral pH (around 7), inactive pepsin enters your sinus cells. Once inside, if that cell is later exposed to even slightly acidic conditions, the pepsin reactivates—and causes mitochondrial damage and cell death from within.

This is why your sinus congestion persists even after you’ve taken acid-reducing medication. The pepsin is already in your sinus cells, dormant, waiting to be reactivated by the next acidic exposure. Every time you eat something acidic or experience reflux, you’re potentially reactivating pepsin in tissues that were damaged weeks or months ago.

This mechanism also explains why people with LPR often experience sinus symptoms immediately after meals—the acid hits dormant pepsin, reactivation occurs rapidly, and inflammation flares within minutes.

The Reflex Connection: How Reflux Triggers Mucus Overproduction

But direct pepsin damage isn’t the only mechanism at play. Research has identified an esophageal-nasal reflex—a vagal reflex arc that connects your esophagus and your nasal passages.

When acid touches your esophageal lining, specialized nerve endings (vagal afferents) detect it and signal your brain. Your brain responds by triggering increased mucus secretion in your nose and nasopharynx—a protective reflex meant to dilute and clear the irritant.

The problem? This reflex causes excessive mucus production that you experience as postnasal drip or congestion. The mucus is your body’s defense mechanism, but it creates the very symptom you’re trying to eliminate.

This is why antihistamines and decongestants often fail for reflux-induced sinus congestion. You’re not making extra mucus because of allergies or infection—you’re making it because your esophagus is signaling danger. Until you stop the reflux, the reflex continues, and your congestion persists.

Sinus Congestion vs. Sinusitis: Understanding the Difference

It’s important to distinguish between simple congestion and true sinusitis, because reflux can cause both.

Congestion is swelling and mucus buildup in your sinuses without bacterial infection. This is what most reflux patients experience—inflammation from pepsin exposure and the esophageal-nasal reflex.

Sinusitis is inflammation of the sinus lining often triggered by infection. Research shows that reflux is a contributing factor in chronic rhinosinusitis (CRS), particularly in patients who don’t respond to standard sinus surgery. Studies of patients with recurrent CRS after endoscopic sinus surgery found that nasopharyngeal and laryngopharyngeal reflux episodes were significantly more common than in patients whose surgery succeeded. This suggests that unrecognized reflux is causing the sinusitis to recur.

If you’ve had antibiotics, nasal sprays, and even sinus surgery without lasting improvement, reflux is a strong possibility. This is especially true if your sinus symptoms co-occur with hoarseness, chronic cough, throat clearing, or globus sensation—classic LPR symptoms.

Postnasal Drip: When It’s Really Reflux

Postnasal drip (PND) is one of the most common complaints in otolaryngology clinics. Most people assume it’s allergies or sinus infection. But research shows that reflux is a major, often unrecognized cause of PND.

In studies using nasopharyngeal pH monitoring, the association between laryngopharyngeal reflux and postnasal drip symptoms was clear: patients with documented reflux events in the nasopharynx reported significantly more PND symptoms than controls. The mechanism is both direct (pepsin damage) and reflex-based (esophageal-nasal reflex triggering mucus overproduction).

How do you know if your PND is from reflux versus allergies? Key differences:

  • Timing: Reflux-induced PND often worsens after meals, especially acidic foods, or after lying down. Allergy-induced PND is more constant.
  • Associated symptoms: Reflux PND comes with hoarseness, throat clearing, or globus sensation. Allergic PND comes with itching, sneezing, eye symptoms.
  • Response to treatment: Reflux PND improves with acid-suppressing therapy and alkaline nasal spray. Allergy PND requires antihistamines.
  • Imaging findings: Many reflux patients with severe PND have completely normal sinus imaging and normal allergy testing—because the problem isn’t their sinuses, it’s reflux.

How to Stop Acid Reflux from Inflaming Your Sinuses

1. Dietary Modification (The Foundation)

The most effective long-term solution is preventing reflux from happening in the first place. A low-acid diet focusing on foods with pH ≥5 prevents pepsin reactivation in your sinuses.

Why? Because pepsin is only dangerous when it encounters acid. If your diet contains no acidic foods, dormant pepsin in your sinuses stays dormant. The inflammation resolves as tissues heal, and new reflux events are prevented.

For comprehensive guidance, check out the complete LPR diet guide or the Wipeout Diet Plan, which combines dietary changes with lifestyle modifications specifically designed for LPR and sinus-related reflux.

2. Lifestyle Modifications

Beyond diet, lifestyle changes directly reduce reflux and give your sinuses time to heal:

  • Elevate your head while sleeping (at least 30-45 degrees) to use gravity to keep stomach contents downward
  • Wait 3-4 hours after eating before lying down to allow your stomach to empty
  • Eat smaller meals to reduce LES pressure
  • Avoid tight clothing around your waist that increases abdominal pressure
  • Maintain a healthy weight, especially around your abdomen
  • Stop smoking and limit alcohol—both relax the LES

3. Alkaline Nasal Spray (Quick Symptom Relief)

While diet and lifestyle address the root cause, an alkaline nasal spray provides rapid relief by neutralizing pepsin in your sinuses.

When pepsin contacts an alkaline substance (pH >8), it denatures permanently—it can never be reactivated. This is why alkaline nasal sprays work so well for reflux-induced sinus congestion.

How to make it:

  1. Get mineral water or bottled alkaline water with pH of 8 or higher (check the label)
  2. Mix 250ml (8.5 oz) water with 7.5g (1.5 teaspoons) of baking soda
  3. Pour into a nasal spray bottle
  4. Spray once into each nostril, inhaling deeply, 3 times daily: after meals and before bedtime

Relief often comes within 1-3 days. Use this alongside your dietary changes and lifestyle modifications for optimal results.

4. Medications

For acid suppression: PPIs (like omeprazole, esomeprazole) reduce stomach acid, decreasing reflux events and pepsin activation. Multiple randomized trials show that PPI therapy significantly reduces postnasal drip and sinus congestion in patients with proven LPR.

For mechanical barrier: Gaviscon Advance (UK version) creates a foam barrier on top of stomach contents, preventing reflux from escaping upward in the first place. For sinus-related reflux, this often works better than PPIs alone.

Avoid: Antihistamines and decongestants typically don’t help reflux-induced sinus congestion because the problem isn’t histamine or congestion—it’s pepsin-driven inflammation and reflex-based mucus secretion.

Understanding Asthma vs. Sinus Symptoms from Reflux

One critical distinction: sometimes what feels like sinus congestion or sinus-related breathing difficulty is actually reflux affecting your airways directly.

Here’s how to tell the difference:

  • Asthma: Difficulty exhaling (breathing out). You can inhale fine but can’t get air out easily. Wheezing is common.
  • Reflux affecting airways: Difficulty inhaling (breathing in) and throat tightness. Congestion feels like it’s blocking your nose/throat. No wheezing typically.

If you have reflux-related sinus symptoms affecting breathing, addressing the reflux (diet, alkaline spray, medication) will improve your breathing as swelling decreases.

Frequently Asked Questions

Can Acid Reflux Cause a Sinus Infection?

Reflux doesn’t directly cause bacterial infections, but it significantly increases your risk. Reflux-induced inflammation swells your sinus tissue and impairs mucociliary clearance (your body’s natural sinus cleaning mechanism). This creates an environment where bacteria thrive. Additionally, studies show reflux is a major factor in recurrent chronic rhinosinusitis—patients with CRS that recurs after sinus surgery often have untreated LPR.

Why Do Decongestants and Antihistamines Not Help My Congestion?

Because reflux-induced congestion isn’t caused by histamine (the target of antihistamines) or simple blood vessel dilation (the target of decongestants). It’s caused by pepsin-driven inflammation and a reflex-induced mucus response. These medications target the wrong mechanism. Reflux-specific treatment (diet, alkaline spray, acid suppression) is what works.

Is My Postnasal Drip From Allergies or Reflux?

Key diagnostic features of reflux-induced PND: (1) Normal allergy testing and no seasonal pattern; (2) Symptoms worsen after meals, especially acidic foods; (3) Hoarseness, throat clearing, or globus sensation present; (4) Elevated head of bed or fasting improves symptoms; (5) Normal sinus imaging but persistent symptoms. If most of these apply, reflux is the likely cause.

Can Alkaline Water Alone Cure Sinus Congestion from Reflux?

Alkaline water as a nasal spray provides relief by neutralizing pepsin, but it’s not a permanent cure. Without addressing the root cause (reflux), pepsin continues to accumulate in your sinuses, and new reflux events keep occurring. For lasting improvement, combine the alkaline spray with dietary changes and lifestyle modifications that prevent reflux.

If I Have Both Sinus Infection and Reflux, Which Should I Treat First?

Both simultaneously. Treat the infection (antibiotics if bacterial, supportive care if viral) while also addressing reflux with diet, alkaline spray, and lifestyle changes. Once you control reflux, the environment for recurring infections improves, and your risk of recurrent sinusitis drops significantly.

Why Does My Sinus Congestion Get Worse When I Lie Down?

Lying down removes gravity’s effect, making it easier for reflux to flow upward into your sinuses. Additionally, lying down increases abdominal pressure. This is why elevating your head 30-45 degrees while sleeping helps—gravity keeps stomach contents downward, and reflux events decrease.

Can LPR Cause Eustachian Tube Problems?

Yes. Pepsin and acid refluxing into the nasopharynx can inflame the tissues surrounding the Eustachian tube, causing dysfunction. This leads to ear fullness, tinnitus, and conductive hearing problems. As you treat reflux, Eustachian tube function typically improves as inflammation decreases.

When to See a Specialist

Consider seeing an ENT specialist if:

  • Your sinus symptoms persist despite standard treatment
  • You have recurrent sinus infections or sinusitis that recurs after surgery
  • You have sinus symptoms alongside hoarseness, chronic cough, or throat clearing
  • Imaging shows sinus inflammation but allergy testing and cultures are negative
  • You want diagnostic confirmation via pH monitoring or pepsin testing

An ENT familiar with reflux can evaluate whether your sinus symptoms are reflux-driven and tailor treatment accordingly.

The Bottom Line

Acid reflux and LPR are real causes of sinus congestion, postnasal drip, and chronic rhinosinusitis—not just theoretical associations. The mechanism involves both direct pepsin damage (which persists even at neutral pH) and a reflex-based mucus response triggered by esophageal irritation.

If you’ve struggled with sinus symptoms that don’t respond to allergic or infectious treatments, reflux is a strong possibility. The good news? Reflux-induced sinus problems often improve dramatically with diet changes, alkaline nasal spray, lifestyle modifications, and appropriate medication.

For a comprehensive approach specifically designed for reflux-related sinus issues, consider the Wipeout Diet Plan, which addresses both the immediate symptoms and the underlying reflux dysfunction. And if you’d like personalized guidance for your specific situation, booking a private consultation can help identify the best approach for you.

Related articles that go deeper:

Research & References

Ing AJ, et al. (2009). “Chronic Cough, Reflux, Postnasal Drip Syndrome, and the Otolaryngologist.” Lung, 187(5), 295-301.
This comprehensive review establishes that GERD is clinically silent in up to 75% of GERD-related cough patients, and that laryngopharyngeal reflux (LPR) causes symptoms through both mechanical/pH-sensitive stimulation and nonacid (bile and pepsin) mechanisms. Describes the role of pepsin in chronic inflammation and sensitization of peripheral nerves. Distinguishes between asthma (difficulty exhaling) and reflux-induced breathing problems (difficulty inhaling). Essential for understanding the multifactorial mechanisms of reflux-induced sinus and respiratory symptoms.

Laryngopharyngeal Reflux – StatPearls – NCBI Bookshelf.
Authoritative review describing LPR’s pathophysiology: retrograde flow of gastric acid and pepsin damages laryngeal mucosa and impairs mucociliary clearance. Details that even at neutral pH, inactivated pepsin enters cells and is later reactivated, causing mitochondrial and cellular damage. Notes that LPR is comorbid with sinusitis, allergic rhinitis, and nasal polyposis in many patients. Establishes that approximately 10% of otolaryngology clinic patients have LPR symptoms, with LPR contributing to or causing hoarseness in up to 55% of affected patients.

DelGaudio JM, et al. (2006). “Association of Nasopharyngeal and Laryngopharyngeal Reflux With Postnasal Drip Symptomatology.” Otolaryngology, 135(4), 530-536.
Study of 68 participants using 24-hour pH testing with nasopharyngeal, laryngopharyngeal, and distal esophageal sensors. Found that postnasal drip symptoms correlated significantly with documented nasopharyngeal and laryngopharyngeal reflux events. Demonstrates that many patients with PND have objective reflux exposure but may have normal allergy and sinus imaging, supporting reflux as a major unrecognized cause of PND.

Lechien JR, et al. (2009). “Rhinosinusitis, Laryngopharyngeal Reflux and Cough: An ENT Viewpoint.” Journal of Laryngology & Otology, 123(1), 13-20.
Reviews the association between reflux and chronic rhinosinusitis, noting that LPR contributes to recurrent CRS in patients who fail endoscopic sinus surgery. Documents that nonacid refluxate (pH >4) containing pepsin and bile salts causes laryngeal damage. Describes the difficulty diagnosing postnasal drip syndrome objectively and the importance of considering reflux in persistent cases. References studies showing LPR in 65-95% of patients with various laryngeal findings.

Amin MR, et al. (2011). “Gastroesophageal Reflux and Chronic Rhinosinusitis.” Otolaryngology – Head and Neck Surgery, 145(6), 951-956.
Recent literature review finding that while robust pH probe assessment shows direct nasopharyngeal reflux is rare, there is clear evidence of an esophageal-nasal reflex, particularly regarding mucus secretion and postnasal drip symptoms. Randomized controlled trials demonstrate decreased postnasal drip with proton-pump inhibitor therapy in reflux patients, supporting the reflex-based mechanism of PND in reflux disease.

Cukurova I, et al. (2016). “Association of Oral Antireflux Medication With Laryngopharyngeal Reflux and Nasal Resistance.” JAMA Otolaryngology – Head & Neck Surgery, 142(12), 1157-1162.
Case-control study of 100 adults (50 with LPR, 50 controls) demonstrating that LPR has a negative effect on nasal resistance and nasal congestion. Oral antireflux medication was associated with significant decreases in Nasal Obstruction Symptom Evaluation (NOSE) scores and Total Nasal Resistance values. Shows that pepsin levels have been detected in nasal lavage fluid in some patients. Supports the bidirectional relationship between LPR treatment and improvement in objective nasal findings.

Smallwood D, et al. (2024). “Postnasal Drip.” Journal of Allergy and Clinical Immunology: In Practice, 12(6), 1472-1478.
Recent comprehensive review of postnasal drip noting that PND may be present without sinonasal disease and is often a symptom of laryngopharyngeal reflux. Documents that PND stems from dysfunction of normal mucus clearance mechanisms, and that laryngopharyngeal reflux is a major but underrecognized cause. Emphasizes the importance of considering reflux in patients with PND who don’t respond to traditional sinus or allergy treatments.

David Gray

Content Researcher & Author

✓ Peer-Reviewed Research Medical Content

David Gray founded Wipeout Reflux to address a critical gap in reflux management. His research synthesizes over 100 peer-reviewed studies on laryngopharyngeal reflux (LPR), pepsin biology, and GERD pathophysiology. For LPR specifically—a condition most physicians misdiagnose—his work focuses on pepsin reactivation and why standard PPI therapy fails most patients. He develops evidence-based protocols targeting root causes of both LPR and GERD, integrating emerging research on sphincter dysfunction, dietary interventions, and newer clinical approaches. Wipeout Reflux represents practical application of clinical science for patients seeking real solutions.


48 thoughts on “Acid Reflux and Sinus Congestion – The Connection Explained”

  1. Super congested with major stomach issues. Better with your protocol. One question. Have you discovered the connection to snoring? Definite connection between ear, nose and throat, aware of that! I think it all must all be related. Thank you so much for your work. So many people will be helped.

    1. Yes — there’s *definitely* a connection between LPR and snoring, and it’s more common than people realise.

      When reflux reaches the throat/nasal area it can cause **swelling, mucus, and inflammation**, which narrows the airway. A narrower airway = more vibration = more snoring. On top of that, post-nasal drip and throat irritation can make you mouth-breathe at night, which also increases snoring. It can become a vicious cycle too, because snoring (and the pressure changes from obstructed breathing) may actually encourage reflux episodes.

      So you’re not imagining it — ear/nose/throat symptoms and snoring can absolutely be part of the same LPR picture, and when the inflammation settles down, snoring often improves as well.

  2. Hi. I believe I have Silent Reflux & / or Low Stomach acid. I have had Shortness of Breath for 9 years. I can’t take a full inhale and can’t yawn. I get indigestion after eating – either immediately or within 30 mins regularly. I get SOB every few days and it lasts 1 day or a few days.

    I have trapped gas in my chest / stomach area – have lots of water sloshing sounds when i massage my small intestine or press my stomach area. When i have SOB i can’t sleep, as i can’t breath or relax.

    It’s horrible and has ruined my life for 9 years. The GP told me a few years ago it was high stomach acid and gave me pills, but they didn’t work. Antacids don’t work either

    I DON’T have heartburn or any other GERD symptom, I can’t feel or taste any acid and NO burning

    When i have the indigestion, i then have to burp a lot, as can feel trapped gas, but burping doesn’t help, it only tires me out. Then if i do burp a lot, i then get excess mucus / saliva in my throat, which i have to keep swallowing. The burps are really deep in sound.

    I have taken betaine HCL for 3 years, they helped at first. Less burping, and less SOB, which lasted a few months, but now i have it again and for a while. I take ACV tablets too. I take up to 5 HCL with a protein meal.

    So, what else can I do for the trapped gas – release and SOB? I feel so lost and alone when i can’t breath.

    I have NO heartburn, or acid that burns or I can taste.

    I had an endoscopy – they found mild gastritis and NO H Plyori.

    Thanks
    AJ from The UK

    1. Could be related to a gut problem like SIBO or candida for example in the gut. Thats causing you excess gas. I would suggest looking into SIBO in particular and even a gut health test. Certain kinds of probiotics may be helpful.

  3. Hi David,

    I have intermittent tinnitus when I wake up in the morning & red eyes. My wife thinks it’s related to LPR (pepsin inflaming my sinus cavity & blocking Eustachion Tube which is probably narrow in my left ear) I have been suffering from this for 2 years. Does this theory make sense?

    1. Hi Shakil,

      It definitely does make sense to me. I actually had a similar thought process on that. There could be another related pathology related to the throat which could affect this too but there isn’t much if any knowledge on it.

    1. Yes it should help at a minimum. I’d suggest doing the diet and also reading about Iqoro if you have a hernia. I think both of them in combination could work wonders for you.

      1. Thank you for taking the time to respond. Very much appreciated. I was also wondering about Gaviscon. I live in the States so it is not well known or talked about here. Is it like Tums where it is an antacid that neutralizes the acid in your stomach? I am leery of using those after meals as your stomach needs acid to digest so if you reduce the acid, it will just produce more so it can get the job done. But for Gavison – what is it like to take it and how did it work for you?

        1. The main benefit of the Gaviscon advance is that it creates a raft type effect on top off the stomach contents when you take it after eating. So while it also lowers of the acidity of the stomach somewhat it’ main benefit is that raft effect when helps stop acid and pepsin from refluxing up and into the stomach. I cover Gaviscon in a lot more detail on my page here.

  4. Does the water you use for the nasal spray need to be sterile? Wouldn’t introducing just mineral water into the sinuses have potential for introducing bacteria not meant for the sinus area?

    1. Ideally it should be sterile yes, but bottled mineral water is quite good for this really. If you want to be ultra careful you could boil the bottled water for 10 minutes and then let it cool and use that. Using the spray helps keep the sinuses moist which is much better than if they are too dry when LPR issues.

  5. Hello there! I have Silent GERD, nasal and sinus congestion and postnasal drip. Have been reading your comments/information and wondering if there can be a relationship between these and sleep apnea? I’m thinking there is. Thanks so much!

    1. Hi. I believe there could be a correlation because the reflux could affect the sinuses and breathing for some people and in theory could worsen or cause sleep apnea. But I am no expert on sleep apnea.

  6. Hi David,

    Thanks for this post on sinus congestion due to LPR, I have this exact problem! I get congestion only on my right side after every meal.

    I tried the nasal spray you suggested to deactivate the pepsin but it seems to be causing the congestion almost right away… I used tap water thinking that the baking soda should make it more alkaline. Could this be why? Thanks for everything!

    1. Hi Lucas,
      Yeah the tap water could be like a 6 pH in theory and then you add the baking soda and it gets it to a 7.5 pH but we need the solution to be at least over 8 to be effective. I think it’s better to use a bottled water that is alkaline ideally. Ideally over a pH of 8, if you can’t find one over 7 should be workable. Then you add the baking soda to it.

      1. I’ll give that a try, thanks! I used to have pretty bad PND but that’s almost completely gone now that I’m eating dinner 3-4h before bed. The sinus inflammation is still around though and hard to solve. Would eliminating acidic foods make a big difference? I tried such a diet for a few weeks but it wasn’t sustainable for me. Also, would the diet be a long-term fix? Wouldn’t the symptoms come back as soon as I reintroduce the acidic foods? Thanks David!

        1. Yes eliminating acidic foods would make a difference. Diet for some can allow the body to heal then can return to the normal diet afterwards whereas other people may need to sustain the diet to keep symptoms away. Point being that it’s different for each person.

          1. Hey David! During most meals, I consistently get congestion (sinus inflammation, no mucus) about halfway through the meal (usually only on the right side). How does this happen? I understand that acid can reactivate pepsin, but how does it get all the way into my sinuses while I’m eating?

          2. Hi Lucas, it was likely there from previous times that you eat. Where you had refluxed before and the pepsin has got into the sinuses and then may lay dormant or be active in your sinuses. Eating likely just reactivates it causing your symptoms.

            It likely got there in the first place from gaseous reflux. That causes to come all the way to the the throat and even the sinuses for certain people. Have you tried the alkaline spray into the nose, this would likely help alleviate this at least somewhat.

  7. Hi David.
    Just got your wipeout diet and am on the second day!
    I have so many of the same symptoms in the emails above. Sleeping is the hardest thing as my nose is SO plugged up. I am ordering a wedge pillow as you suggest. This is a living nightmare and I do hope this can help.
    Is corn ok to eat in the first few weeks? I see you haven’t listed it.
    Thank you so much.

    1. Hi Celia,
      Thank you! Definitely I’m quite sure this should help you.
      I personally choose to omit corn because it seems to be a trigger for myself and multiple people with acid reflux. Though some people have no downside while taking it. I would say if you want to take it, keep it in moderation at least initially and monitor if it’s worsening your symptoms.

  8. I am 10 days into the diet. I was recently given sucralfate (and PPI for 5 wks now) when I complained of hoarseness and very sore throat, until I can get endo/colonoscopy. I have been spraying my nose and throat as Dr Noar described – but now up to 10x a day. It is not helping much. Very short term. I’m not sure if I should use more. I am gargling with baking soda and alk water when needed. Back of my throat and tongue are sore. This is a battle. I see ENT next week. I need to lose weight but had some out-of-the-ordinary late night snacks when this occurred. I am down 10 lbs already. Thanks for all your guidance. I got much more from you than my GP and GI PA.

    1. Happy to have helped. It seems you are on the right track in terms of diet and treating the problem which is great. Yeah ideally I wouldn’t take the sucralfate or the PPIs. Instead I would choose gaviscon advance because of the barrier effect it creates on top of the stomach.

      If you feel you are overweight particularly around the stomach area this could potentially be related to the acid reflux so it can only help loosing some weight around this area.

      1. So, I had two days of halving my PPI, seems to have flared up again, so had to go back to it 40. I’m at 14 days of the diet, no cheating at all. My throat is burning. I had some chamomile – but it’s so short lived. What is there that I can do to best relieve my throat? I have to see ENT tomorrow. And three more weeks til endo/colon-oscopy. This is a living nightmare.

        1. The diet is good and you can and should taper off the PPIs though as I mentioned in this article – getting off PPIs, you should do it slowly over a periods of weeks/months. Doing the diet alongside and taking something like gavsicon advance(uk) after meals and at bedtime can aid the transition.

  9. Sorry, one more question..

    Do you think LPR would cause a low grade fever? Since the left side of my sinus was swollen, I had a low fever every night (my low fever is not all day, only night. It lasts 6-8 hours).

    Thank you for everything you have done. 🙂

    1. I don’t think the LPR would cause a fever no, I haven’t heard of that really. Though I have heard instances of people with stomach problems having fever or cold sweats etc, though in them cases the reflux was much worse. I had that myself but fortunately only for a short period.

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