Insights & Discussion
Patients receiving acupuncture combined with western medicine had a superior global symptom improvement compared with those receiving western medicine alone for gastro-oesophageal reflux disease.
A total of 12 trials involving 1235 patients were included. Meta-analyses demonstrated that patients receiving MA/EA combined with WM had a superior global symptom improvement compared with those receiving WM alone with no significant heterogeneity. Recurrence rates of those receiving MA/EA alone were lower than those receiving WM with low heterogeneity, while global symptom improvement (six studies) and symptom scores (three studies) were similar. Descriptive analyses suggested that acupuncture also improves quality of life in patients with GORD.
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Bicarbonate-rich mineral water “Staatl. Fachingen STILL” significantly reduces heartburn more effectively than placebo, improving patients’ quality of life.
2023 BMJ Open Gastroenterology Heartburn relief with bicarbonate-rich mineral water: results of the randomised, placebo-controlled phase-III trial STOMACH STILL Labenz J, Anschütz M, Walstab J, Wedemeyer RS, Wolters H, Schug B
Randomised Controlled Trial GERD Mineral Water
The STOMACH STILL trial, a multicentre, double-blind, randomized, placebo-controlled study, assessed the effectiveness of Staatl. Fachingen STILL mineral water in relieving heartburn. Adult patients with frequent heartburn episodes for at least six months, but without severe reflux oesophagitis, were recruited. They consumed 1.5 liters per day of either the mineral water (verum) or placebo for six weeks. Primary endpoint was a reduction of at least five points in the Reflux Disease Questionnaire score for heartburn. Secondary endpoints included overall symptom reduction, health-related quality of life measures (QOLRAD), rescue medication intake, and safety/tolerability.
Of the 148 patients randomized, 143 completed the trial. The responder rate was significantly higher in the mineral water group (84.72%) compared to the placebo group (63.51%). Significant improvements were observed in the ‘heartburn’ dimension and overall Reflux Disease Questionnaire scores for the mineral water group. Additionally, three out of five Quality of Life in Reflux and Dyspepsia domains showed improvement: ‘food/drink problems,’ ‘emotional distress,’ and ‘vitality.’ The verum group also reported a decrease in rescue medication use. Only three patients experienced treatment-related adverse events. The study concluded that Staatl. Fachingen STILL mineral water is superior to placebo in relieving heartburn and enhancing health-related quality of life.
Acupuncture covering the depth ranges for BL18, BL20, and BL22 and their targeting of various tissues potentially alleviates sympathetic nerve issues and ischemia with assistance of the diaphragm.
2022 Medicine Anatomical structures and needling method of the back-shu points BL18, BL20, and BL22 related to gastrointestinal organs: A PRISMA-compliant systematic review of acupoints and exploratory mechanism analysis Cho Y, Han Y, Kim Y, Han S, Oh K, Chae H, et al.
Systematic Review Back-Shu Points
Review analyzed 115 articles on needling depth and angle for back-shu acupuncture points in GI diseases. Key findings include the depth range for BL18, BL20, and BL22 points, their targeting of muscles, nerves, and diaphragmatic tissues, and the potential for acupuncture to alleviate sympathetic nerve overexcitability and ischemia while emphasizing the diaphragm's role in digestive function.
Coconut water and coconut milk ameliorate the negative impacts of heat stress on gastrointestinal health by reducing oxidative stress and suppressing inflammatory responses.
2022 Journal of Food Biochemistry Effect of coconut water and milk on heat stress‐induced gastrointestinal tract dysmotility in rats: Role of oxidative stress and inflammatory response Ajeigbe KO, Oladokun OO, Owonikoko MW, Adegoke GA
Experimental Study Coconut Milk Coconut Water Oxidative Stress
The study enlisted four different temperature exposure groups of rats, namely a control group at 30 degrees Celsius, a heat-stressed group exposed to an ambiance of 40 degrees, a heat-stressed group pre-treated with coconut water, and a heat-stressed group with coconut milk. Measurements such as skin and rectal temperatures, as well as evaluations of gastrointestinal motility factors such as intestinal transit, intestinal fluid accumulation, and colonic motility, were taken before and after a two-hour heat exposure over 14 days.
Noticeable increases in gastrointestinal motility factors were observed amongst the heat-stressed rats. However, the introduction of coconut milk and water appeared to reverse these increases. Furthermore, the elevated cortisol levels and intestinal lipid peroxidation in the heat-stressed rats were significantly reduced with the introduction of both coconut products. Likewise, results showed an increase in antioxidant enzyme activities in the rats that received either coconut water or milk, in contrast to the control group. Similarly, the coconut water and milk were seen to suppress inflammatory cytokines while enhancing others. The study also noted significant improvements in intestinal morphology among heat-stressed rats treated with either coconut product.
Fresh and dried ginger displays key botanical, phytochemical and ethnopharmacological differences, which are fundamental for their specific clinical uses in treating gastrointestinal issues.
2022 The American Journal of Chinese Medicine Zingiber officinale: A Systematic Review of Botany, Phytochemistry and Pharmacology of Gut Microbiota-Related Gastrointestinal Benefits Lai W, Yang S, Lin X, Zhang X, Huang Y, Zhou J, et al.
Systematic Review Ginger Gut Microbiota
The methodology used in the research involved a retrospective comparison between Sheng Jiang (SJ, meaning fresh ginger) and Gan Jiang (GJ, meaning dried ginger), two traditional Chinese herbs. The comparison was undertaken specifically considering aspects of botany, phytochemistry, and ethnopharmacology. The research also delved into exploring the traditionally attributed use of ginger, in both its fresh and dried forms, for the treatment of gastrointestinal disorders, and its relationship with human gut microbiota - an aspect that hasn't been considered extensively previously.
The results displayed notable differences between fresh and dried ginger in terms of botany, phytochemical, and ethnopharmacological properties. Fresh and dried ginger are cultivated differently and display distinct physical appearances. This research proposed that these differences lay the foundation for how these two forms of ginger are applied clinically. Furthermore, discussing the pharmacology of gut microbiota-related gastrointestinal benefits, it is suggested that fresh and dried ginger could present innovative and potent avenues for preventing and treating gastrointestinal disorders.
Alginate, as a treatment option for laryngopharyngeal reflux, is equally effective as proton pump inhibitors and may serve as a potential alternative treatment.
2022 European Archives of Oto-Rhino-Laryngology Magnesium alginate versus proton pump inhibitors for the treatment of laryngopharyngeal reflux: a non-inferiority randomized controlled trial Pizzorni N, Ambrogi F, Eplite A, Rama S, Robotti C, Lechien J, et al.
Randomised Controlled Trial Alginate GERD Magnesium
Researchers employed a non-inferiority randomized controlled trial with fifty participants, all of whom exhibited laryngopharyngeal symptoms. They were divided into two treatment groups; one group received the alginate suspension Gastrotuss in three daily doses, while the other was administered Omeprazole once daily. The Reflux Symptom Index and Reflux Finding Score were used to measure the severity of symptoms both before the treatment and after the two-month treatment period.
It was found that both groups had similar Reflux Symptom Index and Reflux Finding Score values initially. After the two-month treatment, both groups demonstrated significant decrease in these indices, suggesting that the symptoms and signs of laryngopharyngeal reflux were significantly reduced, regardless of the treatment given. The difference between the changes in both Reflux Symptom Index and Reflux Finding Score from the two groups was found to be insignificant, thereby indicating that the effectiveness of Alginate is non-inferior to Proton Pump Inhibitors.
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