GERD

Presentation Slides

Chinese Medicine Research Hub

Randomised Controlled Trial

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

Chinese Medicine Research Hub

Review Article

Ginger, peppermint and caraway oil combination showed strong effectiveness in managing upper gastrointestinal complaints, with melatonin and marine alginate demonstrating moderate evidence.

2022 Nutrients Effectiveness of Nutritional Ingredients on Upper Gastrointestinal Conditions and Symptoms: A Narrative Review
Schulz RM, Ahuja NK, Slavin JL

Chinese Medicine Research Hub

Randomised Controlled Trial

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, Schindler A

Chinese Medicine Research Hub

Positive effects of acupuncture and electroacupuncture were observed in regulating gastric motility, gastric accommodation, mental status, gastrointestinal hormones, and central and autonomic functions while improving dyspeptic symptoms and quality of life.

2020 World Journal of Gastroenterology Effects and mechanisms of acupuncture and electroacupuncture for functional dyspepsia: A systematic review
Guo Y, Wei W, Chen JD

Chinese Medicine Research Hub

Systematic Review

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.

2017 Acupuncture in Medicine Acupuncture for the treatment of gastro-oesophageal reflux disease: a systematic review and meta-analysis
Zhu, J., Guo, Y., Liu, S., Su, X., Li, Y., Yang, Y., Hou, L., Wang, G., Zhang, J., Chen, J. J. D., Wang, Q., Wei, R., & Wei, W.

Chinese Medicine Research Hub

Clinical Study

Hydrogen carbonate-rich mineral water significantly reduces heartburn frequency and severity, improving quality of life with excellent tolerability.

2016 World Journal of Gastrointestinal Pathophysiology Efficacy and tolerability of hydrogen carbonate-rich water for heartburn
Beer AM

Chinese Medicine Research Hub

Clinical Study

Drinking hydrogen carbonate-rich mineral water significantly reduces heartburn episodes and improves quality of life in individuals with dyspeptic symptoms.

2016 Open Journal of Gastroenterology Pilot Trial on the Efficacy and Safety of a Natural Mineral Water Rich in Hydrogen Carbonate on Functional Dyspepsia and Heartburn
Pohl U, Auinger A, Bothe G, Uebelhack R

Chinese Medicine Research Hub

High intake of magnesium from foods is linked to a significant decrease in the odds of developing reflux oesophagitis and Barrett's oesophagus.

2015 British Journal of Nutrition Dietary magnesium, calcium:magnesium ratio and risk of reflux oesophagitis, Barrett’s oesophagus and oesophageal adenocarcinoma: a population-based case–control study
Dai Q, Cantwell MM, Murray LJ, Zheng W, Anderson LA, Coleman HG

Chinese Medicine Research Hub

Pantoprazole magnesium, administered once daily, is effective and well-tolerated in significantly improving symptoms of gastroesophageal reflux disease.

2013 Clinical Drug Investigation Efficacy, Safety, and Tolerability of Pantoprazole Magnesium in the Treatment of Reflux Symptoms in Patients with Gastroesophageal Reflux Disease (GERD): A Prospective, Multicenter, Post-Marketing Observational Study
Remes-Troche JM, Sobrino-Cossío S, Soto-Pérez JC, Teramoto-Matsubara O, Morales-Arámbula M, Orozco-Gamiz A, Tamayo de la Cuesta JL, Mateos G

Executive Summary

Write an executive summary in the form of a blog article on the topic of "Research into Chinese medicine treatment for GERD" summarising the research below and using language that can be easily understood by patients and avoiding medical jargon using a professional and caring tone of voice.

Write an executive summary in the form of a blog article on the topic of "Researched Chinese medicine treatments for GERD" summarising the research below in an objective and easy to understand way, and using language that can be easily understood by patients. Group the article into Chinese medicine treatments first, followed by nutrition and other treatments. Avoid using medical jargon and use a professional and caring tone of voice.

Write me a concise but easy to understand executive summary on the topic of "Chinese medicine treatments for GERD" based on the following research that I will give you. Your summary should be 2 paragraphs long in Australian English spelling and include references to the studies.

A Randomised Controlled Trial published in 2023 in the journal BMJ Open Gastroenterology found that Bicarbonate-rich mineral water “Staatl. Fachingen STILL” significantly reduces heartburn more effectively than placebo, improving patients’ quality of life. 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.

A Review Article published in 2022 in the journal Nutrients found that Ginger, peppermint and caraway oil combination showed strong effectiveness in managing upper gastrointestinal complaints, with melatonin and marine alginate demonstrating moderate evidence. The methodology consisted of a literature review of the scientific studies pertaining to nutritional ingredients for upper gastrointestinal relief. The selection was based on recurring mentions within the literature and frequent appearance in consumer products. A predefined search for specific nutritional ingredients and terms related to upper GI health was conducted in five databases - Embase, Medline, Derwent drug file, ToXfile, and PubMed. A manual search was also undertaken for each ingredient to ensure comprehensive review. The studies that gained inclusion encompassed 16 human clinical trials assessing nine different ingredients. The products investigated were divided into categories, including botanicals - with sub-categories of fiber and combinations, and non-botanical extracts. Several products demonstrated good potential, others showed promising but moderate results, while some had limited support from the scientific research.

A Randomised Controlled Trial published in 2022 in the journal European Archives of Oto-Rhino-Laryngology found that Alginate, as a treatment option for laryngopharyngeal reflux, is equally effective as proton pump inhibitors and may serve as a potential alternative treatment. 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.

A published in 2020 in the journal World Journal of Gastroenterology found that Positive effects of acupuncture and electroacupuncture were observed in regulating gastric motility, gastric accommodation, mental status, gastrointestinal hormones, and central and autonomic functions while improving dyspeptic symptoms and quality of life. In this systematic review, we pooled randomized controlled trials with mechanistic investigations of acupuncture or electroacupuncture in improving dyspeptic symptoms, and illustrated the existing results that may provide potential explanations for the therapeutic effects. The findings of included studies in this review suggest that acupuncture and electroacupuncture can improve gastric motility and accommodation, regulate gastrointestinal hormones and mental status, and alter certain central and autonomic functions in patients with functional dyspepsia. However, due to limitations in the included articles, high-quality studies with well-planned designs and multiregional investigations are necessary to provide more convincing and credible evidence.

A Systematic Review published in 2017 in the journal Acupuncture in Medicine found that 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.

A Clinical Study published in 2016 in the journal World Journal of Gastrointestinal Pathophysiology found that Hydrogen carbonate-rich mineral water significantly reduces heartburn frequency and severity, improving quality of life with excellent tolerability. This open, single-center, single-arm clinical pilot study involved 50 patients aged 18-64, suffering from heartburn at least twice weekly for over three months. Excluding those with severe diseases or on heartburn medication, participants drank 1.5 liters of hydrogen carbonate-rich mineral water daily for six weeks, with 300 ml consumed at each meal. The study included five visits for monitoring. Efficacy was assessed through patient self-assessments in a heartburn diary, symptom-specific questionnaires (Reflux Disease Questionnaire, Quality of Life in Reflux and Dyspepsia, Gastrointestinal Quality of Life Index), and overall health-related quality of life using the SF-12. Efficacy and safety were evaluated using the Wilcoxon test, χ2 test, and U-test, considering changes in symptoms and vital signs. The study reported significant reductions in heartburn occurrences at week 6 in both the intention-to-treat and per-protocol populations. The average weekly heartburn episodes decreased by 5.1, and the duration of symptoms reduced by 19 minutes. Symptom frequency decreased in 89.6% of patients, and symptom duration in 79.2%. There were improvements in all dimensions of the RDQ and disease-specific quality of life. Both patients and investigators rated the water’s efficacy positively, with no serious adverse events reported. Additionally, a slight but significant decrease in both systolic and diastolic blood pressure was observed. The study concluded that hydrogen carbonate-rich mineral water is effective and well-tolerated in alleviating heartburn, enhancing quality of life.

A Clinical Study published in 2016 in the journal Open Journal of Gastroenterology found that Drinking hydrogen carbonate-rich mineral water significantly reduces heartburn episodes and improves quality of life in individuals with dyspeptic symptoms. This one-arm pilot study involved 56 men and women experiencing frequent heartburn. Participants were instructed to drink 1.5 liters of mineral water high in hydrogen carbonate daily for six weeks. They kept a daily diary to record the number and duration of heartburn episodes. Additionally, several questionnaires were used to assess the effects of the water on their condition and quality of life. These included the Reflux Disease Questionnaire (RDQ), Quality of Life in Reflux and Dyspepsia questionnaire (QOLRAD), Gastrointestinal Quality of Life Index (GILQI), and the Short Form Health Survey (SF-12). The study analyzed changes in symptoms and quality of life before and after the treatment using the Wilcoxon test. The study reported a significant decrease in the number of weekly heartburn episodes and the duration of each episode after the six-week intervention. Participants also experienced a notable reduction in the severity of heartburn, regurgitation, and dyspeptic complaints. There was a significant improvement in disease-specific quality of life as measured by GILQI and QOLRAD, and in general health-related quality of life as assessed by SF-12. These findings suggest that drinking hydrogen carbonate-rich mineral water can be an effective alternative treatment for dyspeptic symptoms and heartburn, leading to an enhanced quality of life.

A published in 2015 in the journal British Journal of Nutrition found that High intake of magnesium from foods is linked to a significant decrease in the odds of developing reflux oesophagitis and Barrett's oesophagus. The study involved participants who were cases of oesophageal adenocarcinoma, Barrett's oesophagus, reflux oesophagitis and population-based controls, all gathered from throughout Ireland between 2002 and 2005. Each participant completed a 101-item Food Frequency Questionnaire (FFQ). The association between dietary intakes of magnesium, calcium and the ratio of calcium to magnesium on the risk of oesophageal adenocarcinoma, Barrett's oesophagus and reflux oesophagitis was analysed using unconditional logistic regression analysis, adjusting for potential confounders. In terms of results, participants consuming the highest amounts of magnesium from food considerably reduced their odds of reflux oesophagitis and Barrett's oesophagus when compared to those consuming the smallest amounts. This protective effect of magnesium was even more noticeable when the intake of calcium to magnesium was low. However, no significant associations were found between magnesium intake and the risk of oesophageal adenocarcinoma.

A published in 2013 in the journal Clinical Drug Investigation found that Pantoprazole magnesium, administered once daily, is effective and well-tolerated in significantly improving symptoms of gastroesophageal reflux disease. The study was designed as a phase IV, open-label, prospective, multicenter trial where patients who had a history of persistent or recurrent heartburn and/or acid regurgitation for a minimum of three months were prescribed pantoprazole magnesium 40mg orally, once daily for approximately one month. The baseline characteristics and demographics of gastroesophageal reflux disease symptom intensity were recorded and analyzed among thousands of patients who met all inclusion criteria. Patients' symptoms, assessed by the physician using a 4-point Likert scale, showed considerable reduction from baseline intensity following the treatment. The treatment had a high tolerance rate with very few patients experiencing any adverse events, thereby indicating that pantoprazole magnesium is not only an effective but also a safe drug for patients suffering from gastroesophageal reflux disease.

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