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- Title
RA06.07: PSYLLIUM SUPPLEMENTATION EFFECT ON ESOPHAGEAL FUNCTION TESTING AND SYMPTOMS IN PATIENTS WITH NON-EROSIVE GERD.
- Authors
Morozov, Sergey; Isakov, Vasily; Konovalova, Mariya
- Abstract
Background Epidemiological data showed negative correlation between heartburn frequency and amount of dietary fiber consumed. However no interventional study was performed to prove clinically beneficial effect of dietary fibers in gastroesophageal reflux disease (GERD) patients. The aim of the study was to investigate the effect of dietary fiber on symptoms and esophageal function testing parameters in non-erosive GERD patients (NCT01882088) Methods Thirty six NERD patients were examined using food frequency questionnaire and in case of less than 20 g/day dietary fibre intake underwent high-resolution esophageal manometry and 24-hours esophageal pH-impedance. Language-specific GERD-Q questionnaire was used to assess symptoms. Repeated examinations were performed after 10 days of usual diet supplemented by psyllium 15.0 gram a day. Complete data of 30 NERD patients were available for the final analysis. Study design is shown in a figure 1. Wilcoxon matched pairs test was used to assess changes in the studied parameters View large Download slide View large Download slide Results The decrease in proportion of patients experiencing heartburn as well as GERD-Q score decrease were found. Minimal resting lower esophageal sphincter pressure increased from 5.41 ± 10.1 to 11.3 ± 9.4, P = 0.023. No change in residual LES pressure and mean resting pressure was found. Total number of gastroesophageal refluxes decreased from 67.9 ± 17.7 to 42.4 ± 13.5, P < 0.001 (Table 1). Table 1. Results of the study Baseline EOT P Presence of heartburn during 7 days, % 93.3 40 0.000438 GERD-Q score, M ± m 10.9 ± 1.7 6.0 ± 2.3 0.000003 High resolution manometry Mean resting pressure (at rest), mm Hg, M ± m 22.6 ± 9.4 25.6 ± 11.8 0.47 Minimal resting pressure (at rest), mm Hg, M ± m 5.41 ± 10.1 11.7 ± 9.4 0.008 Mean resting pressure (10 water swallows), mm Hg, M ± m 22.8 ± 9.5 22.3 ± 10.3 0.11 Minimal resting pressure (10 water swallows), mm Hg, M ± m 14.1 ± 8.0 14.9 ± 6.4 0.008 Residual pressure (10 water swallows), mm Hg, M ± m 9.8 ± 6.1 8.9 ± 5.4 0.94 24-hours esophageal pH-impedance Number of refluxes, M ± m 67.9 ± 17.7 42.4 ± 13.5 0.000002 Number of acid refluxes, M ± m 43.2 ± 14.7 30.3 ± 15.3 0.002415 Number of weak acid refluxes, M ± m 23.9 ± 11.7 1.3 ± 15.3 0.000016 Number of non-acid refluxes, M ± m 0.7 ± 1.1 0.6 ± 1.7 0.34 Mean pH (5 cm above LES), M ± m 5.9 ± 0.8 5.7 ± 0.9 0.06 % time pH < 4, M ± m 5.6 ± 4.8 5.5 ± 7.57 0.2 Maximal reflux time, minutes, M ± m 10.6 ± 12 5.3 ± 3.7 0.017 Number of high gastroesophageal refluxes (17 cm above LES), M ± m 23.1 ± 9.2 12.2 ± 6.6 0.000004 Baseline EOT P Presence of heartburn during 7 days, % 93.3 40 0.000438 GERD-Q score, M ± m 10.9 ± 1.7 6.0 ± 2.3 0.000003 High resolution manometry Mean resting pressure (at rest), mm Hg, M ± m 22.6 ± 9.4 25.6 ± 11.8 0.47 Minimal resting pressure (at rest), mm Hg, M ± m 5.41 ± 10.1 11.7 ± 9.4 0.008 Mean resting pressure (10 water swallows), mm Hg, M ± m 22.8 ± 9.5 22.3 ± 10.3 0.11 Minimal resting pressure (10 water swallows), mm Hg, M ± m 14.1 ± 8.0 14.9 ± 6.4 0.008 Residual pressure (10 water swallows), mm Hg, M ± m 9.8 ± 6.1 8.9 ± 5.4 0.94 24-hours esophageal pH-impedance Number of refluxes, M ± m 67.9 ± 17.7 42.4 ± 13.5 0.000002 Number of acid refluxes, M ± m 43.2 ± 14.7 30.3 ± 15.3 0.002415 Number of weak acid refluxes, M ± m 23.9 ± 11.7 1.3 ± 15.3 0.000016 Number of non-acid refluxes, M ± m 0.7 ± 1.1 0.6 ± 1.7 0.34 Mean pH (5 cm above LES), M ± m 5.9 ± 0.8 5.7 ± 0.9 0.06 % time pH < 4, M ± m 5.6 ± 4.8 5.5 ± 7.57 0.2 Maximal reflux time, minutes, M ± m 10.6 ± 12 5.3 ± 3.7 0.017 Number of high gastroesophageal refluxes (17 cm above LES), M ± m 23.1 ± 9.2 12.2 ± 6.6 0.000004 Table 1. Results of the study Baseline EOT P Presence of heartburn during 7 days, % 93.3 40 0.000438 GERD-Q score, M ± m 10.9 ± 1.7 6.0 ± 2.3 0.000003 High resolution manometry Mean resting pressure (at rest), mm Hg, M ± m 22.6 ± 9.4 25.6 ± 11.8 0.47 Minimal resting pressure (at rest), mm Hg, M ± m 5.41 ± 10.1 11.7 ± 9.4 0.008 Mean resting pressure (10 water swallows), mm Hg, M ± m 22.8 ± 9.5 22.3 ± 10.3 0.11 Minimal resting pressure (10 water swallows), mm Hg, M ± m 14.1 ± 8.0 14.9 ± 6.4 0.008 Residual pressure (10 water swallows), mm Hg, M ± m 9.8 ± 6.1 8.9 ± 5.4 0.94 24-hours esophageal pH-impedance Number of refluxes, M ± m 67.9 ± 17.7 42.4 ± 13.5 0.000002 Number of acid refluxes, M ± m 43.2 ± 14.7 30.3 ± 15.3 0.002415 Number of weak acid refluxes, M ± m 23.9 ± 11.7 1.3 ± 15.3 0.000016 Number of non-acid refluxes, M ± m 0.7 ± 1.1 0.6 ± 1.7 0.34 Mean pH (5 cm above LES), M ± m 5.9 ± 0.8 5.7 ± 0.9 0.06 % time pH < 4, M ± m 5.6 ± 4.8 5.5 ± 7.57 0.2 Maximal reflux time, minutes, M ± m 10.6 ± 12 5.3 ± 3.7 0.017 Number of high gastroesophageal refluxes (17 cm above LES), M ± m 23.1 ± 9.2 12.2 ± 6.6 0.000004 Baseline EOT P Presence of heartburn during 7 days, % 93.3 40 0.000438 GERD-Q score, M ± m 10.9 ± 1.7 6.0 ± 2.3 0.000003 High resolution manometry Mean resting pressure (at rest), mm Hg, M ± m 22.6 ± 9.4 25.6 ± 11.8 0.47 Minimal resting pressure (at rest), mm Hg, M ± m 5.41 ± 10.1 11.7 ± 9.4 0.008 Mean resting pressure (10 water swallows), mm Hg, M ± m 22.8 ± 9.5 22.3 ± 10.3 0.11 Minimal resting pressure (10 water swallows), mm Hg, M ± m 14.1 ± 8.0 14.9 ± 6.4 0.008 Residual pressure (10 water swallows), mm Hg, M ± m 9.8 ± 6.1 8.9 ± 5.4 0.94 24-hours esophageal pH-impedance Number of refluxes, M ± m 67.9 ± 17.7 42.4 ± 13.5 0.000002 Number of acid refluxes, M ± m 43.2 ± 14.7 30.3 ± 15.3 0.002415 Number of weak acid refluxes, M ± m 23.9 ± 11.7 1.3 ± 15.3 0.000016 Number of non-acid refluxes, M ± m 0.7 ± 1.1 0.6 ± 1.7 0.34 Mean pH (5 cm above LES), M ± m 5.9 ± 0.8 5.7 ± 0.9 0.06 % time pH < 4, M ± m 5.6 ± 4.8 5.5 ± 7.57 0.2 Maximal reflux time, minutes, M ± m 10.6 ± 12 5.3 ± 3.7 0.017 Number of high gastroesophageal refluxes (17 cm above LES), M ± m 23.1 ± 9.2 12.2 ± 6.6 0.000004 Conclusion Supplementation of diet with psyllium 5.0 gram TID in NERD patients led to significant increase of minimal esophageal resting pressure, decrease of number of gastroesophageal refluxes and frequency of heartburn per week. The work was supported by Federal Agency of Scientific Organizations of Russia (0529–2017-0057) Disclosure All authors have declared no conflicts of interest.
- Subjects
RUSSIA; HEARTBURN; NON-erosive reflux disease; DIETARY fiber; ESOPHAGUS; PSYLLIUM (Plants); ESOPHAGOGASTRIC junction
- Publication
Diseases of the Esophagus, 2018, Vol 31, Issue 13, p32
- ISSN
1120-8694
- Publication type
Article
- DOI
10.1093/dote/doy089.RA06.07