Elimination of Dietary Triggers Is Successful in Treating Symptoms of Gastroesophageal Reflux Disease

Tosetti, Cesare; Savarino, Edoardo; Benedetto, Edoardo; Bastiani, Rudi De; Belvedere, Alessandra; Cottone, Carmelo; Gambaro, P.; Mancuso, Maurizio; Pirrotta, Enzo; Scoglio, Riccardo; Ubaldi, Enzo; Zamparella, Maria

doi:10.1007/s10620-020-06414-z

Cited by 25 publications

(19 citation statements)

References 40 publications

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“…Recently, a study based on MII-pH post-prandial analysis by Martinucci et al showed that a meal based on vegetable proteins was associated with a lower number of refluxes, particularly acid refluxes, and with a reduced number of symptoms during the first postprandial hour, compared to one with a prevailing component of animal proteins ( 92 ). Also, regarding avoidance of alcohol, peppermint, coffee or fatty food, evidence is scarce and this suggestion, despite being very frequently proposed in clinical practice, cannot be strictly recommended ( 90 , 93 , 94 ). A clinical trial showed that fermentable oligo-, di-, mono- saccharides and polyols (FODMAPs), particularly fructans, increased the number of TLESRs in healthy patients ( 95 ), and in proven rGERD patients a low- FODMAP diet was shown not to significantly decrease reflux symptoms when compared to usual dietary advice ( 96 ).…”

Section: Therapy Of Rgerdmentioning

confidence: 99%

Refractory Gastroesophageal Reflux Disease: A Management Update

et al. 2021

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Gastroesophageal reflux disease (GERD) is one of the most frequent gastrointestinal disorders. Proton pump inhibitors (PPIs) are effective in healing lesions and improving symptoms in most cases, although up to 40% of GERD patients do not respond adequately to PPI therapy. Refractory GERD (rGERD) is one of the most challenging problems, given its impact on the quality of life and consumption of health care resources. The definition of rGERD is a controversial topic as it has not been unequivocally established. Indeed, some patients unresponsive to PPIs who experience symptoms potentially related to GERD may not have GERD; in this case the definition could be replaced with “reflux-like PPI-refractory symptoms.” Patients with persistent reflux-like symptoms should undergo a diagnostic workup aimed at finding objective evidence of GERD through endoscopic and pH-impedance investigations. The management strategies regarding rGERD, apart from a careful check of patient's compliance with PPIs, a possible change in the timing of their administration and the choice of a PPI with a different metabolic pathway, include other pharmacologic treatments. These include histamine-2 receptor antagonists (H2RAs), alginates, antacids and mucosal protective agents, potassium competitive acid blockers (PCABs), prokinetics, gamma aminobutyric acid-B (GABA-B) receptor agonists and metabotropic glutamate receptor-5 (mGluR5) antagonists, and pain modulators. If there is no benefit from medical therapy, but there is objective evidence of GERD, invasive antireflux options should be evaluated after having carefully explained the risks and benefits to the patient. The most widely performed invasive antireflux option remains laparoscopic antireflux surgery (LARS), even if other, less invasive, interventions have been suggested in the last few decades, including endoscopic transoral incisionless fundoplication (TIF), magnetic sphincter augmentation (LINX) or radiofrequency therapy (Stretta). Due to the different mechanisms underlying rGERD, the most effective strategy can vary, and it should be tailored to each patient. The aim of this paper is to review the different management options available to successfully deal with rGERD.

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Section: Therapy Of Rgerdmentioning

confidence: 99%

Refractory Gastroesophageal Reflux Disease: A Management Update

et al. 2021

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“…However, a recent prospective primary care study showed that patients with reflux symptoms could identify at least one dietary trigger for their symptoms (for example, spicy food, chocolate, or tomato) and that eliminating this food reduced symptoms in the short term. 20 Furthermore, 45% of patients agreed to continue treatment with dietary intervention alone, rather than progress to pharmacological therapy. 20…”

Section: Approaches To Management Lifestyle Factorsmentioning

confidence: 99%

“…20 Furthermore, 45% of patients agreed to continue treatment with dietary intervention alone, rather than progress to pharmacological therapy. 20…”

Section: Approaches To Management Lifestyle Factorsmentioning

confidence: 99%

The tapestry of reflux syndromes: translating new insight into clinical practice

et al. 2021

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“…Selfidentification of bothersome foods and beverages allows for sequential elimination of common triggers followed by reintroduction if tolerated. 10 Often providers will direct patients via a list of implicated foods which classically includes those with high levels of acidity (ie, tomato-based products, citrus fruits, and beverages), specific spices (mints, curies, cayenne, cinnamon), caffeine (coffee, sodas, chocolate), alcohol, and carbonation.…”

Section: Elimination Dietsmentioning

confidence: 99%