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GERD Watch

Published Online: Thursday, April 15, 2010   [ Request Print ]

Darker Coffee Produces Less Stomach Acid
An estimated 40 million people in the United States avoid coffee because of stomach irritation, but a new study offers hope to this population of coffee lovers. Research presented at the 239th National Meeting of the American Chemical Society in March revealed darker roasts of coffee contain a component that blocks the production of hydrochloric acid.

Veronika Somoza, PhD, from the University of Vienna, and Thomas Hofmann, PhD, from the Technische Universität, Munich, exposed cultures of human stomach cells to different formulations of coffee, including regular, dark roast, and decaffeinated. A combination of caffeine, catechols, and N-alkanoly-5-hydroxytryptamides triggered the production of stomach acid in the cells, while N-methylpyridium (NMP) blocked it. NMP is created only once coffee beans are roasted, and so darker roasts contain higher amounts.

Although it is possible to remove the acid-triggering substances by steaming coffee beans or treating them with solvent, such processing can also remove healthful compounds and affect coffee’s taste and aroma. The researchers hope their research will help yield coffee preparations that can maximize flavor while reducing the amount of stomach acid a drinker produces.


Gastric Bypass Successfully Treats GERD
Obese patients with gastroesophageal reflux disease (GERD) are often treated with gastric fundoplication, but a new study published in the Annals of Surgery online December 10, 2009, shows that gastric bypass may be another option.

The study, headed by Fernando Fornari, PhD, of the University of Passo Fundo in Brazil, followed 86 morbidly obese patients with a mean age of 38 years and a body mass index of 45.3. The study group was evaluated for GERD symptoms before gastric bypass and again 6 months after surgery. Dr. Fornari and his colleagues found that the prevalence of GERD before surgery was 64%; 6 months later, 33% of studied patients reported GERD symptoms.

Before surgery, the main gastrointestinal complaint from patients was heartburn, reported by 96%, and after surgery the most prevalent symptom was regurgitation, reported by 64%. The source of the regurgitation, whether from poor diet or reflux disease, was not established. Patients also reported taking fewer proton pump inhibitors.


RFA and Surgery Resolve Barrett’s Esophagus

With Barrett’s esophagus, the cells of the lower esophagus change in response to constant exposure to stomach acid. The condition can cause various painful gastrointestinal symptoms and can increase the risk of esophageal cancer. Although only a small portion of patients affected by gastroesophageal reflux disease (GERD) will develop Barrett’s esophagus, most people with Barrett’s esophagus have a history of prolonged problems with GERD.

A study published online January 14, 2010, in the Journal of Thoracic and Cardiovascular Surgery followed 14 patients with Barrett’s esophagus who received radiofrequency ablation (RFA) 6 weeks before antireflux surgery and 3 months postoperatively. Led by Hiran C. Fernando, MD, of Boston Medical Center, the researchers found that RFA reduced the amount of metaplasia and dysplasia, or cell changes, in patients with Barrett’s esophagus. All patients who received 3 or more RFA treatments saw complete resolution of the metaplasia.

Dr. Fernando and his colleagues noted, “Further evaluation with larger controlled trials will be necessary to better define the success and durability of this approach for preventing progression to esophageal cancer.”


Laparoscopic Surgery Outperforms Pharmacologic Treatment
In the March 17, 2010, issue of the Cochrane Database of Systematic Reviews, Samantha Wileman, PhD, from the Health Services Research Unit at the University of Aberdeen, United Kingdom, and her colleagues from the Cochrane Upper Gastrointestinal and Pancreatic Diseases Group published a review of trials in which pharmacologic treatment was compared with laparoscopic fundoplication (LF). Fundoplication is a procedure performed to treat gastroesophageal reflux disease (GERD) in which part of the stomach is wrapped around the lower part of the gullet.

The systematic review examined 4 studies with 1232 participants and found that LF made statistically significant improvements in patients’ GERD-specific quality of life at 3 months and 1 year postoperatively.

Although LF is more effective in the short term than pharmacologic treatment, Dr. Wileman stated, “Surgery does carry a risk, and whether this is outweighed by the benefits in the long term is still not certain.” ■


FAST FACT: 25 million Americans, or 1 in 14 individuals, experience acid reflux symptoms every day.
➜More on the Web
For pharmacist-recommended products for acid reflux and heartburn, go to www.OTCGuide.net/stomach_remedies.


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