National Health System, Group for Primary Care Gastroenterology (GIGA-CP), Belluno, Italy.
Department of Primary Care Porretta Terme, Health Agency of Bologna, Bologna, Italy.
Dig Dis Sci. 2021 May;66(5):1565-1571. doi: 10.1007/s10620-020-06414-z. Epub 2020 Jun 24.
The relationship between aliments and pathophysiological abnormalities leading to gastroesophageal reflux disease (GERD) symptoms elicitation is unclear. Nevertheless, patients often report symptoms after ingestion of specific foods.
To identify in primary care setting the presence of foods able to trigger GERD symptoms, and evaluate whether a consequent specific food elimination diet may result in clinical improvement.
Diagnosis of GERD and quantification of reflux symptoms were done according to GERD-Q questionnaire (positive when > 8). During clinical data collection, patients were asked to report aliments associated with their symptoms. Also, a precompiled list of additional foods was administered to them. Then, patients were requested to eliminate the specific foods identified, and to come back for follow-up visit after 2 weeks when GERD-Q questionnaire and clinical data collection were repeated.
One-hundred GERD (mean GERD-Q score 11.6) patients (54 females, mean age 48.7 years) were enrolled. Eighty-five patients reported at least one triggering food, mostly spicy foods (62%), chocolate (55%), pizza (55%), tomato (52%), and fried foods (52%). At follow-up visit, the diagnosis of GERD was confirmed in only 55 patients, and the mean GERD-Q score decreased to 8.9. Heartburn reporting decreased from 93 to 44% of patients, while regurgitation decreased from 72 to 28%. About half of the patients agreed to continue with only dietary recommendations.
Most patients with GERD can identify at least one food triggering their symptoms. An approach based on abstention from identified food may be effective in the short term.
食物与导致胃食管反流病(GERD)症状的病理生理异常之间的关系尚不清楚。然而,患者经常在摄入特定食物后报告症状。
在初级保健环境中确定能够引发 GERD 症状的食物,并评估随后的特定食物消除饮食是否会导致临床改善。
根据 GERD-Q 问卷(>8 时为阳性)诊断 GERD 和量化反流症状。在收集临床数据期间,要求患者报告与症状相关的食物。此外,还向他们提供了一份预先编制的其他食物清单。然后,要求患者消除确定的特定食物,并在 2 周后回来进行随访,届时将重复 GERD-Q 问卷和临床数据收集。
共纳入 100 例 GERD 患者(54 名女性,平均年龄 48.7 岁)(平均 GERD-Q 评分 11.6)。85 例患者报告至少有一种诱发食物,主要是辛辣食物(62%)、巧克力(55%)、比萨(55%)、番茄(52%)和油炸食品(52%)。在随访时,仅在 55 例患者中确认 GERD 诊断,GERD-Q 评分平均降至 8.9。烧心报告从 93%减少到 44%的患者,而反流从 72%减少到 28%。大约一半的患者同意仅遵循饮食建议。
大多数 GERD 患者至少可以确定一种引发其症状的食物。基于避免识别食物的方法可能在短期内有效。