Jiang Yan, Sonu Irene, Garcia Patricia, Fernandez-Becker Nielsen Q, Kamal Afrin N, Zikos Thomas A, Singh Sundeep, Neshatian Leila, Triadafilopoulos George, Goodman Steven N, Clarke John O
Division of Gastrointestinal and Liver Diseases, Keck Medicine of University of Southern California, Los Angeles.
Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Redwood City.
J Clin Gastroenterol. 2023;57(10):1001-1006. doi: 10.1097/MCG.0000000000001788. Epub 2022 Nov 1.
The aim was to investigate the short-term impact of time restricted feeding on patients with suspected gastroesophageal reflux disease (GERD).
Lifestyle modifications are often suggested, but the role of diet in GERD is unclear. Intermittent fasting is popular in the media and has demonstrated potential benefits with weight loss and inflammatory conditions as well as alterations in gastrointestinal hormones.
Patients who were referred for 96-hour ambulatory wireless pH monitoring off proton pump inhibitor to investigate GERD symptoms were screened for eligibility. Patients were instructed to maintain their baseline diet for the first 2 days of pH monitoring and switch to an intermittent fasting regimen (16 consecutive hour fast and 8 h eating window) for the second 2 days. Objective measures of reflux and GERD symptom severity were collected and analyzed.
A total of 25 participants were analyzed. 9/25 (36%) fully adhered to the intermittent fasting regimen, with 21/25 (84%) demonstrating at least partial compliance. Mean acid exposure time on fasting days was 3.5% versus 4.3% on nonfasting days. Intermittent fasting was associated with a 0.64 reduction in acid exposure time (95% CI: -2.32, 1.05). There was a reduction in GERD symptom scores of heartburn and regurgitation during periods of intermittent fasting (14.3 vs. 9.9; difference of -4.46, 95% CI: -7.6,-1.32).
Initial adherence to time restricted eating may be difficult for patients. There is weak statistical evidence to suggest that intermittent fasting mildly reduces acid exposure. Our data show that short-term intermittent fasting improves symptoms of both regurgitation and heartburn.
本研究旨在调查限时进食对疑似胃食管反流病（GERD）患者的短期影响。
生活方式的改变常被推荐用于GERD的治疗，但饮食在GERD中的作用尚不清楚。间歇性禁食在媒体上很流行，并且已证明在减肥、炎症性疾病以及胃肠激素变化方面具有潜在益处。
对因GERD症状而被转诊进行96小时动态无线pH监测且停用质子泵抑制剂的患者进行资格筛选。患者被指示在pH监测的前两天保持其基线饮食，并在接下来的两天改为间歇性禁食方案（连续禁食16小时，进食窗口为8小时）。收集并分析反流和GERD症状严重程度的客观指标。
共分析了25名参与者。9/25（36%）的参与者完全遵守间歇性禁食方案，21/25（84%）的参与者至少部分遵守该方案。禁食日的平均酸暴露时间为3.5%，而非禁食日为4.3%。间歇性禁食与酸暴露时间减少0.64相关（95%置信区间：-2.32，1.05）。在间歇性禁食期间，GERD症状中烧心和反流的评分有所降低（14.3对9.9；差值为-4.46，95%置信区间：-7.6，-1.32）。
患者最初可能难以坚持限时进食。有微弱的统计证据表明间歇性禁食可轻度减少酸暴露。我们的数据表明，短期间歇性禁食可改善反流和烧心症状。
