Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Typ-2-Diabetes und Adipositas Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Häufige urologisch-sexualmedizinische Themen in der Praxis sind das Thema des MMW-Webinars am 5. Juni von 17.30 bis 19 Uhr. Konkret geht es um die Frage, wann bei Harnwegsinfektionen auf Antibiotika verzichtet werden kann, und um ein Update zur Therapie von Libido- und Potenzstörungen des Mannes. Der dritte Vortrag behandelt sexuell übertragbare Krankheiten. Stellen Sie Ihre Fragen an die Experten und sammeln Sie 2 CME-Punkte. Jetzt gleich anmelden!
Erweiterte Suche
Anmelden
nach oben
Current Gastroenterology Reports
Erschienen in: Current Gastroenterology Reports 8/2019

01.08.2019 | Esophagus (J Clarke and N Ahuja, Section Editors)

Popular Remedies for Esophageal Symptoms: a Critical Appraisal

verfasst von: Amisha Ahuja, Nitin K. Ahuja

Erschienen in: Current Gastroenterology Reports | Ausgabe 8/2019

Einloggen, um Zugang zu erhalten

Abstract

Purpose of Review

Popular remedies are of ongoing interest to patients experiencing common esophageal symptoms, particularly as typical pharmacologic interventions have been subject to increased scrutiny. Herein we summarize the available data regarding potential risks and benefits of several such remedies.

Recent Findings

With emphasis on reflux and non-cardiac chest pain, research is ongoing into the clinical utility and diverse physiologic mechanisms underlying a variety of complementary and alternative modalities, including dietary manipulation, apple cider vinegar, melatonin, acupuncture, and various herbal products (rikkunshito, STW 5, slippery elm, licorice, and peppermint oil, among others).

Summary

A substantial gap persists between anecdotal and empirical understandings of the majority of non-pharmacologic remedies for esophageal symptoms. This landscape of popular treatments nevertheless raises several interesting mechanistic hypotheses and compelling opportunities for future research.
Literatur
1.
2.
• Yoon SL, Grundmann O, Smith KF, Mason SR. Dietary supplement and complementary and alternative medicine use are highly prevalent in patients with gastrointestinal disorders: results from an online survey. J Diet Suppl. 2018;29:1–14. A recent internet-based survey revealed a high prevalence (84%) of use of dietary supplements and complementary and alternative medicine among respondents with a history of gastrointestinal symptoms. CrossRef
3.
Astin JA. Why patients use alternative medicine: results of a national study. Jama. 1998;279(19):1548–53.PubMedCrossRef
4.
Hung A, Kang N, Bollom A, Wolf JL, Lembo A. Complementary and alternative medicine use is prevalent among patients with gastrointestinal diseases. Dig Dis Sci. 2015;60(7):1883–8.PubMedCrossRef
5.
Vaezi MF, Yang YX, Howden CW. Complications of proton pump inhibitor therapy. Gastroenterology. 2017;153(1):35–48.PubMedCrossRef
6.
El-Serag HB, Sweet S, Winchester CC, Dent J. Update on the epidemiology of gastro-oesophageal reflux disease: a systematic review. Gut. 2014 Jun;63(6):871–80.PubMedCrossRef
7.
Katz PO, Gerson LB, Vela MF. Guidelines for the diagnosis and management of gastroesophageal reflux disease. Am J Gastroenterol. 2013;108(3):308–28 quiz 29.PubMedCrossRef
8.
Ness-Jensen E, Hveem K, El-Serag H, Lagergren J. Lifestyle intervention in gastroesophageal reflux disease. Clin Gastroenterol Hepatol : the official clinical practice journal of the American Gastroenterological Association. 2016;14(2):175–82 e1–3.CrossRef
9.
Kaltenbach T, Crockett S, Gerson LB. Are lifestyle measures effective in patients with gastroesophageal reflux disease? An evidence-based approach. Arch Intern Med. 2006;166(9):965–71.PubMedCrossRef
10.
Nebel OT, Fornes MF, Castell DO. Symptomatic gastroesophageal reflux: incidence and precipitating factors. Am J Dig Dis. 1976;21(11):953–6.PubMedCrossRef
11.
Feldman M, Barnett C. Relationships between the acidity and osmolality of popular beverages and reported postprandial heartburn. Gastroenterology. 1995;108(1):125–31.PubMedCrossRef
12.
Pointer SD, Rickstrew J, Slaughter JC, Vaezi MF, Silver HJ. Dietary carbohydrate intake, insulin resistance and gastro-oesophageal reflux disease: a pilot study in European- and African-American obese women. Aliment Pharmacol Ther. 2016;44(9):976–88.PubMedPubMedCentralCrossRef
13.
Austin GL, Thiny MT, Westman EC, Yancy WS Jr, Shaheen NJ. A very low-carbohydrate diet improves gastroesophageal reflux and its symptoms. Dig Dis Sci. 2006;51(8):1307–12.PubMedCrossRef
14.
Morozov S, Isakov V, Konovalova M. Fiber-enriched diet helps to control symptoms and improves esophageal motility in patients with non-erosive gastroesophageal reflux disease. World J Gastroenterol. 2018;24(21):2291–9.PubMedPubMedCentralCrossRef
15.
16.
Nam SY, Park BJ, Cho YA, Ryu KH, Choi IJ, Park S, et al. Different effects of dietary factors on reflux esophagitis and non-erosive reflux disease in 11,690 Korean subjects. J Gastroenterol. 2017;52(7):818–29.PubMedCrossRef
17.
Mano F, Ikeda K, Sato T, Nakayama T, Tanaka D, Joo E, et al. Reduction in gastroesophageal reflux disease symptoms is associated with miso soup intake in a population-based cross-sectional study: the Nagahama study. J Nutr Sci Vitaminol. 2018;64(5):367–73.PubMedCrossRef
18.
Nam SY, Park BJ, Cho YA, Ryu KH. Gender-specific effect of micronutrient on non-erosive reflux disease and erosive esophagitis. J Neurogastroenterol Motility. 2019;25(1):82–90.CrossRef
19.
Mano F, Ikeda K, Joo E, Yamane S, Harada N, Inagaki N. Effects of three major amino acids found in Japanese broth on glucose metabolism and gastric emptying. Nutrition. 2018;46:153–8 e1.PubMedCrossRef
20.
Hill LL, Woodruff LH, Foote JC, Barreto-Alcoba M. Esophageal injury by apple cider vinegar tablets and subsequent evaluation of products. J Am Diet Assoc. 2005;105(7):1141–4.PubMedCrossRef
21.
Johnston CS, White AM, Kent SM. A preliminary evaluation of the safety and tolerance of medicinally ingested vinegar in individuals with type 2 diabetes. J Med Food. 2008;11(1):179–83.PubMedCrossRef
22.
Hlebowicz J, Darwiche G, Bjorgell O, Almer LO. Effect of apple cider vinegar on delayed gastric emptying in patients with type 1 diabetes mellitus: a pilot study. BMC Gastroenterol. 2007;20(7):46.CrossRef
23.
Petsiou EI, Mitrou PI, Raptis SA, Dimitriadis GD. Effect and mechanisms of action of vinegar on glucose metabolism, lipid profile, and body weight. Nutr Rev. 2014;72(10):651–61.PubMedCrossRef
24.
Yagnik D, Serafin V, Shah AJ. Antimicrobial activity of apple cider vinegar against Escherichia coli, Staphylococcus aureus and Candida albicans; downregulating cytokine and microbial protein expression. Sci Rep. 2018;8(1):1732.PubMedPubMedCentralCrossRef
25.
Brown R, Sam CH, Green T, Wood S. Effect of GutsyGum(tm), a novel gum, on subjective ratings of gastro esophageal reflux following a refluxogenic meal. J Diet Suppl. 2015;12(2):138–45.PubMedCrossRef
26.
Yeh Z. Is apple cider vinegar effective for reducing heartburn symptoms related to gastroesophageal reflux disease?: Arizona State University; 2016.
27.
Langella C, Naviglio D, Marino M, Calogero A, Gallo M. New food approaches to reduce and/or eliminate increased gastric acidity related to gastroesophageal pathologies. Nutrition. 2018;54:26–32.PubMedCrossRef
28.
Kines K, Krupczak T. Nutritional interventions for gastroesophageal reflux, irritable bowel syndrome, and hypochlorhydria: a case report. Integr Med. 2016;15(4):49–53.
29.
Majka J, Wierdak M, Brzozowska I, Magierowski M, Szlachcic A, Wojcik D, et al. Melatonin in prevention of the sequence from reflux esophagitis to Barrett’s esophagus and esophageal adenocarcinoma: experimental and clinical perspectives. Int J Mol Sci. 2018;19(7):E2033.PubMedCrossRef
30.
Kandil TS, Mousa AA, El-Gendy AA, Abbas AM. The potential therapeutic effect of melatonin in gastro-esophageal reflux disease. BMC Gastroenterol. 2010;10:7.PubMedPubMedCentralCrossRef
31.
Pereira RD. Regression of gastroesophageal reflux disease symptoms using dietary supplementation with melatonin, vitamins and aminoacids: comparison with omeprazole. J Pineal Res. 2006;41(3):195–200.CrossRef
32.
• Hoshino N, Nishizaki D, Hida K, Obama K, Sakai Y. Rikkunshito for upper gastrointestinal symptoms: a systematic review and meta-analysis. Compl Ther Med. 2019;42:255–63. The results of a recent meta-analysis of 24 studies involving rikkunshito yielded mixed results, with significant relief of upper gastrointestinal symptoms demonstrated by a 5-point symptom score but not by the Gastrointestinal Symptom Rating Scale. Interpretation is limited generally by significant study heterogeneity and specifically by a lack of focus on esophageal symptoms primarily. CrossRef
33.
Tominaga K, Iwakiri R, Fujimoto K, Fujiwara Y, Tanaka M, Shimoyama Y, et al. Rikkunshito improves symptoms in PPI-refractory GERD patients: a prospective, randomized, multicenter trial in Japan. J Gastroenterol. 2012;47(3):284–92.PubMedCrossRef
34.
Tominaga K, Kato M, Takeda H, Shimoyama Y, Umegaki E, Iwakiri R, et al. A randomized, placebo-controlled, double-blind clinical trial of rikkunshito for patients with non-erosive reflux disease refractory to proton-pump inhibitor: the G-PRIDE study. J Gastroenterol. 2014;49(10):1392–405.PubMedCrossRef
35.
Kawahara H, Kubota A, Hasegawa T, Okuyama H, Ueno T, Ida S, et al. Effects of rikkunshito on the clinical symptoms and esophageal acid exposure in children with symptomatic gastroesophageal reflux. Pediatr Surg Int. 2007;23(10):1001–5.PubMedCrossRef
36.
Yanai M, Mochiki E, Ogawa A, Morita H, Toyomasu Y, Ogata K, et al. Intragastric administration of rikkunshito stimulates upper gastrointestinal motility and gastric emptying in conscious dogs. J Gastroenterol. 2013;48(5):611–9.PubMedCrossRef
37.
Melzer J, Rosch W, Reichling J, Brignoli R, Saller R. Meta-analysis: phytotherapy of functional dyspepsia with the herbal drug preparation STW 5 (Iberogast). Aliment Pharmacol Ther. 2004;20(11–12):1279–87.PubMedCrossRef
38.
Abdel-Aziz H, Zaki HF, Neuhuber W, Kelber O, Weiser D, Khayyal MT. Effect of an herbal preparation, STW 5, in an acute model of reflux oesophagitis in rats. J Pharmacol Sci. 2010;113(2):134–42.PubMedCrossRef
39.
Allescher HD, Abdel-Aziz H. Mechanism of action of STW 5 in functional dyspepsia and IBS: the origin of multi-target. Dig Dis. 2017;35(Suppl 1):18–24.PubMedCrossRef
40.
Ottillinger B, Storr M, Malfertheiner P, Allescher HD. STW 5 (Iberogast(R))—a safe and effective standard in the treatment of functional gastrointestinal disorders. Wien Med Wochenschr. 2013;163(3–4):65–72.PubMedCrossRef
41.
Teschke R, Frenzel C, Glass X, Schulze J, Eickhoff A. Greater Celandine hepatotoxicity: a clinical review. Ann Hepatol. 2012;11(6):838–48.PubMedCrossRef
42.
Watts CR, Rousseau B. Slippery elm, its biochemistry, and use as a complementary and alternative treatment for laryngeal irritation. J Investig Biochem. 2010;1(1):17–23.CrossRef
43.
Yang Y, Wang S, Bao YR, Li TJ, Yang GL, Chang X, et al. Anti-ulcer effect and potential mechanism of licoflavone by regulating inflammation mediators and amino acid metabolism. J Ethnopharmacol. 2017;199:175–82.PubMedCrossRef
44.
Albermann ME, Musshoff F, Hagemeier L, Madea B. Determination of glycyrrhetic acid after consumption of liquorice and application to a fatality. Forensic Sci Int. 2010;197(1–3):35–9.PubMedCrossRef
45.
Tewari SN, Trembalowicz FC. Some experience with deglycyrrhizinated liquorice in the treatment of gastric and duodenal ulcers with special reference to its spasmolytic effect. Gut. 1968;9(1):48–51.PubMedPubMedCentralCrossRef
46.
47.
Setright R. Prevention of symptoms of gastric irritation (GERD) using two herbal formulas: an observational study. J Austral Trad-Med Soc. 2017;23(2):68.
48.
Sewing KF. Efficacy of low-dose antacids in the treatment of peptic ulcers: pharmacological explanation? J Clin Gastroenterol. 1991;13(Suppl 1):S134–8.PubMedCrossRef
49.
Young GP, Nagy GS, Myren J, Kronborg IJ, Logan KR, Reed PI, et al. Treatment of reflux oesophagitis with a carbenoxolone/antacid/alginate preparation. A double-blind controlled trial. Scand J Gastroenterol. 1986;21(9):1098–104.PubMedCrossRef
50.
DiSilvestro RA, Verbruggen MA, Offutt EJ. Anti-heartburn effects of a fenugreek fiber product. Phytother Res : PTR. 2011;25(1):88–91.PubMedCrossRef
51.
Ku SK, Seo BI, Park JH, Park GY, Seo YB, Kim JS, et al. Effect of Lonicerae Flos extracts on reflux esophagitis with antioxidant activity. World J Gastroenterol. 2009;15(38):4799–805.PubMedPubMedCentralCrossRef
52.
Yarnell E, Abascal K. Herbs for gastroesophageal reflux disease. Alternative and Complementary Therapies. 2010;16(6):344–6.CrossRef
53.
Mittal RK, Holloway R, Dent J. Effect of atropine on the frequency of reflux and transient lower esophageal sphincter relaxation in normal subjects. Gastroenterology. 1995;109(5):1547–54.PubMedCrossRef
54.
Math MV, Khadkikar RM, Kattimani YR. Honey—a nutrient with medicinal property in reflux. Indian J Med Res. 2013;138(6):1020–1.PubMedPubMedCentral
55.
Vemulapalli R. Diet and lifestyle modifications in the management of gastroesophageal reflux disease. Nutr Clin Pract : official publication of the American Society for Parenteral and Enteral Nutrition. 2008;23(3):293–8.CrossRef
56.
Eslick GD, Jones MP, Talley NJ. Non-cardiac chest pain: prevalence, risk factors, impact and consulting—a population-based study. Aliment Pharmacol Ther. 2003;17(9):1115–24.PubMedCrossRef
57.
Fass R, Achem SR. Noncardiac chest pain: epidemiology, natural course and pathogenesis. J Neurogastroenterol Motility. 2011;17(2):110–23.CrossRef
58.
Schey R, Villarreal A, Fass R. Noncardiac chest pain: current treatment. Gastroenterol Hepatol. 2007;3(4):255–62.
59.
Pimentel M, Bonorris GG, Chow EJ, Lin HC. Peppermint oil improves the manometric findings in diffuse esophageal spasm. J Clin Gastroenterol. 2001;33(1):27–31.PubMedCrossRef
60.
• Khalaf MHG, Chowdhary S, Elmunzer BJ, Elias PS, Castell D. Impact of peppermint therapy on dysphagia and non-cardiac chest pain: a pilot study. Dig Dis Sci. 2019. A retrospective analysis of 36 patients treated with peppermint oil for dysphagia and/or non-cardiac chest pain found that 24 (63%) had symptom improvement. The presence of a well-defined esophageal motility disorder was associated with a relatively higher rate of symptom improvement.
61.
Banovcin P, Duricek M, Zatko T, Liptak P, Hyrdel R, Kollarik M. The infusion of menthol into the esophagus evokes cold sensations in healthy subjects but induces heartburn in patients with gastroesophageal reflux disease (GERD). Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus. 2019.
62.
Macpherson H, Dumville JC. Acupuncture as a potential treatment for non-cardiac chest pain—a survey. Acupunct Med: journal of the British Medical Acupuncture Society. 2007;25(1–2):18–21.CrossRef
63.
Dickman R, Schiff E, Holland A, Wright C, Sarela SR, Han B, et al. Clinical trial: acupuncture vs. doubling the proton pump inhibitor dose in refractory heartburn. Aliment Pharmacol Ther. 2007;26(10):1333–44.PubMedCrossRef
64.
Zhu J, Guo Y, Liu S, Su X, Li Y, Yang Y, et al. Acupuncture for the treatment of gastro-oesophageal reflux disease: a systematic review and meta-analysis. Acupunct Med : journal of the British Medical Acupuncture Society. 2017;35(5):316–23.CrossRef
65.
Arora AS, Katzka DA. How do I handle the patient with noncardiac chest pain? Clin Gastroenterol Hepatol : the official clinical practice journal of the American Gastroenterological Association. 2011;9(4):295–304 quiz e35.CrossRef
66.
Borjesson M, Pilhall M, Eliasson T, Norssell H, Mannheimer C, Rolny P. Esophageal visceral pain sensitivity: effects of TENS and correlation with manometric findings. Dig Dis Sci. 1998;43(8):1621–8.PubMedCrossRef
Metadaten
Titel
Popular Remedies for Esophageal Symptoms: a Critical Appraisal
verfasst von
Amisha Ahuja
Nitin K. Ahuja
Publikationsdatum
01.08.2019
Verlag
Springer US
Erschienen in
Current Gastroenterology Reports / Ausgabe 8/2019
Print ISSN: 1522-8037
Elektronische ISSN: 1534-312X
DOI
https://doi.org/10.1007/s11894-019-0707-4

Weitere Artikel der Ausgabe 8/2019

Current Gastroenterology Reports 8/2019 Zur Ausgabe

Esophagus (J Clarke and N Ahuja, Section Editors)

The Utility of Esophageal Motility Testing in Gastroesophageal Reflux Disease (GERD)

Stomach and Duodenum (J Pisegna and J Benhammou, Section Editors)

Duodenal Chemosensing of Short-Chain Fatty Acids: Implications for GI Diseases

Stomach and Duodenum (J Pisegna and J Benhammou, Section Editors)

Gastroduodenal Injury: Role of Protective Factors

GI Oncology (R Bresalier, Section Editor)

The Rise of Colorectal Cancer in Asia: Epidemiology, Screening, and Management

Liver (S Cotler and E Kallwitz, Section Editors)

Nutrition in Cirrhosis

Inflammatory Bowel Disease (S Hanauer, Section Editor)

Evolving Epidemiology of IBD

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Kostenlos registrieren

Neu im Fachgebiet Innere Medizin

Erhebliches Risiko für Kehlkopfkrebs bei mäßiger Dysplasie

29.05.2024 Larynxkarzinom Nachrichten

Fast ein Viertel der Personen mit mäßig dysplastischen Stimmlippenläsionen entwickelt einen Kehlkopftumor. Solche Personen benötigen daher eine besonders enge ärztliche Überwachung.

Nach Herzinfarkt mit Typ-1-Diabetes schlechtere Karten als mit Typ 2?

29.05.2024 Herzinfarkt Nachrichten

Bei Menschen mit Typ-2-Diabetes sind die Chancen, einen Myokardinfarkt zu überleben, in den letzten 15 Jahren deutlich gestiegen – nicht jedoch bei Betroffenen mit Typ 1.

15% bedauern gewählte Blasenkrebs-Therapie

29.05.2024 Urothelkarzinom Nachrichten

Ob Patienten und Patientinnen mit neu diagnostiziertem Blasenkrebs ein Jahr später Bedauern über die Therapieentscheidung empfinden, wird einer Studie aus England zufolge von der Radikalität und dem Erfolg des Eingriffs beeinflusst.

Costims – das nächste heiße Ding in der Krebstherapie?

28.05.2024 Onkologische Immuntherapie Nachrichten

„Kalte“ Tumoren werden heiß – CD28-kostimulatorische Antikörper sollen dies ermöglichen. Am besten könnten diese in Kombination mit BiTEs und Checkpointhemmern wirken. Erste klinische Studien laufen bereits.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen
Bildnachweise