Test-based exclusion diets in gastro-esophageal reflux disease patients:A randomized controlled pilot trial

作     者：Michele Caselli Giovanni Zuliani Francesca Cassol Nadia Fusetti Elena Zeni Natalina Lo Cascio Cecilia Soavi Sergio Gullini 

作者机构：Department of Medical Sciences Internal Medicine Institute University of Ferrara Department of Gastroenterology School of Gastroenterology University of Ferrara Center Study Association on Food Intolerance and Nutrition of Ferrara 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2014年第20卷第45期

页      面：17190-17195页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Gastro-esophageal reflux disease Food intol-erance 

摘      要：AIM:To investigate the clinical response of gastroesophageal reflux disease(GERD)symptoms to exclusion diets based on food intolerance ***:A double blind,randomized,controlled pilot trial was performed in 38 GERD patients partially or completely non-responders to proton pump inhibitors(PPI)*** blood samples from each patients were obtained;leukocytotoxic test was performed by incubating the blood with a panel of 60food items to be *** reaction of leukocytes(rounding,vacuolization,lack of movement,flattening,fragmentation or disintegration of cell wall)was then evaluated by optical microscopy and rated as follows:level 0=negative,level 1=slightly positive,level 2=moderately positive,and level 3=highly positive.Atruediet excluding food items inducing moderatesevere reactions,and acontroldiet including them was developed for each ***,twenty patients received thetruediet and 18 thecontroldiet;after one month(T1)symptoms severity was scored by the GERD impact scale(GIS).Hence,patients in thecontrolgroup were switched to thetruediet,and symptom severity was re-assessed after three months(T2).RESULTS:At baseline(T0)the mean GIS global score was 6.68(range:5-12)with no difference betweentrueand control group(6.6±1.19 vs 6.7±1.7).All patients reacted moderately/severely to at least 1 food(range:5-19),with a significantly greater number of food substances inducing reaction in controls compared with thetruediet group(11.6 vs 7.0,P0.001).Food items more frequently involved were milk,lettuce,brewer’s yeast,pork,coffee,rice,sole asparagus,and tuna,followed by eggs,tomato,grain,shrimps,and chemical *** T1 both groups displayed a reduction of GIS score(truegroup 3.3±1.7,-50%,P=0.001;control group 4.9±2.8,-26.9%,P=0.02),although the GIS score was significantly lower intruevscontrolgroup(P=0.04).At T2,after the diet switch,thecontrolgroup showed a further reduction in GIS score(2.7±1.9,-44.9%,P=0.01),while thetrue