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

World Journal of Gastroenterology 2014年第45期20卷 17190-17195页

作者： Michele Caselli Giovanni Zuliani Francesca Cassol Nadia Fusetti Elena Zeni Natalina Lo Cascio Cecilia Soavi sergio gullini 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

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.A"true"diet excluding food items inducing moderatesevere reactions,and a"control"diet including them was developed for each ***,twenty patients received the"true"diet and 18 the"control"diet;after one month(T1)symptoms severity was scored by the GERD impact scale(GIS).Hence,patients in the"control"group were switched to the"true"diet,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 between"true"and 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 the"true"diet group(11.6 vs 7.0,P<0.001).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("true"group 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 in"true"vs"control"group(P=0.04).At T2,after the diet switch,the"control"group showed a further reduction in GIS score(2.7±1.9,-44.9%,P=0.01),while the"true

关键词： Gastro-esophageal reflux disease Food intol-erance

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