Nothwestern Feinberg School of Medicine chicago, IL
Melina Masihi, PhD1, Bethany Doerfler, MS, RDN2, Leila Kia, MD3, Tiffany Taft, PsyD3, Norm Robillard, PhD4, Darren M. Brenner, MD, FACG3, John E. Pandolfino, MD, MSCI, FACG3; 1Northwestern University, Chicago, IL; 2Nothwestern Feinberg School of Medicine, Chicago, IL; 3Northwestern University Feinberg School of Medicine, Chicago, IL; 4Digestive Health Institute, Watertown, MA
Introduction: Gastroesophageal reflux disease (GERD) is a widespread issue impacting 40% of the US population;10-20% of patients report weekly symptoms. Recent PPI safety concerns call for their judicious use.Diet therapy is often recommended but it is unknown to what degree diet alone can treat GERD.The NU-GERD Diet Study is a prospective, randomized controlled study aiming to evaluate the efficacy of three evidenced based diet interventions on GERD symptoms for PPI dependent patients.This report represents preliminary data focused on symptom response to diet intervention. Methods: Adults ages 18-70 with GERD and PPI dependence and no contraindication to stopping PPI were recruited from a gastroenterology clinic for an 8-week diet intervention.After PPI discontinuation and a 2-week wash-out period, subjects were randomized and blinded to 3 diets (A, B, or C) and given instructions on acceptable use of anti-acid therapy.Diets A and C differed in types of carbohydrate recommended while Diet B focused on mindful eating.An advanced practice dietitian instructed subjects on the diet..Symptom severity was evaluated via GERDQ at baseline and week 2 and 8.NIH GI PROMIS symptom scales were collected at weeks 2 and 8, and dietary adherence (0-100) at week 8.Changes in mean scores for GERDQ and GI PROMIS were assessed via a series of paired samples t-Tests. Results: 22 patients to date enrolled: female (72.6%), Caucasian (81.8%), mean age 44.1 (11.1) years.16 subjects (73%) completed all study data. Patients were highly adherent to the study diet (88.1 (10.0), Range: 70 – 100). GERDQ scores did not change during the 2 week wash out period prior to diet initiation (p = .39) then significantly improved during the active diet timeframe (p = .007; Table). This change was also seen in the PROMIS-GI Reflux scale (p = .047).Sleep improved significantly between week 2 and 8 (p=.013) with no change in use of rescue anti-acids.GI PROMIS subscales of nausea and vomiting significantly improved during the intervention with no change in other subscales. Discussion: The NUGERD diet is the first prospective, randomized dietary intervention trial to evaluate if nutritional therapy can help patients cease PPI and effectively control GERD symptoms. Preliminary results suggest significant improvement in symptoms while using diet off PPI therapy. Based on these initial findings, this study will continue recruitment to its target sample size of 90 to determine efficacy and acceptability in patients with GERD.
Disclosures: Melina Masihi indicated no relevant financial relationships. Bethany Doerfler indicated no relevant financial relationships. Leila Kia: Impleo – Grant/Research Support. Tiffany Taft indicated no relevant financial relationships. Norm Robillard indicated no relevant financial relationships. Darren Brenner indicated no relevant financial relationships. John Pandolfino: Ironwood – Consultant, Grant/Research Support. Medtronic – Advisory Committee/Board Member, Consultant, Grant/Research Support, Speaker's Bureau, Stockholder/Ownership Interest (excluding diversified mutual funds). Takeda – Consultant.