Elimination of Dietary Triggers Is Successful in Treating Symptoms of Gastroesophageal Reflux Disease

Dig Dis Sci. 2021 May;66(5):1565-1571. doi: 10.1007/s10620-020-06414-z. Epub 2020 Jun 24.

Abstract

Background: The relationship between aliments and pathophysiological abnormalities leading to gastroesophageal reflux disease (GERD) symptoms elicitation is unclear. Nevertheless, patients often report symptoms after ingestion of specific foods.

Aims: To identify in primary care setting the presence of foods able to trigger GERD symptoms, and evaluate whether a consequent specific food elimination diet may result in clinical improvement.

Methods: Diagnosis of GERD and quantification of reflux symptoms were done according to GERD-Q questionnaire (positive when > 8). During clinical data collection, patients were asked to report aliments associated with their symptoms. Also, a precompiled list of additional foods was administered to them. Then, patients were requested to eliminate the specific foods identified, and to come back for follow-up visit after 2 weeks when GERD-Q questionnaire and clinical data collection were repeated.

Results: One-hundred GERD (mean GERD-Q score 11.6) patients (54 females, mean age 48.7 years) were enrolled. Eighty-five patients reported at least one triggering food, mostly spicy foods (62%), chocolate (55%), pizza (55%), tomato (52%), and fried foods (52%). At follow-up visit, the diagnosis of GERD was confirmed in only 55 patients, and the mean GERD-Q score decreased to 8.9. Heartburn reporting decreased from 93 to 44% of patients, while regurgitation decreased from 72 to 28%. About half of the patients agreed to continue with only dietary recommendations.

Conclusions: Most patients with GERD can identify at least one food triggering their symptoms. An approach based on abstention from identified food may be effective in the short term.

Keywords: Food; Gastroesophageal reflux disease; Heartburn; Primary care; Regurgitation; Symptoms.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Diet / adverse effects*
  • Female
  • Gastroesophageal Reflux / diagnosis
  • Gastroesophageal Reflux / diet therapy*
  • Gastroesophageal Reflux / etiology
  • Humans
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Primary Health Care
  • Prospective Studies
  • Risk Assessment
  • Risk Factors
  • Surveys and Questionnaires
  • Time Factors
  • Treatment Outcome
  • Young Adult