Phase IV Non Comparative Study of the Impact of Dietary Fiber Deficiency Correction Using Mucofalk® on Clinical Features and Motor Function of the Esophagus in Patients With Non-erosive Gastroesophageal Reflux Disease
试验速览
- 阶段
- 4 期
- 状态
- 已完成
- 入组人数
- 36
- 试验地点
- 1
- 主要终点
- Number of Gastroesophageal Refluxes
研究概览
简要总结
Gastroesophageal reflux disease (GERD) is a chronic condition, which may significantly decrease patients' quality of life due to the typical symptoms - heartburn and regurgitation. These are caused by increasing number of transient lower esophageal sphincter relaxations, regularly recurring reflux of gastric content into oesophagus, acidification of the esophagus and consequent esophageal mucosa damage. In addition, an important role is played by the increase in production of hydrochloric acid in the stomach, the slowdown in the evacuation of the contents from the stomach and increase of gastric and intra-abdominal pressure. All of these factors may depend on the patient's diet.
Theoretical premises of the positive influence of including dietary fiber on the course of gastroesophageal reflux disease may be the fact that dietary fiber may absorb nitric oxide (NO) containing in food, which in turn has relaxing effects on the lower esophageal sphincter. In addition, fiber deficiency has been shown to be associated with increased chance of developing hiatal hernia, which is associated with greater risk of the disease manifestations. There is lack of data to confirm that dietary interventions like higher dietary fiber intake may lead to lower frequency of GERD symptoms and influence objective criteria (those, obtained during esophageal pH-impedance (here and further: pH - pondus hydrogenii, i.e. quantity of hydrogen, a scale to measure acidity of a solution) recording and high resolution esophageal manometry).
Mucofalk® is a drug of plant origin, consisting of a shell seeds of Plantago ovata (ispaghula, psyllium). High content of mucuses in the composition of psyllium seed allows it to include to group of soft food fibers, which has fundamental value for the appointment of a drug at a number of diseases, when, for example, the use of coarse food fibres not recommended or contraindicated.
Mucofalk is the registered medicinal (registration number of the Russian State register of medicines P N014176/01, registration date 14.07.2008, manufacturer: Lozan Pharma Gesellschaft mit beschränkter Haftung (GmbH), packager: Dr. Falk Pharma GmbH, Germany). Recommended dosage and administration: orally, adults and children over 12 years - 1 pack. 2-6 times a day. Before use, the contents of 1 packet poured in a glass, in which slowly poured with cold water (150 ml), stir and drink immediately. Then drink another glass of liquid.
详细描述
During the study 14-days screening period is provided to evaluate H.pylori and endoscopic status of the patient and to confirm the presence of dietary fiber deficiency (based on standard computerized dietary questionnaire). On the baseline physical examination, GERD-Q questionnaire, GERD symptom severity scale (by Likert), Bristol stool scale, high resolution esophageal manometry and 24-hours esophageal pH-impedance studies are to be provided. Since baseline, up to day 10 Mucofalk 15 g/day in three times a day (TID) regimen is to be given. All the patient will receive standardized menu. Repeat evaluation of symptoms, high resolution esophageal manometry and 24-hours esophageal pH-impedance are to be done at the day 10 of the study.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 70 Years(Adult, Older Adult)
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Clinical diagnosis of non-erosive form of Gastroesophageal Reflux disease
- •Dietary fiber deficiency by dietary questionnaire
- •pathological gastroesophageal reflux by 24-hours esophageal pH-impedance examination
- •willingness to participate (signed informed consent)
排除标准
- •presence of esophageal mucosal damages (esophagitis) by endoscopic evaluation
- •gastrointestinal surgery in anamnesis
- •current pregnancy or breast-feeding
- •known hypersensitivity to Mucofalk or its components
研究组 & 干预措施
Mucofalk
Mucofalk 15 g/day i.e. 5 g TID per os, 15-20 min before meal
干预措施: Mucofalk (Drug)
结局指标
主要结局
Number of Gastroesophageal Refluxes
时间窗: End of Treatment, on day 10 of psyllium intake
Number of gastroesophageal refluxes registered with 24-hours esophageal pH-impedance on the 10th day of psyllium intake. Statistical data represent the results of the comparison of the data obtained on the day 10 of study (EOT) with the baseline characteristics provided in the specific section
次要结局
- Minimal Lower Esophageal Sphincter Pressure at Rest(End of Treatment, on day 10 of psyllium intake)
- Number of Acid Gastroesophageal Refluxes(End of Treatment, on day 10 of psyllium intake)
- Acid Exposure Time(End of Treatment, on day 10 of psyllium intake)
- Number of Patients Experiencing Heartburn During 7 Days Prior the Day 10 of Psyllium Intake(7 days prior to EOT)
- Mean Resting Lower Esophageal Sphincter (LES) Pressure After 10 Water Swallows at the End of Treatment (the Day 10 of Psyllium Intake)(End of Treatment, on day 10 of psyllium intake)
- Minimal Resting Lower Esophageal Sphincter (LES) Pressure After 10 Water Swallows(End of Treatment, on day 10 of psyllium intake)
- Residual Lower Esophageal Sphincter Pressure(End of Treatment, on day 10 of psyllium intake)
研究者
Vasily Isakov
MD, PhD, AGAF, Professor
Russian Academy of Medical Sciences
