ABSTRACT
Background: GERD is a common gastro-intestinal disorder. It is considered as chronic medical that needs long term medical treatment. Long term acid suppressive therapy, inspite of being considered safe, may result in bacterial overgrowth and secondary hypergastrinemia
The aim of this study is to evaluate the effectiveness of natural sialagogues [sugarless gum] as non-pharmacologicai treatment to control the pathological acid reflux
Subject and methods: 50 patients were selected from outpatient clinic of tropical medicine department complaining of heart burn and/or epigastric pain. They were confirmed as having pathological GERD by 24 hr pH metry. All patients were subjected to: full history, thorough physical examination, ECG, and Upper G.I.T endoscopy. Ambulatory 24 hrs. esophageal pH monitoring was done in the first day without using natural sialagogues and repeated in second day during using natural sialagogues. Measurement of salivary volume, ph, bicarbonate and Epidermal growth factor [EGF] before and after using natural sialagogues
The result: there was statistically significant symptomatic improvement in patients with GERD. 20% of patients with GERD by ph metry showed normal endoscopoic findings. There were statistically significant increase in all measured parameters after chewing gum. 41% of Patients who had GERD showed decrease in 24 hrs pH metry score after chewing sugarless gum. The higher the grade of reflux eosophagitis, the lower the response to chewing sugarIess gum as regards salivary volume, ph, bicarbonate and EGF. While the highest response in salivary secretion parameters was reported in patients who had GERD with normal endoscopic findings followed by GERD with gastritis and the least response was found in GERD with hiatus hernia [HH]
In conclusion: Chewing sugarless gum as natural sialagogues showed statistically significant increase of salivary volume, ph, bicarbonate and EGF, together with improvement of symptoms of pathological GERD. So, chewing sugarless gum is believed to be good and effective non pharmacological method to control GERD
ABSTRACT
Levels of PLA[2]. PGE[2]. CAMP, IFN-omega and SIL-2R were estimated in middle ear effusions from 32 patients suffering from otitis media with effusion. They were 19 patients with mucoid type effusion and 13 with serous type. All parameters estimated showed significant increase in cases with mucoid effusion except level of IFN-omega which was significantly increased in the serous type and we suggested that both serous and mucoid types of otitis media with effusion may have different immunological background