ABSTRACT
A randomized crossover study in eight patients (6 F, age 57 ± 13) with overlapping GERD-IBS (non-constipation) was conducted to evaluate the effects of rice noodle vs. wheat noodle meals for breakfast and lunch on postprandial TLESR, intestinal gas production, and GERD/GI symptoms. Results: Wheat ingestion was significantly associated with more frequent TLESR after lunch than rice (5.0 ± 0.7 vs. 1.9 ± 0.3 times/2 h, p = 0.01). After lunch, wheat ingestion was significantly associated with higher H2 and CH4 levels compared to rice ingestion (p < 0.05), while H2 and CH4 levels before lunch were similar (p > 0.05). The area under curve of H2 concentration until 2 h after lunch significantly correlated with the TLESR number (r = 0.69, p = 0.04). Postprandial regurgitation (2.9 ± 1.2 vs. 0.4 ± 0.2), bloating (7.0 ± 0.4 vs. 3.1 ± 0.9), satiety (7.7 ± 0.4 vs. 3.5 ± 0.9), and belching (3.8 ± 1.2 vs. 1.1 ± 0.6) symptom scores were significantly greater after wheat compared to rice noodle ingestion (p < 0.05). Conclusion: Wheat noodle meals, part of a high FODMAP diet, induced a higher frequency of TLESRs, a higher GERD, and higher upper-GI symptom scores than rice noodle meals, part of a low FODMAP diet, in patients with overlapping IBS-GERD. These effects were associated with more intestinal gas production. Thus, a low FODMAP diet may relieve GERD symptoms in GERD patients with overlapping IBS.
Subject(s)
Gastroesophageal Reflux , Irritable Bowel Syndrome , Oryza , Adult , Aged , Cross-Over Studies , Diet, Carbohydrate-Restricted , Disaccharides , Fermentation , Humans , Meals , Middle Aged , Monosaccharides , Oligosaccharides , Polymers , TriticumABSTRACT
A randomized crossover study in twenty-one patients (18F, age 50 ± 13 years) with overlapping GERD-IBS was conducted to evaluate the effects of rice noodles (low FODMAPs) vs. wheat noodles (high FODMAPs) on typical GER symptoms, and the correlation between GERD symptoms and intestinal gas production. Results: Heartburn and regurgitation scores were highest in most patients (19/21) during the first 15 min after meals. At 15 min after lunch, wheat was significantly associated with more regurgitation and heartburn than rice. Also, at 15 min after breakfast, wheat aggravated more regurgitation than rice. Wheat ingestion was significantly associated with higher H2 and CH4 levels after lunch compared to rice, whereas gas levels before lunch were similar (p > 0.05). The area under the curve of H2 and CH4 concentration 15 min after a lunch of wheat moderately correlated with the regurgitation severity at 15-min (r = 0.56, p < 0.05). Conclusion: Wheat induced more GERD symptoms than rice in patients with overlapping GERD-IBS. This effect, immediately developed after lunch, was associated with more intestinal gas production. Thus, a low FODMAPs diet may relieve postprandial GERD symptoms in GERD patients with overlapping IBS. Wheat inducing more regurgitation than rice after breakfast suggests other mechanism(s) besides gut fermentation.
