Mediterranean Diet Is as Effective as Pharmacotherapy in Treating Reflux

A plant-based Mediterranean diet and alkaline water consumption, in addition to standard reflux precautions, can treat laryngopharyngeal reflux (LPR) more effectively than proton pump inhibitors (PPI), according to a recent study.

In their retrospective study, the researchers reviewed the medical charts of 2 cohorts treated with either PPIs and standard reflux precautions or alkaline water and a 90% plant-based Mediterranean diet in addition to standard reflux precautions (AMS).
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PPIs were used to treat 85 patients with LPR from 2010 to 2012, and AMS was used to treat 99 patients with LPR from 2013 to 2015. Changes in Reflux Symptoms Index (RSI) scores after 6 weeks of treatment were assessed as the main outcome, with a clinically meaningful change in RSI score defined as 6 points or more.

A clinically meaningful reduction in RSI score was achieved by 62.6% of patients treated with AMS compared with 54.1% of patients treated with PPIs. The mean reduction in RSI score was 39.8% among patients treated with AMS and 27.2% among patients treated with PPIs.

Overall, the researchers found that PPIs did not significantly improve RSI scores compared with AMS. Their data suggested that AMS could result in more clinically meaningful changes in RSI score, because the dietary approach to treating LPR was associated with significantly greater percent reductions in RSI score.

“Because the relationship between percent change and response to treatment has not been studied, the clinical significance of this difference requires further study,” the researchers concluded. “Nevertheless, this study suggests that a plant-based diet and alkaline water should be considered in the treatment of LPR.”

“This approach may effectively improve symptoms and could avoid the costs and adverse effects of pharmacological intervention as well as afford the additional health benefits associated with a healthy, plant-based diet.”

—Melissa Weiss

Reference:

Zalvan CH, Hu S, Greenberg B, Geliebter J. A comparison of alkaline water and Mediterranean diet vs proton pump inhibition for treatment of laryngopharyngeal reflux [published online September 7, 2017]. JAMA Otolaryngol Head Neck Surg. doi:10.1001/jamaoto.2017.1454.