Dietary Fiber in Treatment of Upper Functional Gastrointestinal Disorders
Giga Sordia1*, Gela Sulaberidze1, Maia Okujava2, Konstantine Liluashvili1, Vakhtang Shoshiashvili3 and Marina Tughushi1
1Department of General Internal Medicine, Tbilisi State Medical University, Tbilisi, Georgia
2Department of Medical Pharmacology, Tbilisi State Medical University, Tbilisi, Georgia
3First University Clinic, Tbilisi State Medical University, Tbilisi, Georgia
*Corresponding Author: Giga Sordia, Department of General Internal Medicine, Tbilisi State Medical University, Tbilisi, Georgia.
July 03, 2023; Published: July 17, 2023
The Beneficial effect of dietary fiber on lower functional gastrointestinal disorders is well established, but the information about its therapeutic effect on the upper gastrointestinal disorders is insufficient. The aim of the study was to evaluate the effectiveness of dietary intervention using fiber-rich foods in patients with upper functional gastrointestinal disorders. The study involved 164 female patients with corresponding symptoms of functional dyspepsia or nonerosive reflux disease. The average amount of dietary fiber consumed per day was measured at the first visit using the nutritional history questionnaire. The functional state of the gastrointestinal tract was assessed with the clinical questionnaire. To supplement the target rate of dietary fiber to 40 grams per day, patients additionally received 20.2 ± 8.3 grams of fiber. For this purpose, with a regular diet, for breakfast was prescribed 100-400 g bread with a high fiber content or 60-150 g muesli. The clinical condition of patients was assessed initially and after initiation of dietary changes with intervals of two weeks, three times. Assessment of signs and symptoms of functional disorder revealed manifestation of diseases by the overlap of clinical symptoms from different locations. Optimization of the amount of dietary fiber in the diet of patients led to a significant improvement in clinical symptoms. Among the patients with nonerosive reflux disease frequency of esophageal symptoms declined considerably. The frequency of these complaints was estimated at 6 points for the basal condition and decreased to 1.8 after six weeks, in the group of patients with functional dyspepsia esophageal symptoms decreased from 6 to 2.4 points. Optimizing the daily intake of dietary fiber also led to a reduction in symptoms in the epigastric region. In the general group of patients, the initial score of 5.6 points decreased to 2.1 points, the decrease in other symptoms of dyspepsia was also significant. Along with a decrease in symptoms of the upper gastrointestinal tract, intestinal symptoms, in particular constipation, significantly declined, although the number of cases of diarrhea remained almost unchanged. These effects are explained by the influence of dietary fiber on transition time and motility of the intestine.
Keywords: Non-erosive Reflux Disease; Functional Dyspepsia; Dietary Fiber; Esophageal Symptoms; Epigastric Symptoms
- Singh R., et al. “Current Treatment Options and Therapeutic Insights for Gastrointestinal Dysmotility and Functional Gastrointestinal Disorders”. Frontiers in Pharmacology 13 (2022): 808195.
- de Bortoli N., et al. “Gastroesophageal reflux disease, functional dyspepsia and irritable bowel syndrome: common overlapping gastrointestinal disorders”. Annals of Gastroenterology6 (2018): 639-648.
- Drossman DA and Hasler WL. “Rome IV-Functional GI Disorders: disorders of gut-brain interaction”. Gastroenterology 150 (2016): 1257-1261.
- Manabe N., et al. “Clinical significance of gastroesophageal reflux disease with minimal change: a multicenter prospective observational study”. Scientific Report1 (2022): 15036.
- Palsson O S., et al. “Rome IV diagnostic questionnaires and tables for investigators and clinicians”. Gastroenterology 6 (2016): 1481-1491.
- Adachi K., et al. “A study on the efﬁcacy of rebamipide for patients with proton pump inhibitor-refractory non-erosive reﬂux disease”. Digestive Diseases and Sciences 57 (2012): 1609-1617.
- Shi Y., et al. “Predictors of proton pump inhibitor failure in non-erosiveb reﬂux disease: A study with impedance-pH monitoring and high-resolution manometry”. Neurogastroenterology and Motility 28 (2016): 674-679.
- Hershcovici T and Fass R. “Management of gastroesophageal reﬂux disease that does not respond well to proton pump inhibitors”. Current Opinion in Gastroenterology 26 (2010): 367-378.
- Ried K., et al. “Herbal formula improves upper and lower gastrointestinal symptoms and gut health in Australian adults with digestive disorders”. Nutrient Research 76 (2020): 37-51.
- Gill SK., et al. “Dietary fibre in gastrointestinal health and disease”. Nature Reviews Gastroenterology and Hepatology 2 (2021): 101-116.
- So D., et al. “Dietary fibres and IBS: translating functional characteristics to clinical value in the era of personalised medicine”. Gut 12 (2021): 2383-2394.
- Duboc H., et al. “The Role of Diet in Functional Dyspepsia Management”. Frontiers in Psychiatry 11 (2020): 23.
- Popa SL., et al. “Exclusion Diets in Functional Dyspepsia”. Nutrients10 (2022): 2057.
- Brownlee I. “The impact of dietary ﬁbre intake on the physiology and health of the stomach and upper gastrointestinal tract”. Bioactive Carbohydrates and Dietary Fibre 4 (2014) 155-169.
- Sawicki CM., et al. “Dietary Fiber and the Human Gut Microbiota: Application of Evidence Mapping Methodology”. Nutrients 2 (2017): 125.
- Edwards CH., et al. “Manipulation of starch bioaccessibility in wheat endosperm to regulate starch digestion, postprandial glycemia, insulinemia, and gut hormone responses: A randomized controlled trial in healthy ileostomy participants”. The American Journal of Clinical Nutrition 102 (2015): 791-800.
- Edwards CH., et al. “Structure-function studies of chickpea and durum wheat uncover mechanisms by which cell wall properties influence starch bioaccessibility”. Nature Food2 (2021): 118-126.
- Myhrstad MCW., et al. “Dietary Fiber, Gut Microbiota, and Metabolic Regulation-Current Status in Human Randomized Trials”. Nutrients 3 (2020): 859.
- Capuano E. “The behavior of dietary fiber in the gastrointestinal tract determines its physiological effect”. Critical Reviews in Food Science and Nutrition 16 (2017): 3543-3564.
- Rettura F., et al. “Refractory Gastroesophageal Reflux Disease: A Management Update”. Frontiers in Medicine (Lausanne) 8 (2021): 765061.
- Suzuki H. “The Application of the Rome IV Criteria to Functional Esophagogastroduodenal Disorders in Asia”. Journal of Neurogastroenterology and Motility 2 (2017): 325-333.
- “Diet History Questionnaire II, National Cancer Institute”.
- Palsson O S., et al. “Rome IV diagnostic questionnaires and tables for investigators and clinicians”. Gastroenterology6 (2016): 1481-1491.
- Sulaberidze G., et al. “Impact of food enriched with dietary fiberon patients with constipation-predominant irritable bowel syndrome”. Georgian Medical News 264 (2017): 132-135.
- Sulaberidze G. Patent No.: US 8,834,941 B2, “Methods of Tretment and Prevention of Metabolic and Digestive Disorders and of Pathological States Associated Therewith and Products used Therein”, (2014).
- Nobel YR., et al. “Increasing Dietary Fiber Intake Is Associated with a Distinct Esophageal Microbiome”. Clinical and Translational Gastroenterology 10 (2018): 199.
- Grenda T., et al. “Probiotic Potential of Clostridium spp.-Advantages and Doubts”. Current Issues in Molecular Biology 7 (2022): 3118-3130.
- Tomé-Sánchez I., et al. “Bioprocessed Wheat Ingredients: Characterization, Bioaccessibility of Phenolic Compounds, and Bioactivity During in vitro Digestion”. Frontiers in Plant Science 12 (2021): 790898.