W1075 Symptomatic Improvement in Gastroesophageal Reflux Disease (GERD) Following Weight Loss Through Caloric Restriction and Behavioral Modification

Abstract

Curcumin, the active component of turmeric, a common spice used in Indian cooking, has been used for medicinal purposes for centuries due to its anti-inflammatory properties. Curcumin regulates multiple molecular targets, including transcription factors, such as nuclear factor κ-light-chain-enhancer of activated B cells and activator protein 1, which promote the production of inflammatory cytokines. The traditional treatment for gastroesophageal reflux (GERD) has involved mainly acid suppression. Recent literature (Souza et al, Gastroenterology 2009; 137:1776-1784) suggests that cytokine mediated inflammation may play a role in the pathophysiology of GERD. A small prospective pilot study was conducted consisting of 14 typical GERD patients who are dependent on proton-pump inhibitors (PPIs) or H2-receptor antagonists (H2 blockers) on a daily basis for complete symptomatic relief. Our aim was to evaluate curcumin as a replacement therapeutic agent in place of PPIs and H2 blockers. These patients were started on curcumin (2 g/day) and their PPI or H2 blockers therapy was discontinued at 2 weeks after the initiation of curcumin therapy. They were then followed for 2 months. 11 out of 14 patients (about 79% of patients with a 95% confidence interval ranging from 45% 95%) were asymptomatic on curcumin therapy alone without their daily use of PPI or H2 blocker therapy. Of the 3 patients who were non-responders, 1 patient was able to have complete symptomatic relief on a lower dose of PPI therapy than the previous dose while on curcumin therapy. No patient had worsening symptoms during the first 2 weeks while on both curcumin and their usual PPI or H2 blocker therapy. There were also no reports of side effects from curcumin. Based on our small pilot study, curcumin appears to be a promising therapeutic agent for GERD patients. Further larger scale studies are needed to fully elucidate the potential of curcumin as an effective treatment alternative for GERD. Patient Data