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Acupuncture vs. Higher PPI Doses for GERD Patients

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  • Acupuncture vs. Higher PPI Doses for GERD Patients

    Summary and Comment

    Acupuncture vs. Higher PPI Doses for GERD Patients

    Can this alternative technique reduce persistent GERD symptoms in patients with incomplete responses to PPIs?

    Although proton-pump inhibitors (PPIs) are the most effective therapy available for gastroesophageal reflux disease, 25% to 40% of patients who use these medications continue to suffer persistent GERD-related symptoms. The standard approach for treating such patients is to double their PPI doses, but, even at this higher level, only a subset of patients will demonstrate substantial improvement. Encouraged by the success of acupuncture in treating various gastrointestinal disorders, researchers studied whether double-dose PPI therapy (40 mg daily) or acupuncture plus standard-dose PPI therapy (20 mg daily) was more effective in controlling persistent GERD symptoms.

    Thirty patients from two U.S. medical centers were randomized to standard-dose omeprazole plus acupuncture or to double-dose omeprazole for 4 weeks. The acupuncture procedure stimulated five points that, according to traditional Chinese medicine theory, regulate acid secretion and gastric motility. Acupuncture was administered three times weekly for the first 2 weeks and then twice weekly for 2 weeks. Groups were matched for age, sex, race, and body-mass index. Patients were evaluated using the validated GERD Symptom Checklist.

    When baseline and follow-up scores were compared within each group, only the group that received acupuncture plus omeprazole exhibited significant improvements in daytime and nighttime heartburn, acid regurgitation, dysphagia, and mean general health scores.

    Comment: Naysayers might dismiss acupuncture as "voodoo medicine," but scientific data support its therapeutic benefit for some conditions. Acupuncture has been reported to alter gastric acid secretion, enhance esophageal peristalsis, and alter visceral hypersensitivity. Although the lack of a sham control and questions about durability of acupuncture’s effect limit the validity of this trial, its findings clearly warrant further study.

    — David A. Johnson, MD

    Published in Journal Watch Gastroenterology January 4, 2008

  • #2
    Thats interesting, though the study would have been more interesting if they had given the participants 24hr ph studies at the beginning, during and end of the study.

    They should have also done sham accupuncture on the group not receiving the proper accupuncture.