Acid Reflux or Gastro-Oesophageal Reflux (GOR) is a condition suffered by many individuals at some point in their lives, with some estimates suggesting 60-70% of the population suffering from reflux in any 12 month period. A more severe and chronic progression is diagnosed as Gastro-Oesophageal Reflux Disease (GORD; also known as GERD) approximately 60,000 people are hospitalised with severe GORD a year in Australia alone. The Montreal Definition and Classification of GORD is a condition which develops when the reflux of stomach contents causes troublesome symptoms or complications. Contrary to popular belief, people who lead healthy lifestyles are only slightly less likely to develop GORD than people who are overweight or who smoke or drink alcohol heavily.
The diagnosis of GORD is generally set by its cardinal symptoms of heartburn and acid regurgitation, occurring at least weekly. The prevalence of these weekly symptomatic events among adults has been reported to be in the range of 10-20% in the western world, with higher prevalence in recent years. A study ranging over the last 10 years including 80,000 subjects revealed an increase of 47% on weekly events with gender and age being significant factors. The symptoms of GORD are associated with a decreased health-related quality of life and an increased risk of oesophageal adenocarcinoma.
A more detailed description of the primary event in most people with GORD would be refluxed gastric juices causing heart burn, experienced as a painful or burning sensation in the oesophagus with regurgitation of gastric juices also being common. In addition, other symptoms such as chest pain (reflux chest pain) and extra-oesophageal symptoms such as, reflux asthma, reflux cough, and reflux laryngitis may result. Despite the impact of GORD symptoms on an individual's life, many sufferers do not consult a physician and attempt self-medication.
In simple terms, the oesophagus is the tube between the stomach and the pharynx; more specifically it is the portion of the alimentary canal between the pharynx and the stomach. It is about 25 cm long and consists of three parts; the cervical part, from the cricoid cartilage to the thoracic inlet, the thoracic part, from the thoracic inlet to the diaphragm, and the abdominal part, below the diaphragm to the cardiac opening of the stomach. At the junction of the stomach and oesophagus lies the oesophageal sphincter. During digestion the stomach produces strong acids and enzymes (gastric juices). While the inner lining of the stomach has several mechanisms that provide a protective barrier to these gastric juices the oesophagus does not. The lower oesophageal sphincter (LOS) is the valve that prevents gastric juices encountering the oesophagus. When the lower oesophageal sphincter becomes weakened gastric juices can seep upwards into the oesophagus and GORD/reflux symptoms will generally be the result.
Although it is known that a faulty LOS is a common cause of GORD symptoms it is not known why the fault develops. While pregnancy, hiatus hernia, peptic ulcers, asthma, and smoking can be targeted as triggers of reflux there are many sufferers who experience the condition regardless of their lifestyle.
The primary treatments for Acid Reflux and GORD rely on changes to diet as well as various medications. The aim of both diet and medication based treatments is the reduction in stomach acid, reduction in the occupied volume of the stomach to reduce pressure on the oesophageal sphincter, and reduction in the inflammation of the stomach lining and associated acid production that can result.
The medications typically fall into two major categories; they either act on stomach acid or reduce volume pressures. Acid suppressants, such as Histamine2-receptor antagonists, have shown to be effective as they are good anti-inflammatory agents. An inflamed stomach produces more acid. Accordingly, blocking this extra production of acid prevents excessive concentrations and upwards seeping/pressures. Proton pump inhibitors act on the cells in the stomach wall which produce acids to reduce acid production. Prokinetic agents help promote the emptying of the stomach and stop it becoming overfull. Antacids neutralize the acids in the stomach but are not recommended for frequent events as suffered by patients with GORD, as they interfere with overall stomach function if used for long periods of time.
The vast majority of people suffering acid reflux will improve their symptoms through changes to diet. These include elimination of alcohol, chilli and spicy foods, acidic fruit and vegetables (be it liquid drinks or solid foods). Given that all people react differently to foods there is no prescribed reflux friendly diet applicable to all people. It is a process of removing the foods that cause problems for the specific individual that is applied. For periodic sufferers it would be appropriate to say that eliminating the trigger foods and eating less per meal will result in an improvement to the events and symptoms.
Though there are no hard and fast rules as to diet changes for the treatment of Acid Reflux and GORD, it is accepted that certain foods can help reduce symptoms. These include foods that provide a sated palate and discourage overeating (such as Low Glycaemic Index (GI) foods), foods that provide a thickening characteristic to the gastric juices in the stomach (such as foods high in dietary fibre), high pH vegetables and fruits (that act as natural antacids), and especially complex carbohydrates (that require a greater amount of acid to digest than simple foods) have all been shown to have a beneficial effect when regularly included in the diet.
Typically it has been suggested that soluble fibre has the most pronounced benefit for Acid Reflux and GORD due to its ability to absorb stomach acid and promote gastric clearing there is very little evidence that it provides acute relief from symptoms, rather that inclusion in the diet reduces overall incidence over an extended period of time. The benefits of high fibre diets have recently been called into doubt and this may be largely due to the fact that many fibres are either highly processed (such as chemically modified starches) or from non-vegetable sources such as wheat bran and psyllium husk—both from seed).
Accordingly it is an object of this invention to provide high quality dietary fibre source that alleviates the symptoms of Acid Reflux and GORD, either as an acute treatment (taken immediately after an attack) or as a long term relief by inclusion into the regular diet.