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“Satureja Hortensis L.” on Improving Adult Gastroesophageal Reflux

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“Satureja Hortensis L.” on Improving Adult Gastroesophageal Reflux See discussions, stats, and author profiles for this publication at: https://www.researchgate.net/publication/323127915 Effects of “Satureja Hortensis L.” on Improving Adult Gastroesophageal Reflux Disease: A Double-Blind, Randomized, Controlled, Clinical Trial Article · February 2018 DOI: 10.5812/ircmj.57953 CITATIONS READS 0 62 provided by eprints Iran University of Medical Sciences View metadata, citation and similar papers at core.ac.uk CORE brought to you by 7 authors, including: Ghazaleh Heydarirad Seyde Sedighe Yousefi Mazandaran University of Medical Sciences 18 PUBLICATIONS 63 CITATIONS 7 PUBLICATIONS 0 CITATIONS SEE PROFILE SEE PROFILE Rasool Choopani Seyed Hamdollah Mosavat Shahid Beheshti University of Medical Sciences Shiraz University of Medical Sciences 63 PUBLICATIONS 278 CITATIONS 53 PUBLICATIONS 235 CITATIONS SEE PROFILE SEE PROFILE Some of the authors of this publication are also working on these related projects: traditional medicine View project Efficacy of aromatherapy with Rosa damascena Mill aroma on the quality of sleep in cancer patients with sleep disorder (RCT) View project All content following this page was uploaded by Seyed Hamdollah Mosavat on 14 February 2018. The user has requested enhancement of the downloaded file. Iran Red Crescent Med J. In Press(In Press):e57953. doi: 10.5812/ircmj.57953. Published online 2018 February 12. Brief Report Effects of “Satureja Hortensis L.” on Improving Adult Gastroesophageal Reflux Disease: A Double-Blind, Randomized, Controlled, Clinical Trial Amir Hossein Faghihi Kashani,1 Ghazaleh Heydarirad,2,* Seyde Sedighe Yousefi,3 Rasool Choopani,2 Mohamad Kamalinejad,4 Shahnaz Karkon Varnosfaderani,5 and Seyed Hamdollah Mosavat6 1Associate Professor, MD, Colorectal Research Center, Iran University of Medical Sciences, Tehran, Iran 2Assistant Professor, MD, Ph.D in Traditional Persian Medicine, Department of Traditional Medicine, School of Traditional Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran 3Assistant Professor, MD, Ph.D in Traditional Persian Medicine, Traditional and Complementary Medicine Research Center, Mazandaran University of Medical Science, Sari, Iran 4Department of Pharmacology, Shahid Beheshti University of Medical Sciences, Tehran, Iran 5School of Traditional Medicine and Persian Medicine and Pharmacy Research Center, Tehran University of Medical Sciences, Tehran, Iran 6Assistant Professor, MD, Ph.D in Traditional Persian Medicine, Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran *Corresponding author: Ghazaleh Heydarirad, No. 8 Shams Alley, Vali-e-Asr St, P. O. Box 1516745811, Tehran, Iran, E-mail: [email protected] Received 2017 May 05; Revised 2017 July 11; Accepted 2017 August 23. Abstract Proof Background: Gastro-esophageal reflux disease (GERD) is one of the most widespread gastrointestinal disorders. In addition, there is increasing evidence that not all patients respond to its current remedies. Objectives: The aim of this pilot study was to investigate the effect of “Satureja hortensis L.” on improving the symptoms of mild to moderate GERD in adults. Methods: In this double-blind, randomized, controlled, clinical trial, we evaluated the efficacy of “Satureja hortensis L.” compared to placebo in the symptoms of GERD in fifty-eight adults with GERD who referred to Hazrat Rasool-e-Akram hospital in Tehran, Iran, in 2015. In order to assess GERD symptoms, a standardized questionnaire of frequency scale (FSSG) was used before and after the intervention. Results: Regarding within-group changes, a significant decrease was observed in FSSG, dysmotility-like symptoms and acid reflux related scores in both groups of the study after the intervention compared to baseline (P < 0.001). Regarding between-group anal- ysis, no significant differences were observed between the two groups in terms of FSSG total scores (0.05 < P). Conclusions: According to the results of the current study, Satureja hortensis L. with the dose of 500 mg three times per day failed to improve the symptoms of GERD in adults compared to placebo. The significant reductions in the GERD scores in both groups seem to be related to the lifestyle modification that was prescribed to both groups. Keywords: Heartburn, GERD, Savory Plant, Saturejas, Herbal Medicine 1. Background titude of side effects such as enteric infections, sustained hyper-gastrinemia , impaired vitamin B, and iron absorp- Gastro-esophageal reflux disease (GERD) is a condition tion, acute interstitial nephritis, colon or gastric malignan- that occurs when contents of the stomach reflux into the cies, osteoporosis, myopathy, acute coronary syndromes, esophagus, leading to troublesome symptoms and/or mu- and rebound acid hypersecretion (4, 6). In addition, there cosal lesions in the distal esophagus (1). GERD is a com- is increasing evidence that not all patients respond satis- mon problem affecting nearly 20% of people in Iran and factorily to this kind of remedy and about one-third of the so does in western countries, making it one of the most patients need additional intervention to manage symp- widespread gastrointestinal disorders (2,3). Most of the toms (7). Besides conventional intervention, complemen- people with reflux disease show mild symptoms and need tary and alternative medicine (CAM) has introduced many little, if any, medication. Few patients will require surgery; approaches for this disorder (8). As well, new investiga- and in the rest, control of symptoms needs continuing tions have introduced various methods such as natural ap- acid-suppression therapy; the latter requires maintenance proaches, lifestyle modification, and herbal medicine for ofUnCorrected medical management (4, 5). Long-term usage of sup- the management of GERD symptoms (9-11). pressing gastric acid has lately been associated with a mul- Copyright © 2018, Iranian Red Crescent Medical Journal. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited. Faghihi Kashani AH et al. The traditional Persian medicine (TPM), which dates Written informed consent was obtained from patients be- back to thousands of years ago, consists of the assemblage fore participating in this study. Patients aged 18 - 65 with of whole knowledge applied in diagnosis, prevention, and mild to moderate symptomatic GERD (discomfort enough treatment of diseases in Iran from ancient times until now to interfere with ordinary activities such as sleep or work) (12-18). TPM has given more regard and importance to diagnosed by a gastroenterologist were included in the the prevention of a disease rather than its treatment, so study. The exclusion criteria consisted of occult blood “lifestyle modification” is the first approach to the man- (OB) positive, risk of cancer, risk of peptic ulcer, pregnancy agement of the diseases. After modifying the lifestyle, the and breastfeeding, any digestive disorder requiring new use of simple remedies is the second approach to control- protocols, abnormalities of laboratory tests (such as low ling diseases. Finally,if a disease does not improve through hemoglobin, high ESR, CRP positive, and so on), signif- simple treatment, the third line will be the administration icant surgical or medical disorders, hospitalization, and of compound medicines comprising two or more simple non-users of S. hortensis capsules for 2 weeks. A standard- medicines (19, 20). ized questionnaire of frequency scale for the symptoms Satureja hortensis L (Savory) is an edible vegetable that of GERD (FSSG) was filled out by patients. FSSG is a use- Iranian people use as a flavor component in their diet. In ful questionnaire for objective assessment of the therapeu- addition, in Iranian folk medicine, S. hortensis has been tic response of GERD (25). This questionnaire included used as a carminative and antispasmodic remedy for disor- twelve questions with five dysmotility-like (DS) symptoms ders like mild to moderate GERD (21). Studies have shown (DS questions about flatulence, feeling heavy or sick af- the effectiveness of S. hortensis as an anti-inflammatory fac- ter meals, feeling full while eating meals, as well as much tor in acute inflammation of the stomach and intestines, as burping) and seven acid reflux-relatedProof symptoms (RS ques- well as carminative, anti-diarrhea, pain relieving, antibac- tions about heartburn, regurgitation into the throat, chest terial, antiviral, antifungal, and anti-oxidant medication rubbing, heartburn after meals or while bending, burning (22-24). sensation in throat, and difficulty swallowing). The utmost The aim of this study was to assess the efficacy of scores of total FSSG, DS, and RS were 48, 20, and 28, respec- “lifestyle modification” and “S. hortensis” in improving the tively. Also, with this questionnaire, patients had no diffi- symptoms of GERD in a pilot open-label clinical trial. culty in rating their symptoms as occurring occasionally (about 30% of the time), sometimes (50%), often (70%), or always (100%) (25, 26). At the end of the intervention, the 2. Methods same questionnaire was completed by patients. In addi- tion, the efficacy of each treatment was assessed by sub- 2.1. Study Design jects using the visual analogue scale (27). VAS scores were This study is a randomized, double-blind, placebo- compared
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