Case Report

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CellMed 2024; 14(8): 3.1-3.4

Published online June 30, 2024

https://doi.org/10.5667/CellMed.spc.086

© Cellmed Orthocellular Medicine and Pharmaceutical Association

세포교정영양요법(OCNT)을 이용한 역류성 식도염 및 장상피화생 개선 사례

김성훈 약사

전라남도 순천시 대석길 31 소망약국

A Case Study on Reflux Esophagitis and Intestinal Metaplasia Using Ortho-Cellular Nutrition Therapy (OCNT)

Pharmacist, Seong-hun Kim

Somang Pharmacy, 31, Daeseok-gil, Suncheon-si, Jeollanam-do, Republic of Korea

Correspondence to : Seong-hun Kim
E-mail: nigro03@hanmail.net

☨ This report has been translated and edited by the CellMed editor-in-chief, Prof. Beom-Jin Lee.

Received: June 28, 2024; Accepted: June 28, 2024

This is an open access article under the CC BY-NC license. (http://creativecommons.org/licenses/by-nc/3.0/)

Objective: Report on a case of improvement in reflux esophagitis and intestinal metaplasia through Ortho-Cellular Nutrition Therapy (OCNT).
Methods: A Korean woman in her 50s suffering from reflux esophagitis and intestinal metaplasia underwent OCNT for approximately 9 months.
Results: After OCNT, reflux esophagitis and intestinal metaplasia improved.
Conclusion: OCNT can aid in alleviating symptoms of reflux esophagitis and intestinal metaplasia.

Keywords Ortho-Cellular Nutrition Therapy (OCNT), reflux esophagitis, intestinal metaplasia, gastrointestinal mucosa

Reflux esophagitis is a condition that causes inflammation in which the contents of the stomach flow back into the esophagus. Heartburn and acid reflux are common symptoms of reflux esophagitis, typically presenting as a burning sensation rising from behind the sternum to the chest and throat, and sometimes extending to the back. These symptoms usually occur after eating and are more frequent after the consumption of oily or spicy foods, citrus products, fats, chocolate, and alcohol.1 Additional symptoms include upper abdominal fullness, pressure, pain, indigestion, nausea, abdominal bloating, belching, chronic cough, bronchospasm, wheezing, hoarseness, sore throat, asthma, laryngitis, and tooth erosion.2

Reflux esophagitis is one of the most common gastrointestinal disorders and significantly lowers the quality of life. One in ten cases of reflux esophagitis may lead to Barrett's esophagus, which carries a higher risk of developing esophageal adenocarcinoma.3

Three primary treatments for reflux esophagitis include: reducing the acid's ability to irritate the esophagus using Proton Pump Inhibitors (PPIs) to block the production of acid by stomach wall cells; employing prokinetic drugs to accelerate gastric emptying; and reducing acid secretion utilizing histamine H2 receptor antagonists to inhibit the histamine H2 receptors on stomach wall cells. Surgery is also an option.4

Intestinal metaplasia refers to a precancerous change where the stomach mucosa transforms into intestinal epithelium, increasing the risk of dysplasia and cancer. Key causes include Helicobacter pylori infection, genetic factors, environmental factors, rheumatic diseases, dietary factors, and intestinal microbiota. However, there is currently no standard treatment for intestinal metaplasia.5

This case study reports significant improvement in a patient with reflux esophagitis and intestinal metaplasia after Ortho-Cellular Nutrition Therapy (OCNT), with the patient's consent obtained for this report.

1. Subject

A case involving a patient with reflux esophagitis and intestinal metaplasia was studied.

1) Name: Kim O O (F/52 years old)

2) Diagnosis: Reflux esophagitis, intestinal metaplasia

3) Date of Onset: July 2023

4) Treatment Duration: July 2023 to April 2024

5) Primary Symptoms: Indigestion, dizziness, headaches

6) Medical History: Occasionally prescribed PPIs since July 2019

7) Social History: Alcohol consumption for 10 years (one bottle per week)

8) Family History: None

9) Medications and Treatments Applied: None

2. Methods

First OCNT

- Cyaplex A granule (101, twice a day, one packet per dose)

- Gastron (101, twice a day, one packet per dose)

- Yangwibo (101, twice a day, one packet per dose)

Second OCNT

- Cyaplex A granule (101, twice a day, one packet per dose)

- Gastron (101, twice a day, one packet per dose)

- Calmaplex capsule (202, twice a day, two tablets per dose)

Third OCNT

- Cyaplex A granule (101, twice a day, one packet per dose)

- Gastron (101, twice a day, one packet per dose)

- Calmaplex capsule (202, twice a day, two tablets per dose)

- Eufaplex Alpha (101, twice a day, one packet per dose)

- Heartberry Black (001, once a day, one packet per dose)

- Cyaplex Mineral Rock Salt (001, once a day, one packet per dose)

- Aqua SAC Pure (001, once a day, one packet per dose)

- Banha-sasim-tang (111, three times a day, one packet per dose)

Also, avoiding food before bedtime, restricting alcohol intake due to its effect on decreasing sphincter contraction, and avoiding foods that cause indigestion such as flour, milk, sweets, bread, etc. was recommended.

The patient was a 52-year-old woman who initially visited the pharmacy in April 2023 with issues of indigestion and gas after taking prescription medications. Subsequently, she started the first OCNT.

After this, the symptoms she complained about almost disappeared, and she built trust in the OCNT. The patient revisited the pharmacy after receiving an endoscopy in July 2023, which diagnosed her with reflux esophagitis.

The second OCNT recommended, including Cyaplex A, Gastron, and Calmaplex capsules. The intake of alcohol was restricted, which can relax the esophageal sphincter.

Her symptoms subsided significantly following the second OCNT. After that, she complained of symptoms of intestinal metaplasia, leading to a third OCNT for six months.

Six months after starting the third OCNT, an endoscopy showed no signs of reflux esophagitis or intestinal metaplasia.

Endoscopic images before and after the OCNT treatment are presented in Fig. 1.

Fig. 1. Endoscopic images of the patient before OCNT in July 2023 (A, B) and after OCNT in April 2024 (C, D). Before OCNT, the mucosa around the esophagus was red and swollen, and the folds of the stomach wall were abnormally thick. After OCNT, endoscopic results showed significant improvement in the mucosa, and the stomach wall folds returned to normal levels. Additionally, there were no unusual findings other than a positive test for Helicobacter pylori.

The subject of this case study was a Korean woman in her fifties who began to experience bloating after being prescribed PPIs at the hospital in April 2023. She started the first phase of OCNT with Cyaplex A, Gastron, and Yangwibo as a result.

Anthocyanins found in Cyaplex A have anti-inflammatory and antioxidant effects that can reduce inflammation in the gastrointestinal tract, protect against oxidative stress, and help balance the intestinal microbiota, thereby alleviating the symptoms of indigestion.6,7

Alginate is more effective than placebos or antacids for treating reflux esophagitis in patients who do not respond to PPI treatment.8

Mucin contained in Gastron protects the esophagus from reflux and acts as a crucial defensive factor in protecting the gastrointestinal mucosa from intestinal metaplasia and Helicobacter pylori.9,10 Enzymes improve symptoms of indigestion,11 and licorice has various roles including anti-inflammatory effects. Also, flavonoid components in licorice show significant activity against Helicobacter pylori and other antibiotic-resistant strains.12,13

Yangwibós cornelian cherry fruit significantly improves functional dyspepsia by reducing the residual ratio in the stomach and increases intestinal motility, as well as the intake of food and water, and levels of gastrointestinal hormones.14 Mandarin peel has bioactive properties in the digestive system,15 and rhizome of Atractylodes lancea significantly improves pathological damage in gastric tissues.16 Peony root and Atractylodes rhizome alleviate indigestion symptoms by improving delayed gastric emptying, whereas cinnamon twig helps improve gastric health by reducing gastric mucosal damage and stomach acid.20 Ginger eradicates Helicobacter pylori and aids in relieving symptoms of indigestion.21

After the bloating subsided, the patient diagnosed with reflux esophagitis in July of the same year by following endoscopy. She visited the pharmacy and the second phase of OCNT was implemented after explaining the side effects of PPI. While PPIs are commonly prescribed for acid-related disorders, they can potentially lead to osteoporosis and an increased risk of fractures by interfering with calcium absorption.22 Therefore, the second OCNT excluded Yangwibo from the first OCNT and added Calmaplex capsules, along with restricting alcohol intake.

Calmaplex contains marine calcium, which is more effective in improving bone health compared to synthetic calcium.

Although there was significant improvement in her symptoms, the patient also complained about intestinal metaplasia, prompting the start of the third OCNT. In the third OCNT, Calmaplex capsules were removed, and Eufaplex Alpha, Heartberry Black, Cyaplex Mineral Rock Salt, Aqua SAC, and Bioplex were recommended for six months.

In patients with dyspepsia caused by Helicobacter pylori infection, excessive levels of toxic nitric oxide (NO) are produced. This leads to lipid oxidation and damage to cell membranes, ultimately generating nitrosative stress that leads to abnormal cell death.23 The polyunsaturated fatty acids (PUFAs, including omega-3, omega-6, and omega-9 fatty acids) in Eufaplex Alpha help reduce these symptoms and are beneficial in inducing mucosal recovery.24

Cyaplex mineral rock salt enhances the secretion of gastric juice, increases the pH of gastric acid, and boosts antioxidant activity, thus helping to prevent gastric damage.25

Reflux esophagitis can be influenced by specific microbial groups acting as risk determinants,26 The active probiotics and prebiotics in Bioplex address imbalances in the intestinal microbiota.27

Subsequent endoscopic examinations showed a positive response for Helicobacter pylori but no signs of intestinal metaplasia or reflux esophagitis.

This case report is a single instance and cannot universally applied to all patients with reflux esophagitis and intestinal metaplasia. However, after implementing simple OCNT, the patient's quality of life significantly improved. Therefore, this case has been reported with the patient's consent.

  1. Richter JE, Rubenstein JH. Presentation and Epidemiology of Gastroesophageal Reflux Disease. Gastroenterology. 2018/01/01/ 2018;154(2):267-276.
    Pubmed KoreaMed CrossRef
  2. Badillo R, Francis D. Diagnosis and treatment of gastroesophageal reflux disease. World journal of gastrointestinal pharmacology and therapeutics. 2014;5(3):105.
    Pubmed KoreaMed CrossRef
  3. Maev IV, Livzan MA, Mozgovoi SI, Gaus OV, Bordin DS. Esophageal Mucosal Resistance in Reflux Esophagitis: What We Have Learned So Far and What Remains to Be Learned. Diagnostics. 2023;13(16):2664.
    Pubmed KoreaMed CrossRef
  4. Chhabra P, Ingole N. Gastroesophageal reflux disease (GERD): highlighting diagnosis, treatment, and lifestyle changes. Cureus. 2022;14(8)
    CrossRef
  5. Jencks DS, Adam JD, Borum ML, Koh JM, Stephen S, Doman DB. Overview of current concepts in gastric intestinal metaplasia and gastric cancer. Gastroenterology & hepatology. 2018;14(2):92.
  6. Tian L, Tan Y, Chen G, et al. Metabolism of anthocyanins and consequent effects on the gut microbiota. Critical Reviews in Food Science and Nutrition. 2019;59(6):982-991.
    Pubmed CrossRef
  7. Verediano TA, Stampini Duarte Martino H, Dias Paes MC, Tako E. Effects of anthocyanin on intestinal health: A systematic review. Nutrients. 2021;13(4):1331.
    Pubmed KoreaMed CrossRef
  8. Leiman D, Riff B, Morgan S, et al. Alginate therapy is effective treatment for GERD symptoms: a systematic review and meta-analysis. Diseases of the Esophagus. 2017;30(5):1.
    KoreaMed CrossRef
  9. Corfield AP, Carroll D, Myerscough N, Probert CS. Mucins in the gastrointestinal tract in health and disease. Front Biosci. Oct 1 2001;6:D1321-57.
    Pubmed CrossRef
  10. Niv Y, Hardy B, Koren R, Rodiomov G, Fraser GM. Association between gastric acid and mucin secretion in dyspeptic patients. Digestion. 1940;65(3):141-148.
    Pubmed CrossRef
  11. Ullah H, Di Minno A, Piccinocchi R, et al. Efficacy of digestive enzyme supplementation in functional dyspepsia: A monocentric, randomized, double-blind, placebo-controlled, clinical trial. Biomedicine & Pharmacotherapy. 2023;169:115858.
    CrossRef
  12. Murray MT. Glycyrrhiza glabra (licorice). Textbook of Natural Medicine. 2020:641.
    KoreaMed CrossRef
  13. Fukai T, Marumo A, Kaitou K, Kanda T, Terada S, Nomura T. Anti-Helicobacter pylori flavonoids from licorice extract. Life Sciences. 2002/08/09/ 2002;71(12):1449-1463.
    Pubmed CrossRef
  14. Hao L, Yu Z, Sun J, et al. Supplementation of Crataegi fructus alleviates functional dyspepsia and restores gut microbiota in mice. Frontiers in Nutrition. 2024;11:1385159.
    Pubmed KoreaMed CrossRef
  15. Yu X, Sun S, Guo Y, et al. Citri Reticulatae Pericarpium (Chenpi): Botany, ethnopharmacology, phytochemistry, and pharmacology of a frequently used traditional Chinese medicine. Journal of Ethnopharmacology. 2018;220:265-282.
    Pubmed CrossRef
  16. Zhen B, Cai Q, Li F. Study on the Gastroprotective Mechanism of Atractylodes Japonica Koidz. Ex Kitam Against Acetic Acid-Induced Gastric Ulcer in Rats by Metabolomics. Ex Kitam Against Acetic Acid-Induced Gastric Ulcer in Rats by Metabolomics.
  17. Zou X, Wang Y, Wang Y, Yang J, Guo H, Cai Z. Paeoniflorin alleviates abnormalities in rats with functional dyspepsia by stimulating the release of acetylcholine. Drug Design, Development and Therapy. 2020:5623-5632.
    Pubmed KoreaMed CrossRef
  18. Nakai Y, Kido T, Hashimoto K, et al. Effect of the rhizomes of Atractylodes lancea and its constituents on the delay of gastric emptying. Journal of ethnopharmacology. 2003;84(1):51-55.
    Pubmed CrossRef
  19. Kimura Y, Sumiyoshi M. Effects of an Atractylodes lancea rhizome extract and a volatile component β-eudesmol on gastrointestinal motility in mice. Journal of ethnopharmacology. 2012;141(1):530-536.
    Pubmed CrossRef
  20. Lee JH, Kwak HJ, Shin D, et al. Mitigation of gastric damage using Cinnamomum cassia extract: network pharmacological analysis of active compounds and protection effects in rats. Plants. 2022;11(6):716.
    Pubmed KoreaMed CrossRef
  21. Attari VE, Somi MH, Jafarabadi MA, Ostadrahimi A, Moaddab S-Y, Lotfi N. The gastro-protective effect of ginger (Zingiber officinale Roscoe) in Helicobacter pylori positive functional dyspepsia. Advanced Pharmaceutical Bulletin. 2019;9(2):321.
    Pubmed KoreaMed CrossRef
  22. Madanick RD. Proton pump inhibitor side effects and drug interactions: much ado about nothing. Cleve Clin J Med. 2011;78(1):39-49.
    Pubmed CrossRef
  23. Wang F, Yuan Q, Chen F, et al. Fundamental Mechanisms of the Cell Death Caused by Nitrosative Stress. Front Cell Dev Biol. 2021;9:742483.
    Pubmed KoreaMed CrossRef
  24. Sharifi R, Nouri M, Eidi A, Noormohammadi Z, Dolatkhah H, Shirmohammadi M. Dietary PUFA increase apoptosis in stomach of patients with dyspeptic symptoms and infected with H. pylori. Lipids. 2017;52:549-558.
    Pubmed CrossRef
  25. Zhao X, Song J-L, Jung O-S, Lim Y-I, Park K-Y. Chemical properties and in vivo gastric protective effects of bamboo salt. Food science and biotechnology. 2014;23:895-902.
    CrossRef
  26. Rescigno M. Microbiota in reflux esophagitis and peptic ulcer disease. Surgical Infections. 2023;24(3):245-249.
    Pubmed CrossRef
  27. Lin C-S, Chang C-J, Lu C-C, et al. Impact of the gut microbiota, prebiotics, and probiotics on human health and disease. Biomedical journal. 2014;37(5)
    Pubmed CrossRef

Article

Case Report

CellMed 2024; 14(8): 3.1-3.4

Published online June 30, 2024 https://doi.org/10.5667/CellMed.spc.086

Copyright © Cellmed Orthocellular Medicine and Pharmaceutical Association.

세포교정영양요법(OCNT)을 이용한 역류성 식도염 및 장상피화생 개선 사례

김성훈 약사

전라남도 순천시 대석길 31 소망약국

Received: June 28, 2024; Accepted: June 28, 2024

A Case Study on Reflux Esophagitis and Intestinal Metaplasia Using Ortho-Cellular Nutrition Therapy (OCNT)

Pharmacist, Seong-hun Kim

Somang Pharmacy, 31, Daeseok-gil, Suncheon-si, Jeollanam-do, Republic of Korea

Correspondence to:Seong-hun Kim
E-mail: nigro03@hanmail.net

☨ This report has been translated and edited by the CellMed editor-in-chief, Prof. Beom-Jin Lee.

Received: June 28, 2024; Accepted: June 28, 2024

This is an open access article under the CC BY-NC license. (http://creativecommons.org/licenses/by-nc/3.0/)

Abstract

Objective: Report on a case of improvement in reflux esophagitis and intestinal metaplasia through Ortho-Cellular Nutrition Therapy (OCNT).
Methods: A Korean woman in her 50s suffering from reflux esophagitis and intestinal metaplasia underwent OCNT for approximately 9 months.
Results: After OCNT, reflux esophagitis and intestinal metaplasia improved.
Conclusion: OCNT can aid in alleviating symptoms of reflux esophagitis and intestinal metaplasia.

Keywords: Ortho-Cellular Nutrition Therapy (OCNT), reflux esophagitis, intestinal metaplasia, gastrointestinal mucosa

Introduction

Reflux esophagitis is a condition that causes inflammation in which the contents of the stomach flow back into the esophagus. Heartburn and acid reflux are common symptoms of reflux esophagitis, typically presenting as a burning sensation rising from behind the sternum to the chest and throat, and sometimes extending to the back. These symptoms usually occur after eating and are more frequent after the consumption of oily or spicy foods, citrus products, fats, chocolate, and alcohol.1 Additional symptoms include upper abdominal fullness, pressure, pain, indigestion, nausea, abdominal bloating, belching, chronic cough, bronchospasm, wheezing, hoarseness, sore throat, asthma, laryngitis, and tooth erosion.2

Reflux esophagitis is one of the most common gastrointestinal disorders and significantly lowers the quality of life. One in ten cases of reflux esophagitis may lead to Barrett's esophagus, which carries a higher risk of developing esophageal adenocarcinoma.3

Three primary treatments for reflux esophagitis include: reducing the acid's ability to irritate the esophagus using Proton Pump Inhibitors (PPIs) to block the production of acid by stomach wall cells; employing prokinetic drugs to accelerate gastric emptying; and reducing acid secretion utilizing histamine H2 receptor antagonists to inhibit the histamine H2 receptors on stomach wall cells. Surgery is also an option.4

Intestinal metaplasia refers to a precancerous change where the stomach mucosa transforms into intestinal epithelium, increasing the risk of dysplasia and cancer. Key causes include Helicobacter pylori infection, genetic factors, environmental factors, rheumatic diseases, dietary factors, and intestinal microbiota. However, there is currently no standard treatment for intestinal metaplasia.5

This case study reports significant improvement in a patient with reflux esophagitis and intestinal metaplasia after Ortho-Cellular Nutrition Therapy (OCNT), with the patient's consent obtained for this report.

Case Study

1. Subject

A case involving a patient with reflux esophagitis and intestinal metaplasia was studied.

1) Name: Kim O O (F/52 years old)

2) Diagnosis: Reflux esophagitis, intestinal metaplasia

3) Date of Onset: July 2023

4) Treatment Duration: July 2023 to April 2024

5) Primary Symptoms: Indigestion, dizziness, headaches

6) Medical History: Occasionally prescribed PPIs since July 2019

7) Social History: Alcohol consumption for 10 years (one bottle per week)

8) Family History: None

9) Medications and Treatments Applied: None

2. Methods

First OCNT

- Cyaplex A granule (101, twice a day, one packet per dose)

- Gastron (101, twice a day, one packet per dose)

- Yangwibo (101, twice a day, one packet per dose)

Second OCNT

- Cyaplex A granule (101, twice a day, one packet per dose)

- Gastron (101, twice a day, one packet per dose)

- Calmaplex capsule (202, twice a day, two tablets per dose)

Third OCNT

- Cyaplex A granule (101, twice a day, one packet per dose)

- Gastron (101, twice a day, one packet per dose)

- Calmaplex capsule (202, twice a day, two tablets per dose)

- Eufaplex Alpha (101, twice a day, one packet per dose)

- Heartberry Black (001, once a day, one packet per dose)

- Cyaplex Mineral Rock Salt (001, once a day, one packet per dose)

- Aqua SAC Pure (001, once a day, one packet per dose)

- Banha-sasim-tang (111, three times a day, one packet per dose)

Also, avoiding food before bedtime, restricting alcohol intake due to its effect on decreasing sphincter contraction, and avoiding foods that cause indigestion such as flour, milk, sweets, bread, etc. was recommended.

Results

The patient was a 52-year-old woman who initially visited the pharmacy in April 2023 with issues of indigestion and gas after taking prescription medications. Subsequently, she started the first OCNT.

After this, the symptoms she complained about almost disappeared, and she built trust in the OCNT. The patient revisited the pharmacy after receiving an endoscopy in July 2023, which diagnosed her with reflux esophagitis.

The second OCNT recommended, including Cyaplex A, Gastron, and Calmaplex capsules. The intake of alcohol was restricted, which can relax the esophageal sphincter.

Her symptoms subsided significantly following the second OCNT. After that, she complained of symptoms of intestinal metaplasia, leading to a third OCNT for six months.

Six months after starting the third OCNT, an endoscopy showed no signs of reflux esophagitis or intestinal metaplasia.

Endoscopic images before and after the OCNT treatment are presented in Fig. 1.

Figure 1. Endoscopic images of the patient before OCNT in July 2023 (A, B) and after OCNT in April 2024 (C, D). Before OCNT, the mucosa around the esophagus was red and swollen, and the folds of the stomach wall were abnormally thick. After OCNT, endoscopic results showed significant improvement in the mucosa, and the stomach wall folds returned to normal levels. Additionally, there were no unusual findings other than a positive test for Helicobacter pylori.

Discussion

The subject of this case study was a Korean woman in her fifties who began to experience bloating after being prescribed PPIs at the hospital in April 2023. She started the first phase of OCNT with Cyaplex A, Gastron, and Yangwibo as a result.

Anthocyanins found in Cyaplex A have anti-inflammatory and antioxidant effects that can reduce inflammation in the gastrointestinal tract, protect against oxidative stress, and help balance the intestinal microbiota, thereby alleviating the symptoms of indigestion.6,7

Alginate is more effective than placebos or antacids for treating reflux esophagitis in patients who do not respond to PPI treatment.8

Mucin contained in Gastron protects the esophagus from reflux and acts as a crucial defensive factor in protecting the gastrointestinal mucosa from intestinal metaplasia and Helicobacter pylori.9,10 Enzymes improve symptoms of indigestion,11 and licorice has various roles including anti-inflammatory effects. Also, flavonoid components in licorice show significant activity against Helicobacter pylori and other antibiotic-resistant strains.12,13

Yangwibós cornelian cherry fruit significantly improves functional dyspepsia by reducing the residual ratio in the stomach and increases intestinal motility, as well as the intake of food and water, and levels of gastrointestinal hormones.14 Mandarin peel has bioactive properties in the digestive system,15 and rhizome of Atractylodes lancea significantly improves pathological damage in gastric tissues.16 Peony root and Atractylodes rhizome alleviate indigestion symptoms by improving delayed gastric emptying, whereas cinnamon twig helps improve gastric health by reducing gastric mucosal damage and stomach acid.20 Ginger eradicates Helicobacter pylori and aids in relieving symptoms of indigestion.21

After the bloating subsided, the patient diagnosed with reflux esophagitis in July of the same year by following endoscopy. She visited the pharmacy and the second phase of OCNT was implemented after explaining the side effects of PPI. While PPIs are commonly prescribed for acid-related disorders, they can potentially lead to osteoporosis and an increased risk of fractures by interfering with calcium absorption.22 Therefore, the second OCNT excluded Yangwibo from the first OCNT and added Calmaplex capsules, along with restricting alcohol intake.

Calmaplex contains marine calcium, which is more effective in improving bone health compared to synthetic calcium.

Although there was significant improvement in her symptoms, the patient also complained about intestinal metaplasia, prompting the start of the third OCNT. In the third OCNT, Calmaplex capsules were removed, and Eufaplex Alpha, Heartberry Black, Cyaplex Mineral Rock Salt, Aqua SAC, and Bioplex were recommended for six months.

In patients with dyspepsia caused by Helicobacter pylori infection, excessive levels of toxic nitric oxide (NO) are produced. This leads to lipid oxidation and damage to cell membranes, ultimately generating nitrosative stress that leads to abnormal cell death.23 The polyunsaturated fatty acids (PUFAs, including omega-3, omega-6, and omega-9 fatty acids) in Eufaplex Alpha help reduce these symptoms and are beneficial in inducing mucosal recovery.24

Cyaplex mineral rock salt enhances the secretion of gastric juice, increases the pH of gastric acid, and boosts antioxidant activity, thus helping to prevent gastric damage.25

Reflux esophagitis can be influenced by specific microbial groups acting as risk determinants,26 The active probiotics and prebiotics in Bioplex address imbalances in the intestinal microbiota.27

Subsequent endoscopic examinations showed a positive response for Helicobacter pylori but no signs of intestinal metaplasia or reflux esophagitis.

This case report is a single instance and cannot universally applied to all patients with reflux esophagitis and intestinal metaplasia. However, after implementing simple OCNT, the patient's quality of life significantly improved. Therefore, this case has been reported with the patient's consent.

Fig 1.

Figure 1.Endoscopic images of the patient before OCNT in July 2023 (A, B) and after OCNT in April 2024 (C, D). Before OCNT, the mucosa around the esophagus was red and swollen, and the folds of the stomach wall were abnormally thick. After OCNT, endoscopic results showed significant improvement in the mucosa, and the stomach wall folds returned to normal levels. Additionally, there were no unusual findings other than a positive test for Helicobacter pylori.
CellMed 2024; 14: 3.1-3.4https://doi.org/10.5667/CellMed.spc.086

References

  1. Richter JE, Rubenstein JH. Presentation and Epidemiology of Gastroesophageal Reflux Disease. Gastroenterology. 2018/01/01/ 2018;154(2):267-276.
    Pubmed KoreaMed CrossRef
  2. Badillo R, Francis D. Diagnosis and treatment of gastroesophageal reflux disease. World journal of gastrointestinal pharmacology and therapeutics. 2014;5(3):105.
    Pubmed KoreaMed CrossRef
  3. Maev IV, Livzan MA, Mozgovoi SI, Gaus OV, Bordin DS. Esophageal Mucosal Resistance in Reflux Esophagitis: What We Have Learned So Far and What Remains to Be Learned. Diagnostics. 2023;13(16):2664.
    Pubmed KoreaMed CrossRef
  4. Chhabra P, Ingole N. Gastroesophageal reflux disease (GERD): highlighting diagnosis, treatment, and lifestyle changes. Cureus. 2022;14(8)
    CrossRef
  5. Jencks DS, Adam JD, Borum ML, Koh JM, Stephen S, Doman DB. Overview of current concepts in gastric intestinal metaplasia and gastric cancer. Gastroenterology & hepatology. 2018;14(2):92.
  6. Tian L, Tan Y, Chen G, et al. Metabolism of anthocyanins and consequent effects on the gut microbiota. Critical Reviews in Food Science and Nutrition. 2019;59(6):982-991.
    Pubmed CrossRef
  7. Verediano TA, Stampini Duarte Martino H, Dias Paes MC, Tako E. Effects of anthocyanin on intestinal health: A systematic review. Nutrients. 2021;13(4):1331.
    Pubmed KoreaMed CrossRef
  8. Leiman D, Riff B, Morgan S, et al. Alginate therapy is effective treatment for GERD symptoms: a systematic review and meta-analysis. Diseases of the Esophagus. 2017;30(5):1.
    KoreaMed CrossRef
  9. Corfield AP, Carroll D, Myerscough N, Probert CS. Mucins in the gastrointestinal tract in health and disease. Front Biosci. Oct 1 2001;6:D1321-57.
    Pubmed CrossRef
  10. Niv Y, Hardy B, Koren R, Rodiomov G, Fraser GM. Association between gastric acid and mucin secretion in dyspeptic patients. Digestion. 1940;65(3):141-148.
    Pubmed CrossRef
  11. Ullah H, Di Minno A, Piccinocchi R, et al. Efficacy of digestive enzyme supplementation in functional dyspepsia: A monocentric, randomized, double-blind, placebo-controlled, clinical trial. Biomedicine & Pharmacotherapy. 2023;169:115858.
    CrossRef
  12. Murray MT. Glycyrrhiza glabra (licorice). Textbook of Natural Medicine. 2020:641.
    KoreaMed CrossRef
  13. Fukai T, Marumo A, Kaitou K, Kanda T, Terada S, Nomura T. Anti-Helicobacter pylori flavonoids from licorice extract. Life Sciences. 2002/08/09/ 2002;71(12):1449-1463.
    Pubmed CrossRef
  14. Hao L, Yu Z, Sun J, et al. Supplementation of Crataegi fructus alleviates functional dyspepsia and restores gut microbiota in mice. Frontiers in Nutrition. 2024;11:1385159.
    Pubmed KoreaMed CrossRef
  15. Yu X, Sun S, Guo Y, et al. Citri Reticulatae Pericarpium (Chenpi): Botany, ethnopharmacology, phytochemistry, and pharmacology of a frequently used traditional Chinese medicine. Journal of Ethnopharmacology. 2018;220:265-282.
    Pubmed CrossRef
  16. Zhen B, Cai Q, Li F. Study on the Gastroprotective Mechanism of Atractylodes Japonica Koidz. Ex Kitam Against Acetic Acid-Induced Gastric Ulcer in Rats by Metabolomics. Ex Kitam Against Acetic Acid-Induced Gastric Ulcer in Rats by Metabolomics.
  17. Zou X, Wang Y, Wang Y, Yang J, Guo H, Cai Z. Paeoniflorin alleviates abnormalities in rats with functional dyspepsia by stimulating the release of acetylcholine. Drug Design, Development and Therapy. 2020:5623-5632.
    Pubmed KoreaMed CrossRef
  18. Nakai Y, Kido T, Hashimoto K, et al. Effect of the rhizomes of Atractylodes lancea and its constituents on the delay of gastric emptying. Journal of ethnopharmacology. 2003;84(1):51-55.
    Pubmed CrossRef
  19. Kimura Y, Sumiyoshi M. Effects of an Atractylodes lancea rhizome extract and a volatile component β-eudesmol on gastrointestinal motility in mice. Journal of ethnopharmacology. 2012;141(1):530-536.
    Pubmed CrossRef
  20. Lee JH, Kwak HJ, Shin D, et al. Mitigation of gastric damage using Cinnamomum cassia extract: network pharmacological analysis of active compounds and protection effects in rats. Plants. 2022;11(6):716.
    Pubmed KoreaMed CrossRef
  21. Attari VE, Somi MH, Jafarabadi MA, Ostadrahimi A, Moaddab S-Y, Lotfi N. The gastro-protective effect of ginger (Zingiber officinale Roscoe) in Helicobacter pylori positive functional dyspepsia. Advanced Pharmaceutical Bulletin. 2019;9(2):321.
    Pubmed KoreaMed CrossRef
  22. Madanick RD. Proton pump inhibitor side effects and drug interactions: much ado about nothing. Cleve Clin J Med. 2011;78(1):39-49.
    Pubmed CrossRef
  23. Wang F, Yuan Q, Chen F, et al. Fundamental Mechanisms of the Cell Death Caused by Nitrosative Stress. Front Cell Dev Biol. 2021;9:742483.
    Pubmed KoreaMed CrossRef
  24. Sharifi R, Nouri M, Eidi A, Noormohammadi Z, Dolatkhah H, Shirmohammadi M. Dietary PUFA increase apoptosis in stomach of patients with dyspeptic symptoms and infected with H. pylori. Lipids. 2017;52:549-558.
    Pubmed CrossRef
  25. Zhao X, Song J-L, Jung O-S, Lim Y-I, Park K-Y. Chemical properties and in vivo gastric protective effects of bamboo salt. Food science and biotechnology. 2014;23:895-902.
    CrossRef
  26. Rescigno M. Microbiota in reflux esophagitis and peptic ulcer disease. Surgical Infections. 2023;24(3):245-249.
    Pubmed CrossRef
  27. Lin C-S, Chang C-J, Lu C-C, et al. Impact of the gut microbiota, prebiotics, and probiotics on human health and disease. Biomedical journal. 2014;37(5)
    Pubmed CrossRef
CellMed
Jun 30, 2024 Vol.14 No.8, pp. 1.1~4.4

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