Antioxidants may be better than antacids for treating reflux


WESTPORT, CT (Reuters Health) – Free radicals produced by gastric acid may be more important than the acid itself in the development of reflux esophagitis, according to researchers in Korea.

The new finding, reported in the August 15th issue of Gut, suggests that "supplementation of antioxidants" could improve both treatment and prevention of reflux esophagitis, Dr. Ki-Baik Hahm told Reuters Health.

Dr. Hahm, a researcher at Ajou University School of Medicine, in Suwon, and a multicenter team examined the role of free radicals and the benefits of an antioxidant herbal extract, DA-9601, in 60 rats with induced reflux esophagitis. The animals received no pretreatment, pretreatment with ranitidine hydrochloride, or one of two doses of DA-9601.

Pretreatment with the antioxidant "significantly attenuated the gross and histopathological scores of reflux esophagitis" compared with ranitidine or no treatment, the investigators say. In fact, while 80% and 60% of rats in the control and ranitidine groups, respectively, developed esophageal lesions, the researchers observed lesions in only 27% of rats pretreated with the lower dose of DA-9601 and 20% of those pretreated with the higher dose.

Antioxidant therapy also significantly reduced the activation of nuclear factor kappa-B, an oxidative stress-related factor that was present at high levels in the rats with reflux esophagitis.

"This study provides concrete evidence that oxygen free radicals are involved in esophageal mucosal damage from reflux esophagitis in rats," the authors say. While the rat model is somewhat different from reflux esophagitis in humans, Dr. Hahm said, the new findings prove the hypothesis that free radical damage, rather than gastric acid, is the major cause of the tissue damage that leads to this condition.

He told Reuters Health that antioxidant therapy might prove particularly beneficial for the many patients who have continued symptoms or complications while using acid suppressants.

Gut 2001;49:364-371.

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