DGL Licorice (Heartburn)

OBJECTIVE: A large number of patients on dialysis have gastrointestinal (GI) manifestations. However, it remains unclear whether dialysis modality affects their prevalence. We present the first systematic review and meta-analysis of literature comparing the risk of GI manifestations between hemodialysis (HD) and peritoneal dialysis (PD). METHODS: Comparative studies were searched on Embase, PubMed, and Scopus from January 1, 2000, to April 1, 2025. Any GI manifestation reported by at least two studies were quantitatively analysed to obtain the odds ratio (OR) in a random-effect meta-analysis model. RESULTS: A total of 12 studies were included. Pooled analysis of four studies showed no statistically significant difference in the presence of any GI manifestation between HD and PD. Moreover, the meta-analysis showed no significant differences between the two groups for abdominal pain, anorexia, constipation, diarrhoea, duodenal ulcer, dyspepsia, dysphagia, epigastric pain, esophagitis, gastritis, heartburn, inflammatory bowel disease, nausea, vomiting, pancreatitis, and GI polyps. The risk of cirrhosis, pancreatitis, GI bleeding, and gastric ulcer was significantly higher in HD while the risk of gastroesophageal reflux disease was significantly increased in patients on PD. CONCLUSIONS: Present evidence from a small number of observational studies suggests that majority of GI signs or symptoms do not differ between HD and patients receiving PD. The risk of cirrhosis, pancreatitis, GI bleeding, and gastric ulcer appears higher in HD, whereas the likelihood of gastroesophageal reflux disease is elevated in PD. Observed differences between HD and PD should be interpreted cautiously, as they may partly reflect differences in patient selection, comorbidity profiles, and care pathways rather than a direct causal effect of dialysis modality. Further research can strengthen the quality of the evidence. ©2026 Li et al.

OBJECTIVE: Helicobacter pylori (H. pylori) infection represents a global health challenge. This study aimed to evaluate the effect of probiotic supplementation on the efficacy and safety of bismuth-containing quadruple therapy (BQT) for H. pylori eradication. METHODS: Randomized controlled trials (RCTs) meeting the eligibility criteria were identified through systematic searches of five databases, including PubMed, Embase, Cochrane Library, Web of Science, and ClinicalTrials.gov. Meta-analyses were conducted using Review Manager software with a random-effects model to calculate pooled relative risks (RR) and 95% confidence intervals (CI). The potential publication bias was evaluated qualitatively, and the certainty of the evidence was subsequently assessed. RESULTS: In total, 10 RCTs involving 1,630 patients were included in the analysis. The results demonstrated that, compared with the BQT group, the H. pylori eradication rate was significantly higher in the probiotics combined with the BQT group (RR 1.06, 95% CI 1.01-1.11, p = 0.009, ARR = 7.5%, NNT ≈ 13). Additionally, the combined therapy significantly reduced the adverse event rate (RR 0.58, 95% CI 0.42-0.80, p = 0.001, ARR = 11.1%, NNT ≈ 9), diarrhea (RR 0.48, 95% CI 0.32-0.73, p = 0.0007, ARR = 0.7%, NNT ≈ 142), and constipation (RR 0.53, 95% CI 0.29-0.94, p = 0.04, ARR = 2.5%, NNT ≈ 40). However, no statistically significant differences were observed for other specific adverse events, including nausea, vomiting, anorexia, heartburn, belching, taste disturbance, abdominal pain, and abdominal bloating. Sensitivity analyses confirmed the robustness of the results for the H. pylori eradication rate and adverse event rate. CONCLUSION: Combining probiotics with BQT significantly increases the H. pylori eradication rate and reduces adverse events, particularly diarrhea and constipation. These findings support the role of probiotics as a supplementary strategy to enhance both the efficacy and safety of H. pylori eradication therapy. However, the overall certainty of the evidence is low to very low, and the optimal probiotic protocol has yet to be determined, highlighting the need for further high-quality researc

Potassium-competitive acid blockers (PCABs), a new class of potent and sustained acid-suppressing drugs, have emerged as an alternative to proton pump inhibitors (PPIs) for gastroesophageal reflux disease (GERD) management. However, the specific benefits of PCABs for nocturnal GERD symptoms remain unclear. This systematic review and meta-analysis aimed to evaluate the efficacy and safety of PCAB therapy compared with PPIs or placebo for managing nighttime heartburn and related symptoms in adults with GERD. We systematically searched the MEDLINE, EMBASE, and Cochrane CENTRAL databases from inception to August 8, 2024. We included randomized controlled trials (RCTs) that compared any PCAB (vonoprazan, tegoprazan, or fexuprazan) with either a PPI or placebo in adult GERD patients. The primary outcome was the proportion of patients with complete resolution of nighttime heartburn throughout the treatment period; the secondary outcome was the treatment-emergent adverse events (TEAEs). Meta-analyses were performed using random-effects models with risk ratios (RRs). Sensitivity analyses were used to assess the robustness of the results. Risk of bias was evaluated using the Cochrane RoB 2 tool. Three RCTs were included in the meta-analysis. PCABs significantly increased the likelihood of complete nighttime heartburn resolution compared with PPIs (RR2.29, 95% CI 1.36-3.87; p = 0.002), with no heterogeneity. Safety analysis of the three trials showed no significant difference in TEAE risk (RR0.88, 95% CI 0.53-1.45; p = 0.62). The findings were consistent across all sensitivity analyses. Our study results suggest that PCABs therapy may provide better nighttime heartburn resolution than PPIs. © 2026. The Author(s) under exclusive licence to The Japan Esophageal Society.

BACKGROUND: To evaluate the efficacy and safety of potassium-competitive acid blockers (P-CABs) versus proton pump inhibitors (PPIs) in the treatment of gastroesophageal reflux disease (GERD) through a meta-analysis, explores the preliminary pharmacoeconomic advantages. METHODS: Randomized controlled trials (RCTs) comparing P-CABs and PPIs for GERD treatment were identified from database, up to July 2025. After processing the studies and extracting the data. RevMan and Stata was used for data analysis. A preliminary pharmacoeconomic analysis was performed based on market survey data. RESULTS: A total of 10 RCTs (5133 participants) were included. P-CABs demonstrated better overall efficacy than PPIs [risk ratio (RR) = 0.72, P = 0.02]. Sensitivity analysis indicated higher applicability in Asian populations (RR = 0.69, P = 0.01). Subgroup analysis showed P-CABs had a significant advantage over lansoprazole (P < 0.001, RR = 0.50), but not over esomeprazole (P = 0.93). P-CABs were superior in the low-dose group, 2-week and 8-week treatment courses group. In the high-dose P-CABs group, 4-week treatment courses group, heartburn relief group and adverse event rates were comparable to PPIs. Pharmacoeconomic analysis revealed that CERP-CABs ≈ 0.1 CNY/day (d)/1%cure rate (1%CR); CERPPIs ≈ 0.01 CNY/d/1%CR; ICER = 3.125 CNY/d/1%CR. CONCLUSIONS: P-CABs demonstrate relatively greater efficacy than PPIs, especially in Asian populations. However, in terms of symptom relief, mid-term efficacy and safety both classes show comparable effects. PPIs are more cost-effective in specific contexts. Due to the limited follow-up duration in the included studies, the conclusions are applicable only to short-term symptom control.

OBJECTIVE: The aim of this meta-analysis was to evaluate long-term outcomes and patient-reported satisfaction after Laparoscopic Nissen fundoplication (LNF). BACKGROUND: LNF has demonstrated short-term and mid-term symptom relief in patients with gastroesophageal reflux disease (GERD). However, long-term outcomes have not been clearly defined. METHODS: A systematic PubMed search identified studies of LNF for GERD with ≥10-year follow-up. The main outcome was effectiveness of the operation, which was determined by symptomatic improvement, esophagitis improvement, and proton pump inhibitor use. Secondary endpoints included adverse events, patient satisfaction, and willingness to undergo LNF again. A meta-analysis of proportions was performed to calculate weighted pooled estimates with 95% CIs, and paired t tests compared preoperative and postoperative symptoms. RESULTS: A total of 12 studies comprising 1334 patients were analyzed. The mean follow-up across studies was 13.1 (10 to 22) years. The presence of heartburn decreased from 94.2% to 33.7% ( P < 0.001), regurgitation from 68.7% to 13.4% ( P = 0.02), and esophagitis from 61.7% to 7.4% ( P = 0.001). The weighted pooled proportion of symptom recurrence was 17% (95% CI, 5%-47%). Postoperative proton pump inhibitor use was reported in 24% (95% CI, 14%-38%) of patients. Gas-bloating and dysphagia occurred in 53% (95% CI, 20%-83%) and 26% (95% CI, 18%-37%) of patients. Overall patient satisfaction was 87% (95% CI, 81%-92%), and 87% of patients (95% CI, 82%-90%) reported willingness to undergo LNF again. The proportion of patients requiring reoperation was 6% (95% CI, 3%-9%). CONCLUSIONS: LNF provides durable long-term improvement of GERD symptoms. Although postoperative gas-bloating and dysphagia are frequent, long-term patients' satisfaction is high.

BACKGROUND: Gastroesophageal reflux disease (GERD), manifested by heartburn and regurgitation, is a common pregnancy complaint that significantly impairs quality of life. Reported prevalence varies widely, with differences observed across pregnancy trimesters. This first systematic review and meta-analysis synthesizing global data aimed to estimate the pooled prevalence and risk of GERD symptoms during pregnancy, including trimester-specific trends. METHODOLOGY: Following PRISMA 2020 guidelines, a comprehensive literature search was conducted across MEDLINE/PubMed, EMBASE, Cochrane Library, and Google Scholar from 1 January 1975 to 10 July 2025. The protocol was registered in PROSPERO (CRD420251102794). Eligible studies included observational studies reporting the prevalence of GERD symptoms in pregnant populations. Two independent reviewers screened articles, extracted data, and assessed methodological quality using the Newcastle-Ottawa Scale. A random-effects meta-analysis model was applied. RESULTS: A total of 21 studies involving 9497 pregnant participants were included. The pooled prevalence of GERD symptoms during pregnancy was 40.96% (95% CI: 27.63-54.28). Subgroup analysis by trimester revealed a progressive increase in GERD prevalence, from 26.12% in the first trimester to 33.40% in the second, peaking at 55.93% in the third, reflecting the growing physiological burden. In studies that included non-pregnant control groups, pregnant women had a significantly higher risk of experiencing GERD symptoms compared to non-pregnant controls (OR = 8.37; 95% CI: 2.93-23.89). Subgroup analysis showed that the pooled prevalence of heartburn was 43.81% (95% CI: 23.74-63.87), while regurgitation affected 37.94% (95% CI: 26.23-49.65) of pregnant women. CONCLUSION: GERD symptoms are highly prevalent during pregnancy, especially in the third trimester. Early identification and management may improve maternal comfort and quality of life. © 2025. The Author(s).

BACKGROUND: Peroral endoscopic myotomy (POEM) has emerged as a minimally invasive alternative to laparoscopic Heller myotomy (LHM) for the treatment of achalasia. While short-term outcomes have been widely studied, evidence on long-term efficacy and safety remains limited and heterogeneous. This meta-analysis aimed to compare long-term clinical outcomes between POEM and LHM. METHODS: We systematically searched PubMed, Embase, Scopus, Web of Science, and the Cochrane Library from inception to 15th August 2025. Studies were included if they directly compared POEM with LHM, reported outcomes with ≥2 years of follow-up, and provided data on operative time, length of hospital stay, functional outcomes, or reflux-related outcomes. Pooled mean differences (MDs) and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using random-effects models. Risk of bias was assessed using RoB 2 and Newcastle-Ottawa Scale. RESULTS: A total of 10 studies involving 1158 patients (POEM = 609; LHM = 549) were included, comprising nine unique studies and one follow-up publication. POEM was associated with significantly shorter operative time (MD: -31.65 minutes, 95% CI: -46.39 to -16.92, P < 0.001) and shorter hospital stay (MD: -0.78 days, 95% CI: -1.40 to -0.52, P < 0.001). Functional outcomes, including dysphagia scores (MD: -0.24, 95% CI: -0.62 to 0.15, P = 0.23), postoperative Eckardt scores (MD: 0.11, 95% CI: -0.38 to 0.60, P = 0.65), and treatment success rates (OR: 1.43, 95% CI: 0.96 to 2.13, P = 0.08), were comparable between POEM and LHM at both 2-5 years and ≥ 5 years. Reflux-related outcomes, including RSI, GERD-HRQL, GERD symptoms, heartburn resolution, and incidence of esophagitis, did not significantly differ between groups. However, continued postoperative proton pump inhibitor (PPI) use was significantly more frequent after POEM (OR: 1.94, 95% CI: 1.35 to 2.78, P = 0.003). CONCLUSION: Both POEM and LHM provide durable long-term relief of achalasia symptoms with comparable efficacy and reflux-related outcomes. POEM offers advantages in shorter operative time and hospital stay but is associated with a higher need for long-term PPI therapy. These findings

Objective: This study aims to conduct a systematic review and network meta-analysis comparing the safety and efficacy of endoscopic versus surgical treatments for gastroesophageal reflux disease (GERD). Methods: Randomized controlled trials were identified through systematic searches of MEDLINE, Embase, Web of Science, and CNKI. Both direct effect models and Bayesian random-effects network meta-analysis were used to compare treatments directly and indirectly. The following types of studies were included : (1) RCTs involving endoscopic or surgical treatment for adult GERD patients aged ≥18 years with no previous history of gastroesophageal surgery; (2) studies comparing two or more treatment methods, including different endoscopic or surgical procedures, proton pump inhibitor (PPI) therapy, and/or sham surgery; and (3) articles published in Chinese or English. Review articles and conference abstracts were excluded. Results: A total of 47 randomized controlled trials were enrolled, and 43 studies were network meta-analyzed. Both endoscopic and surgical treatments significantly reduced postoperative PPI use compared to PPI therapy (P <0.05). Among all treatment modalities, laparoscopic Nissen fundoplication (LNF, SUCRA=0.84) demonstrated the highest efficacy, followed by laparoscopic Toupet fundoplication (LTF, SUCRA=0.71) and anterior partial fundoplication (APF, SUCRA=0.70). Transoral incisionless fundoplication (TIF) demonstrated the best outcomes in relieving heartburn (SUCRA=0.87) and bloating (SUCRA=0.86) symptoms. The overall safety of surgical treatment was comparable to that of PPI therapy. However, LNF was associated with a higher incidence of postoperative dysphagia and gas-related symptoms, whereas TIF had a lower risk of postoperative complications. Conclusions: Both endoscopic and surgical treatments are effective for GERD. LNF provides the highest rate of medication discontinuation but carries a higher risk of postoperative complications. TIF offers better relief of heartburn and bloating with fewer complications. Publisher: 目的： 通过系统评价和网状Meta分析，综合比较内镜与外科手术治疗胃食管反流病（GERD）的疗效及安全性。 方法： 系统检索MEDLINE、Embase、Web of Science及中国知网数据库，纳入符合下述标准的随机对照研究（RCT）：（1）针对

BACKGROUND: Proton pump inhibitors are currently the primary treatment option for refractory gastroesophageal reflux disease (rGERD), yet they have limitations, including poor efficacy and potential adverse events. Chinese herbal medicine (CHM) may offer an effective and safe adjunctive therapy. METHODS: This network meta-analysis investigate the adjunctive therapeutic effect and safety of CHM on rGERD. Randomized controlled trials (RCTs) of CHM combined with conventional Western medicine in the treatment of rGERD added to 8 online databases from its inception to January 2024 were systematically searched. Review Manager 5.3 and and Stata 14.0 software were used to conduct pairwise meta-analysis and network meta-analysis of RCTs that met the inclusion criteria. In addition, the methodological quality of RCTs was analyzed using the Cochrane Collaboration Risk of Bias ROB 2.0 assessment tool. This study was registered in PROSPERO (International Prospective Register of Systematic Reviews) (CRD42024532264). RESULTS: This study included a total of 19 RCTs, comparing 16 CHMs. Pairwise meta-analysis indicated that CHM combined with conventional Western medicine outperformed the latter in terms of overall clinical efficacy, recurrence rate, and symptom improvement. Network meta-analysis suggested that Shugan Jieyu Capsule may significantly enhance overall clinical efficacy, while Buzhongyiqi Granules may significantly reduce the recurrence rate, Sanji Powders may significantly improve symptoms of acid reflux, Shugan Jieyu Capsule may significantly improve symptoms of heartburn, and Shugan Jianpi Hewei Decoction may significantly improve symptoms of esophageal chest pain, Qingweishu Granules may significantly improve the frequency scale for the symptoms of GERD score. No serious adverse events were reported in any of the RCTs. CONCLUSION: The findings of this study indicate that CHM offers a positive adjunctive therapeutic benefit for rGERD; however, it is imperative to enhance the quality of future RCTs to validate these preliminary findings.

BACKGROUND: Although proton-pump inhibitors (PPIs) have long been the mainstay of therapy for endoscopy-negative reflux disease (ENRD), their therapeutic limitations have become apparent. AIM: This study aimed to evaluate the efficacy and safety of potassium-competitive acid blockers (PCABs) compared to PPIs/placebos in treating ENRD. METHODS: Only randomized controlled trials (RCTs) comparing PCABs with PPIs/placebos in ENRD and indexed in MEDLINE, EMBASE, and CENTRAL until May 20, 2024, were included. A random-effects model meta-analysis was performed to pool the primary efficacy outcomes (heartburn resolution and mean heartburn severity at week four) and safety data (any treatment-emergent adverse event or TEAE). The risk of bias was assessed using the Cochrane's Risk of Bias 2 (RoB2) tool. RESULTS: Four RCTs comparing PCABs and placebos with a total of 2387 participants, were included. All the trials had a low risk of bias. Compared with placebos, PCABs significantly increased the likelihood of heartburn resolution (risk ratio[RR]:1.43;95 %CI:1.22-1.68). The severity of heartburn was significantly reduced by PCABs (standardized mean difference[SMD]:0.19;95 %CI:0.35 to -0.02). TEAEs were comparable between the PCABs and placebos (odds ratio[OR]:1.06;95 %CI:0.82-1.37). CONCLUSIONS: PCABs are superior to placebos in enhancing heartburn resolution and reducing heartburn severity in patients with ENRD, and their safety profile is comparable to that of placebos.

BACKGROUND: Certain patients still experience nocturnal reflux symptoms despite taking a standard morning PPI. This study compares the efficacy of adding a wedge pillow versus an evening PPI to the morning PPI for treating nocturnal reflux symptoms. METHODS: This noninferiority randomized trial included patients with ≥ 2/week nocturnal heartburn/regurgitation despite morning PPI use for ≥ 4 weeks. Participants were randomized to either a wedge pillow with morning or twice-daily PPI for 4 weeks. Nocturnal reflux symptoms were assessed using the nocturnal gastroesophageal reflux disease symptom severity and impact questionnaire (NGSSIQ) at Weeks 0, 2, and 4, along with quality of life, daytime sleepiness, and sleep quality. Twenty-four hour pH-impedance monitoring was conducted at baseline and Week 4. Wedge pillow compliance was monitored with a pressure-sensing timekeeper. RESULTS: Twenty-four patients were enrolled with comparable baseline characteristics and severity of nocturnal reflux. At Week 4, NGSSIQ scores were 30.01 ± 1.97 in the wedge pillow group and 36.33 ± 1.96 in the twice-daily PPI group (mean difference - 6.32; 95% CI -10.28 to 6.21), which falls below the predefined non-inferiority margin demonstrating non-inferiority. Sleep quality was better in the pillow group (5.55 ± 0.56 vs. 7.53 ± 0.60, p = 0.001). Although nighttime median bolus contact time was longer in the twice-daily PPI group [4.3 (2.9-5.4) vs. 7.4 (3.5-15.5) seconds, p = 0.03], other reflux parameters did not show clinically relevant differences between groups. Pillow compliance was high, with 83.3% reporting satisfaction. CONCLUSION: Adding a wedge pillow was not inferior to evening PPI for nocturnal reflux symptoms and was associated with greater improvements in sleep quality, despite the absence of clinically relevant differences in reflux parameters, supporting the wedge pillow as a potential alternative for managing nocturnal reflux symptoms. TRIAL REGISTRATION: Thaiclinicaltrials.org: TCTR20240920004. © 2026 John Wiley & Sons Ltd.

Gastroesophageal reflux disease represents a growing global burden, and a subset of patients remains symptomatic despite standard-dose proton pump inhibitor therapy. This trial aimed to compare the efficacy of acupuncture combined with standard-dose proton pump inhibitor therapy versus high-dose proton pump inhibitor therapy in reducing symptoms and improving quality of life for treatment-resistant gastroesophageal reflux disease. In this parallel-group randomized controlled trial, 72 adults with persistent gastroesophageal reflux symptoms despite once-daily proton pump inhibitor therapy were randomized to receive either acupuncture plus standard-dose omeprazole or double-dose omeprazole for 4 weeks. The primary outcome was a change in reflux symptoms assessed with the Gastroesophageal Reflux Disease Questionnaire, and the secondary outcome was the quality of life measured by the Short Form-36 questionnaire. Both groups showed significant improvement in symptom burden and quality of life. Acupuncture was associated with a greater reduction in heartburn (p = 0.026) and an improvement in quality of life (p < 0.001), while high-dose proton pump inhibitor therapy demonstrated more favorable effects on regurgitation (p = 0.001) and sleep disturbance (p < 0.001). A clinically meaningful reduction in total reflux score was observed in both groups without significant between-group differences. Adverse events were mild and transient, with no serious complications reported. Acupuncture combined with standard-dose proton pump inhibitor therapy provides clinical benefits comparable to high-dose proton pump inhibitor therapy, with favorable effects on quality of life and symptom control. These findings support acupuncture as a safe, patient-centered alternative for managing resistant gastroesophageal reflux disease. HIGHLIGHTS Both acupuncture plus standard-dose PPI and high-dose PPI improve symptoms in resistant GERD.Acupuncture achieved greater improvements in health-related quality of life.High-dose PPI showed stronger effects on regurgitation and sleep disturbances.No serious adverse events occurred with either intervention.Acupuncture provides a safe, non-pharmacologic

BACKGROUND: Refractory gastroesophageal reflux disease (GERD) often requires endoscopic or surgical intervention. We evaluated the efficacy of antireflux mucosal ablation (ARMA) versus sham treatment in patients with reflux-predominant refractory GERD. METHODS: This single-center, randomized sham-controlled trial enrolled patients with persistent GERD symptoms on optimized proton pump inhibitor (PPI) therapy, with acid exposure time (AET) <6%, and >80 reflux episodes on 24-hour pH-impedance monitoring. Patients were randomized to the ARMA or sham groups. The primary outcome was the proportion of patients achieving 50% improvement in GERD health-related quality-of-life (GERD-HRQL) score from baseline to 6 months. Secondary outcomes included heartburn and regurgitation symptom scores, AET, DeMeester score, reflux episodes, endoscopy findings, and PPI consumption. Mixed-effects models were applied, with group (ARMA vs. sham) as fixed effect and participant as random effect. RESULTS: 58 patients (ARMA, n = 28; median age 41; 32% women vs. sham, n = 30; median age 40; 36% women) were included. Baseline mean (SD) duration of PPI use was similar: ARMA, 3.5 (2.7) years; sham, 3.7 (1.8) years. At 6 months, 20 of the ARMA group (71.4%) achieved ≥50% GERD-HRQL score reduction vs. one in the sham group (3.6%; P <0.001). Statistically significant reductions in heartburn, regurgitation, AET, and reflux episodes were seen with ARMA versus sham (P <0.05). Interaction effects revealed greater improvements over time with ARMA versus sham for AET (P = 0.03), total reflux episodes (P = 0.001), and nonacid reflux episodes (P = 0.009), but not for DeMeester score. The ARMA group improved in endoscopic Hill's grading and esophagitis at 6 months; 35.7% of patients were completely off PPIs. CONCLUSION: ARMA improves symptoms, AET, and reflux episodes in reflux-predominant PPI-refractory GERD. Thieme. All rights reserved.

Functional dyspepsia (FD) is a prevalent gastrointestinal disorder characterized by chronic upper abdominal symptoms and complex pathophysiology. Conventional therapies show limited efficacy, prompting interest in alternative approaches. Mastiha, is a natural resin with antioxidant, anti-inflammatory and prebiotic properties. Mastiha-water contains water-soluble components and essential oil traces. We aimed to evaluate the efficacy of Mastiha and Mastiha-water in alleviating FD symptoms and improving quality of life in a randomized, three-way crossover study conducted in Athens, Greece. Adult volunteers,diagnosed based on Rome IV Criteria and differential diagnosis were enrolled after written consent. They underwent a three-phase intervention, each lasting four weeks, with a 14-day washout period between interventions: (A) Mastiha capsules (1.4 g/day); (B) Mastiha-water (20 ml/day); (C) a no-intervention period. Primary outcomes were assessed using the Leuven Postprandial Distress Scale (LPDS). Secondary outcomes included quality of life, anxiety levels, and changes in medication. Statistical analysis was conducted on an intention-to-treat basis. Both Mastiha and Mastiha-water significantly improved FD symptoms compared to the no-intervention period (p < 0.001). Mastiha effectively reduced upper abdominal bloating, epigastric burning, and heartburn, while Mastiha-water improved quality of life (p = 0.012). In conclusion, Mastiha-based therapies may have a potential benefit in FD. Findings hereby support the selective use of Mastiha and Mastiha-water based on specific FD symptoms profile.ClinicalTrials.gov number: [NCT05687539].

PURPOSE: For unclear reasons, up to 50% of subjects with gastroesophageal reflux disease have an inadequate symptomatic response to treatment with a proton pump inhibitor. Our primary objective was to examine esophageal acid in subjects who experienced heartburn following a standard meal that failed to respond to a proton pump inhibitor. METHODS: We analyzed data from a previous randomized crossover trial of proton pump inhibitors in 27 subjects with gastroesophageal reflux disease and baseline esophageal pH < 4 for more than 10% of a 24-h recording. Esophageal pH and heartburn severity were measured over 3 h following a standard meal at baseline and after omeprazole. RESULTS: Relationships between heartburn severity and esophageal acid were identified using the quadrant method. Twelve subjects had high values for heartburn severity with omeprazole, indicating a failed response; 75% of these subjects had low esophageal acid reflecting esophageal hyperalgesia or a cause other than esophageal acid. In subjects with high esophageal acid that failed to improve with omeprazole, heartburn severity improved with omeprazole in 57%, reflecting esophageal hypoalgesia or silent esophageal reflux. CONCLUSIONS: Failure of heartburn to respond to omeprazole was common in subjects with gastroesophageal reflux disease who exhibited high baseline esophageal acid exposure and most of these failures were associated with low esophageal acid. © 2025. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

Gastroesophageal reflux disease (GERD) is a prevalent global condition, affecting 18.1-27.8% of North Americans and 6.3-18.3% of the Thai population. While proton pump inhibitors (PPIs) are the first-line treatment, only about one-third of patients achieve adequate symptom control. Alginate-based medications in combination with PPIs have shown promise, but the comparative effectiveness of generic versus original alginates remains unexplored. To compare the effectiveness of generic alginate (ONE GERD) versus original alginate (Gaviscon Dual Action Suspension) in combination with PPIs for treating GERD symptoms in patients who failed standard PPI therapy.This multicenter prospective randomized controlled non-inferiority trial included 48 patients who failed standard-dose PPI treatment. Patients were randomized to receive either generic or original alginate four times daily for 28 days. Treatment response was evaluated using the Reflux Disease Questionnaire (RDQ) at days 7 and 28. At day 7, both groups showed identical response rates of 45.83%. By day 28, response rates increased to 54.17% for generic alginate and 70.83% for original alginate (p = 0.23). Total RDQ scores and symptom-free rates showed no significant differences between groups at both time points. Adverse event rates were comparable (16.67% vs. 8.33%, p = 0.66). Analysis of specific symptoms (heartburn, chest pain, and regurgitation) revealed similar improvements in both groups throughout the study period. This study provides evidence supporting the therapeutic equivalence of the generic alginate (ONE GERD) to the original formulation (Gaviscon Dual Action Suspension) in treating symptoms for patients with GERD who have failed PPI therapy. Crucially, the comparable efficacy and safety, coupled with the inherent lower cost of generic medications, suggest significant economic benefits and the potential for wider patient access to effective GERD management. This makes generic alginate a viable and attractive alternative in clinical practice, particularly in resource-limited settings or for patients facing financial constraints, thereby contributing to more equitable healthcare solutions without compromi

Symptoms in symptomatic GERD patients result from esophageal acid exposure and are treated with agents that inhibit gastric acid secretion. We analyzed data from a clinical trial evaluating the effect of ranitidine plus antacid on heartburn severity in GERD patients. After 26 subjects ingested a standard meal and received either placebo or ranitidine-antacid, heartburn severity (assessed via a visual analog scale), esophageal pH, and gastric pH were measured at 15-min intervals. Two phenotypes emerged based on heartburn severity patterns: "Persistent Heartburn" (PH), characterized by sustained high severity, and "Non-persistent Heartburn" (NPH), where severity peaked and then declined. PH subjects had similar gastric acidity but higher overall heartburn severity and lower esophageal acid exposure than NPH subjects. Both phenotypes exhibited esophageal hyperalgesia, with significant heartburn even at esophageal pH above 4.0, and hyperalgesia was more pronounced in PH subjects. These findings suggest that esophageal sensitivity, rather than acid exposure alone, contributes to symptom severity. The differing responses to placebo and ranitidine-antacid highlight potential mechanisms underlying treatment failure in some GERD patients, emphasizing the need for tailored therapeutic approaches. © 2025 The Author(s). Physiological Reports published by Wiley Periodicals LLC on behalf of The Physiological Society and the American Physiological Society.

ETHNOPHARMACOLOGICAL RELEVANCE: Zataria multiflora Boiss. (Shirazi thyme) is traditionally used for digestive disorders and inflammatory conditions. Despite its known anti-inflammatory, immunomodulatory, and antioxidant properties, there is limited clinical evidence on its efficacy for ulcerative colitis (UC). AIM OF THE STUDY: To evaluate the effectiveness of Zataria multiflora Boiss. (Z. multiflora) extract in alleviating UC symptoms, reducing inflammatory markers, and modulating immune-related gene expression. MATERIALS AND METHODS: In a multicenter, randomized, placebo-controlled, triple-blind trial in Iran, 92 participants received Z. multiflora extract (6 mg/kg/day) or a placebo for two months. Inflammatory markers and gene expression were analyzed from blood samples. Disease activity was assessed using the Partial Mayo Score (p-Mayo) and the Gastrointestinal Symptom Rating Scale (GSRS). Data were analyzed with SPSS software. RESULTS: The Z. multiflora group showed significant reductions in C-reactive protein (CRP) (p < 0.001), Interleukin-17 (IL-17) (p = 0.001), Interferon-gamma (IFN-γ) (p = 0.002), Nuclear Factor kappa B (NF-κB) (p = 0.002), T-box Transcription Factor T-bet (T-bet) (p = 0.006), and Retinoic Acid-Related Orphan Receptor gamma t (ROR-γt) (p < 0.001). No significant changes were observed in Erythrocyte Sedimentation Rate (ESR) (p = 0.25), GATA Binding Protein 3 (GATA3) (p = 0.09), and Forkhead Box P3 (FOXP3) (p = 0.17). Symptoms such as heartburn, acid reflux, bloating, diarrhea, and fecal urgency improved (p < 0.05). The GSRS score improved (p < 0.001), while the p-Mayo score did not show a significant change (p = 0.24). CONCLUSION: Z. multiflora extract significantly alleviated UC symptoms and reduced inflammatory markers, indicating its potential as a complementary treatment for UC. However, the study was limited by its short intervention period and the absence of biopsy analysis to assess local tissue effects. Further longitudinal studies are required to validate these findings and determine long-term efficacy.

INTRODUCTION: Liquorice (Glycyrrhiza glabra) is a traditional herbal remedy with various pharmacological activities mainly used for digestive and respiratory ailments. GutGard® is a flavonoid-rich, deglycyrrhizinated liquorice root extract and is standardized to glabridin (≥3.5% w/w), and others viz., glabrol, eicosanyl caffeate, docosyl caffeate, and total flavonoids (≥10% w/w) with glycyrrhizin (≤3.0% w/w) as glycyrrhizin causes electrolyte imbalance, hypertension, and water retention. Hence, the objective of the current study was to assess the efficacy, safety, and tolerability of GutGard® in managing gastroesophageal reflux (GER)-related symptoms when compared to placebo. METHODS: It was a double-blind, parallel group, randomized, placebo-controlled trial with participants randomized in a 1:1 ratio to either the placebo group or GutGard® group. The duration of the interventions/treatment was for 28 days and the follow-up visits were done at day 7, day 14, day 28, and day 35. A telephonic follow-up was also done on day 21. The primary outcome measures studied was the change in the Gastroesophageal Reflux Disease-Health-Related Quality of Life and the Gastroesophageal Reflux Disease Symptom Assessment Scale. RESULTS: We screened a total of n = 296 participants and enrolled n = 200 participants and obtained written, informed consent from them. Participants in the GutGard® group reported a significantly better quality of life at the end of the intervention period (p = 0.014). They also reported earlier resolution of symptoms of GER as against the placebo group, especially the symptoms of heartburn (p = 0.017 on day 14 and p = 0.005 on day 28) and regurgitation (p = 0.025 on day 7, p = 0.029 on day 14, and p = 0.022 on day 28). CONCLUSIONS: The GutGard® group showed better and earlier resolution (within 2 weeks) of symptoms of GER as against the placebo group, especially heartburn and regurgitation. INTRODUCTION: Liquorice (Glycyrrhiza glabra) is a traditional herbal remedy with various pharmacological activities mainly used for digestive and respiratory ailments. GutGard® is a flavonoid-rich, deglycyrrhizinated liquorice root extract and is standardized to glabr

INTRODUCTION: Lugol chromoendoscopy (LCE) is valuable, cost-effective, and widely used in early esophageal cancer screening, yet it suffers from low compliance because of adverse events after LCE. In addition, the reflux of iodine during iodine staining in the upper esophagus brings the risk of bucking and aspiration. We introduced a new model called distance countdown (DC) aimed to reduce reflux during iodine staining in upper esophageal LCE. METHODS: In this randomized controlled trial, 204 patients were randomized into the DC and No-DC groups. The primary end point was the difference in the incidence of positive starch reagent reaction (iodine solution reflux) between the 2 groups. The secondary end points were the comparisons of the incidence of other adverse events after LCE between the 2 groups. RESULTS: The rate of iodine solution reflux was 1.0% in the DC group and 26.5% in the No-DC group ( P < 0.001). Furthermore, the incidences of bucking between the 2 groups were 1.0% and 9.8% ( P = 0.005). LCE satisfaction rates were 78.4% and 76.5% in the DC and No-DC groups ( P = 0.363), respectively. Concerning symptoms after LCE, incidences of sore throat, pharyngeal discomfort or odor, bitter taste, and heartburn were also reduced in the DC group (all P < 0.05). DISCUSSION: Adding DC as an auxiliary effect during LCE would reduce the risk of iodine solution reflux, as well as other adverse events after LCE. Implementing this measure could be beneficial in improving the safety of LCE in early esophageal cancer screening.

Helichrysum odoratissimum (L.) Less. is used as a traditional medicine in South Africa to treat tuberculosis, abdominal pains, heartburn, coughs, colds, female sterility, eczema and wounds. In Uganda, the leaves are used to treat dental/oral diseases. This review aims to provide detailed information on the traditional uses, essential oils, phytochemistry, in silico studies, and pharmacological studies and propose possible future research directions on this widely investigated species. The data was gathered from various online electronic databases such as Science Direct, Scopus, Google Scholar, Web of Science, SciFinder, Wiley Online, SpringerLink, and PubMed. Reports on the essential oil composition of H. odoratissimum showed the dominance of monoterpenoids and sesquiterpenoid compounds. Several studies also reported the isolation of the non-volatile compounds, which were mainly flavonoids and terpenes. The species has been reported to have pharmacological activities such as antimicrobial, antimycobacterial, antioxidant activity, antidiabetic, antiproliferative, anti-inflammatory activity and antityrosinase activity. The most important study on H. odoratissimum was a clinical trial in human participants in South Africa addressing its in vivo irritancy potential. However, further research on the clinical and scientific aspects is needed to justify some of its other medicinal uses.

BACKGROUND: Dual primary malignancies, including colorectal (CRC) and gastric cancers (GC), are complicated cases due to the complexity of managing patients. CASE REPORT: This case report presents a 62-year-old male patient with rectal and gastric adenocarcinomas. Initially, rectal adenocarcinoma after a complaint of hematochezia was diagnosed by prognostic modalities. The patient received total neoadjuvant therapy with FOLFOX chemotherapy and chemoradiotherapy. After surgery, a complete pathological response was obtained. A few months later, gastric adenocarcinoma with persistent heartburn was detected through esophagogastroduodenoscopy (EGD). total neoadjuvant therapy with FOLFOX chemotherapy and chemoradiotherapy followed by total gastrectomy were prescribed. After gastrectomy, a complete pathological response was obtained. CONCLUSION: This case of synchronous CRC and GC, diagnosed 5 months apart, underscores the pivotal role of early detection and multidisciplinary management in achieving favorable outcomes. Complete pathologic responses in both malignancies following tailored TNT with FOLFOX and FLOT regimens, combined with surgical interventions, highlight the efficacy of personalized treatment strategies, even in resource-constrained settings. Continued research is essential to optimize diagnostic protocols, refine therapeutic approaches, and improve access to genetic testing for synchronous and metachronous malignancies, promoting equitable cancer care globally.

Functional esophageal disorders manifest a complex interplay between subtle physiomechanical perturbations and altered peripheral and central neuropsychological processing. These disorders present with heartburn, chest pain, globus and/or dysphagia, in the absence of structural abnormalities, esophageal motility disorders, or overt gastroesophageal reflux disease. Visceral hypersensitivity from peripheral or central neural dysfunction is thought to contribute significantly to symptom generation, potentially triggered by low-grade inflammation or compensatory responses to repetitive noxious stimuli. Hypervigilance impairs interpretation and regulation of internal sensory signals, modulated by cognitive and affective processes and by psychosocial stressors. Therapeutic approaches targeting minimal motor abnormalities or further reducing physiologic reflux have limited benefit. In contrast, modulation of peripheral sensory inputs and central perception pathways are conceptually and clinically promising, although outcome data remain sparse. Future research should prioritize elucidating the neurobiological mechanisms underlying esophageal hypersensitivity and hypervigilance to inform the development of targeted and effective treatments.

Gastroesophageal reflux disease (GERD) is a chronic relapsing disorder often inadequately controlled with proton pump inhibitors (PPIs), particularly in patients with nocturnal acid breakthrough (NAB) or non-erosive reflux disease (NERD). Tegoprazan, a potassium-competitive acid blocker (PCAB), offers rapid, potent, and CYP2C19-independent acid suppression. This systematic review and meta-analysis evaluated randomized controlled trials comparing Tegoprazan with PPIs in adults with GERD and related disorders. Databases searched included PubMed, Cochrane, Wiley, and ClinicalTrials.gov (2015-2026). Eighteen studies met inclusion criteria. In erosive esophagitis, Tegoprazan 50 mg once daily achieved mucosal healing rates of 91.1%-99.1%, non-inferior to PPIs (93.5%-98.9%; pooled RR = 1.01, 95% CI 0.98-1.05). Pharmacodynamic and clinical studies demonstrated faster acid suppression and improved nocturnal pH control versus PPIs, achieving pH ≥ 4 within 30-60 min and maintaining levels throughout the 12-h period. In nocturnal symptom analyses, Tegoprazan achieved earlier relief (1.5 vs. 3 days to first heartburn-free night) and higher proportions of heartburn-free nights (57.8% vs. 43.1%), with significantly greater complete (p = 0.038) and partial (p = 0.034) nighttime symptom resolution than Esomeprazole. In NERD, symptom resolution ranged from 42.5% to 48.9% versus 24.2% with placebo. In open-label functional dyspepsia cohorts, improvements ranged from 74.6% to 86.7% in open-label cohorts. Seven trials (n = 2492) showed higher Helicobacter pylori eradication with Tegoprazan-based therapy (RR = 1.05, 95% CI 1.01-1.09; p = 0.006; I 2 = 0%). Adverse events were mild and comparable to PPIs. Tegoprazan provides rapid, sustained acid suppression, effective nocturnal symptom control, and a modest but statistically significant improvement in H. pylori eradication, representing a potential alternative to PPIs for patients with persistent or CYP2C19-related variable response. © 2026 The Author(s). JGH Open published by Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

BACKGROUND: Diastasis recti (DR) is a common condition, particularly in post-partum women, which may impair core function and alter intra-abdominal pressure (IAP). Gastro-esophageal reflux disease (GERD) is frequently associated with IAP imbalance, to which DR may be a contributing factor. This study aims to evaluate whether surgical correction of DR using pre-aponeurotic endoscopic repair (REPA) improves symptoms of GERD. METHODS: Symptom changes were assessed in 115 REPA patients using a validated questionnaire (modified Italian GERD Health-Related Quality of Life, MI-GERD-HRQL) administered pre-operatively and post-operatively. All respondents had a body mass index (BMI) ≤ 25 and no other relevant gastrointestinal or systemic comorbidities. RESULTS: This study showed a significant reduction in both prevalence and severity of GERD symptoms after surgery. The presence of reflux symptoms decreased from 75% pre-operatively to 50% post-operatively, p < 0.001. In particular, a significant reduction in prevalence was observed for heartburn after meals (28% vs. 57%), sensation of reflux (19% vs. 57%), reflux after meals (25% vs. 57%), heartburn (30% vs. 54%) and reflux when lying down (24% vs. 53%). Mean MI-GERD-HRQL score went from 16 (± 17) pre-operatively to 5 (± 10) post-operatively, p < 0.001. Mean scores for all symptoms examined showed a significant reduction in the post-operative period. Male sex, age ≥ 50 years and patients' geographical location (Italian sub-group) did not influence post-operative MI-GERD-HRQL score. CONCLUSIONS: Our findings suggest a possible mechanistic link between abdominal wall integrity and GERD. Epidemiological and prospective comparative studies are necessary to validate our results and provide a more precise understanding of the physiological impact of DR repair on GERD. © 2026. Indian Society of Gastroenterology.

BACKGROUND: Saccharomyces boulardii CNCM I-745 (Sb) is one of the most widely used probiotics in clinical practice. The aim of this study was to assess the impact of adding Sb to Helicobacter pylori eradication therapy on treatment outcomes (effectiveness and safety) in routine European gastroenterology clinical practice. MATERIALS AND METHODS: Treatment-naive cases from the European registry on H. pylori management (Hp-EuReg) collected from 2013 to 2023 at AEG-REDCap were analyzed. Effectiveness was assessed by modified intention-to-treat, by treatment and geographic regions. Multivariate analysis identified factors independently associated with eradication success and adverse event incidence. RESULTS: Among 69,922 cases, probiotics were used in 16,528 (24%) treatments, of which 4404 (27%) included Sb. Sb use was significantly associated with an increase in effectiveness (OR = 2.32; 95% confidence interval, 1.38-4.03; p < 0.01) only when prescribed with concomitant therapy encompassing a proton pump inhibitor plus clarithromycin-amoxicillin-metronidazole. In addition, a significant reduction in the overall incidence of at least one adverse event was observed in the Sb group (OR = 0.803; 0.66-0.97; p < 0.05). Specifically, diarrhea, nausea, dyspepsia, abdominal pain, asthenia, anorexia, heartburn, and dysgeusia occurred significantly less frequently with Sb. Treatment compliance was high in both groups (with and without Sb). CONCLUSIONS: In Europe, the addition of Sb to first-line regimens in clinical practice was associated with higher effectiveness when combined with concomitant therapy with clarithromycin-amoxicillin-metronidazole and with fewer overall adverse events, supporting its role as a beneficial adjunct in H. pylori eradication therapy. REGISTRATION NUMBER: ClinicalTrials.gov identifier: NCT02328131. © 2026 The Author(s). Helicobacter published by John Wiley & Sons Ltd.

BACKGROUND: The mucosal protective agent, bismuth potassium citrate, is used for treatment of chronic gastritis and gastric stress conditions, including heartburn and acid reflux. OBJECTIVES: 1) To establish and validate a new inductively coupled mass spectrometry (ICP-MS) analytical method for the determination of bismuth metal in human plasma; and 2) to determine the systemic absorption and safety characteristics of bismuth following the administration of bismuth potassium citrate granules (test drug) and bismuth potassium citrate tablets (reference drug) in healthy Chinese subjects. MATERIALS AND METHODS: A single-center, randomized, open-label, two-drug, single-dose, two-cycle, double-crossover pharmacokinetics study was carried out in a cohort of 24 healthy adult subjects in the fasting state. Subjects meeting the inclusion criteria were randomly assigned to the first cycle in ascending order of screening number obtained prior to dosing. The randomization table assigned subject either to the TR-group (test-reference cycle) or the RT group (reference-test cycle) where each group contained a total of 12 subjects. Subjects recruited but not completing the study, or in whom the data sets were incomplete, were not replaced. Using this study design, all subjects received a single dose of both preparations in the fasting state whereby 12 subjects received the drugs in the order RT and 12 subjects in the order TR, with a washout period of 7 days between each drug administration cycle, respectively. RESULTS: Pharmacokinetic parameters (concentration maximum (Cmax), AUC0-t, and area under the concentration-time curve to infinity (AUC0-∞) were analyzed using a linear mixed-effects model after natural log transformation. The lower limit of the 90% confidence intervals for the geometric mean ratio (test preparation/reference preparation) were below 100%, and the bioavailability of the test formulation (granules) was markedly superior to that for the reference formulation (tablets) where values for Cmax, AUC0-t, and AUC0-∞ after natural log transformation were 5.44, 12.82, 10.86, 22.44, and 13.79%, 27.42%, respectively. The systemic absorption of bismuth metal from the g

<p>Background: Guidelines for the management of reflux-like symptoms (primarily heartburn and regurgitation) offer limited guidance to support decision-making in the nonprescription setting. This review aimed to summarize and compare nonprescription treatment options within the context of reflux-like symptom pathophysiology and provide a practical evidence-based tool to help guide tailored treatment selection. Summary: A patient-centered approach should consider the requirement for reactive versus preventative therapies and each product's unique characteristics. Antacids neutralize refluxed acid in the esophagus, providing temporary relief from occasional heartburn. Raft-forming alginate formulations provide relief of heartburn and regurgitation after meals by forming a viscous gel near the gastroesophageal junction, neutralizing the postprandial acid pocket and coating the esophagus when refluxed. Histamine-2 receptor antagonists reduce gastric acid secretion within 30 min, lasting for up to 12 h, making them useful for treatment and prevention of heartburn, but tachyphylaxis is a limitation. Nonprescription proton pump inhibitors are most effective for preventing frequent acid-related symptoms. They are packaged as a 2-week course for daily use, achieving maximum effect after a few days. Key Messages: Important differences exist among self-management treatment options for reflux-like symptoms. A standardized algorithm is proposed to help tailor treatment selection according to symptom profile. </p>. © 2026 The Author(s). Published by S. Karger AG, Basel.

BACKGROUND: Tubular gastric substitution is a common procedure after esophagectomy, and postoperative reflux symptoms significantly impair the patients' quality of life and nutritional status. Effective long-term nursing strategies are crucial in managing this complication. This study aimed to evaluate the efficacy of a comprehensive follow-up approach. AIM: To investigate the follow-up nursing interventions and clinical outcomes of reflux following tubular gastric esophageal replacement surgery. METHODS: A randomized prospective trial was conducted using clinical data from 100 patients with postoperative reflux following tubular gastric esophageal replacement surgery treated at our hospital's Department of Thoracic Surgery between July 2023 and July 2025. Patients were divided into control and study groups based on differing clinical nursing approaches; the control group received routine follow-up care, while the study group underwent comprehensive follow-up care for two months. Pre- and post-intervention comparisons assessed 24-hour reflux frequency, reflux episodes lasting over five minutes, reflux symptom scores, nutritional indicators, quality of life scores, complication rates, and nursing satisfaction. RESULTS: Pre-intervention, no significant differences existed between groups in 24-hour reflux frequency (study: 9.25 ± 1.33 vs control: 9.30 ± 1.28, P = 0.848) or episodes lasting ≥ 5 minutes (study: 4.83 ± 1.16 vs control: 4.78 ± 1.09, P = 0.825). Post-intervention, both groups showed reductions, with the study group exhibiting significantly lower rates than the control group (24-hour frequency: 2.13 ± 0.35 vs 4.52 ± 1.06, P = 0.000; episodes ≥ 5 minutes: 0.88 ± 0.17 vs 2.03 ± 0.44, P = 0.000). The assessment revealed no significant pre-intervention differences in the scores for heartburn, acid regurgitation, upper abdominal distension, or upper abdominal pain. Post-intervention, all scores decreased, with the study group showing significantly lower scores than the control group (e.g., heartburn: 0.91 ± 0.12 vs 1.46 ± 0.26, P = 0.001). Pre-intervention hemoglobin (Hb), serum albumin, and prealbumin levels were not significantly different between the group

Proton pump inhibitors (PPIs) are commonly used to treat heartburn and acid-related disorders. However, their misuse and prolonged use contribute to gut dysbiosis. This study investigated whether well-known prebiotic dietary sources, blueberries or strawberries, can reverse PPI (omeprazole) induced dysbiosis and gut inflammation by modulating gut microbes. Male C57BL/6J mice (7 weeks old) were fed a diet with or without omeprazole (40 mg/kg diet), blueberry (3.7% in the diet; ∼1.5 human servings) or strawberry (2.35% in the diet; ∼2 human servings) for 12 weeks. Metabolic parameters, gut microbes (in the cecum and colon), and inflammatory markers were assessed. In this study, no changes were observed in metabolic parameters in mice fed a diet supplemented with omeprazole or berries. Second, blueberry or strawberry supplementation at nutritional dosages improved alterations in gut microbial ecology induced by omeprazole, with effects varying between the cecum and colon. Third, strawberry supplementation reduced omeprazole-induced gut inflammation. Fourth, selected genera were either positively or negatively associated with markers of gut inflammation, suggesting that dietary berries can ameliorate inflammatory signaling through modifications in the gut microbiome. Dietary berries represent a potential nutritional strategy for improving PPI-induced gut dysbiosis and inflammation. © 2025 The Author(s). Molecular Nutrition & Food Research published by Wiley‐VCH GmbH.