title: The effect of increased chewing strokes on the DeMeester score.
abstract: Saliva is known to be protective for esophageal mucosa. Increased chewing strokes result in a quantitative and qualitative enhancement of saliva. Reduction in the amount of saliva produced results in an increased incidence of gastroesophageal reflux disease (GERD), which can be objectively measured by the DeMeester score. The impact of increased chewing strokes on the DeMeester score remains largely unknown, thus this study aimed to find out their impact on the value of the DeMeester score and its individual components.The effect of increased chewing strokes on the DeMeester score was investigated in 12 subjects (5 male and 7 female) who were diagnosed with GERD. All subjects underwent a 48-hour pH monitoring using the Bravo® pH capsule. All the patients chewed their food 20 times more on Day 2 as compared to Day 1. The data were analyzed for change in the DeMeester score and its individual components in 2 days.In patients with GERD (DeMeester score > 14.72 on Day 1), the number of long refluxes (>5 minutes) on Day 2 (mean = 3.2, SD = 2.3) was significantly lower than on Day 1 (mean = 6.4, SD = 2.7); Z = -2.032, p = 0.04. Though, the DeMeester score and its other individual parameters decreased on Day 2, they were not statistically significant.In patients with GERD, increased chewing strokes lead to a decrease in the number of long reflux episodes. Though there is a decrease in the DeMeester score and its other individual components, larger randomized controlled studies are required to reach statistical significance.
authors.affiliation: Division of Gastroenterology and Hepatobiliary Diseases, Wyckoff Heights Medical Center, New York, USA.|Hofstra-Northwell School of Medicine, Hempstead, New York, USA.
authors.forename: V
authors.initials: V
authors.lastname: Arya
authors.affiliation: NYU Langone Medical Center, New York, USA.
authors.forename: S
authors.initials: S
authors.lastname: Agarwal
authors.affiliation: Hofstra-Northwell School of Medicine, Hempstead, New York, USA.
authors.forename: S
authors.initials: S
authors.lastname: Singh
authors.affiliation: Feinstein Institute for Medical Research, North Shore Long Island Jewish Hospital, USA.
authors.forename: C
authors.initials: C
authors.lastname: Sison
authors.affiliation: Methodist Hospital, New York, USA.
authors.forename: K A
authors.initials: KA
authors.lastname: Gupta
mesh_terms: D000328:Adult; D050782:Esophageal pH Monitoring; D005260:Female; D005764:Gastroesophageal Reflux / Q000175:diagnosis* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008409:Mastication / Q000502:physiology*; D008875:Middle Aged; D012463:Saliva / Q000378:metabolism*; D012720:Severity of Illness Index; D055815:Young Adult
keywords: BMI body mass index; EGF epidermal growth factor; GERD gastroesophageal reflux disease; GI gastrointestinal; H2-RA H2 receptor antagonist; LA classification Los Angeles classification; PGE2 prostaglandin E2; PPI proton pump inhibitors; SD standard deviation; TGF transforming growth factor