Effects of a Polyphenol Nutraceutical Containing Hesperidin, Noni, Dandelion and Atractylodes macrocephala Extracts on GERD Symptoms: A Retrospective Chart Analysis

Background: Gastroesophageal reflux disease (GERD) is a chronic condition with substantial morbidity and reliance on proton pump inhibitors (PPIs). Long-term adverse effects of PPIs, including enteric infection, nutrient malabsorption, kidney disease, and dementia, increase interest in alternative therapies. A novel over-the-counter polyphenol-based nutraceutical containing hesperidin, Noni fruit, dandelion root, and Atractylodes macrocephala defined extracts were taken by patients with chronic GERD for its potential effect on reflux symptoms and compared to patients on usual care. Methods: A retrospective analysis was performed using patient chart data of convenience cohorts from a community gastroenterology practice. All patients had confirmed chronic GERD by esophagogastroduodenoscopy. Patients choosing to take the nutraceutical (n = 47) discontinued PPIs and H2-receptor antagonists prior to receiving 2 capsules BID before meals for 4 weeks, while other patients (n = 25) continued usual care, including PPIs. Overall symptom improvement was evaluated using frequency and severity reports from structured clinical notes with a 5-point scale. Results: In the nutraceutical group, 81% (38/47) patients reported 100% resolution of their GERD symptoms compared to 16% (4/25) in the usual care group [risk difference (RD): 0.649 (95% CI: 0.476 - 0.822)]. Clinically meaningful improvement of ≥75% for symptoms was 91.5% (43/47) for the nutraceutical vs 24.0% (6/25) in the usual care group [RD: 0.675 (0.520 - 0.830)]. All 32 patients who reported bloating prior to the nutraceutical stated they had less bloating by week 4. The nutraceutical group also had reduced reflux frequency, severity, improved symptoms and decreased reliance on pharmaceutical drugs. There were a few non-serious side effects in the group taking the nutraceutical. Conclusion: This is the first retrospective analysis of combined hesperidin/Noni/dandelion root/Atractylodes extracts showing reflux symptom improvement and favorable tolerability. Care must be taken when interpreting these results, however, as GERD symptoms can wax and wane, the sample size was small, adherence to therapy was not recorded and this was not a placebo-controlled study. A larger, well-controlled study is needed to confirm these results.