Hi everyone. Welcome to the FFMR Plus. You're about to get up to speed on some of the most impactful research in health and medicine. This audio read represents seven to ten hours of reading and filtering to bring you the most relevant and clinically important information. I hope this helps you help your patients and operate at the

clinical cutting edge.

Hello, this is Galvengarde with the Ruechho Institute and welcome to the FFMR Plus, keeping you on the cutting edge of clinical care in functional and integrative medicine.

Dr. Rucho and I have been hard at work, sifting through the latest research in order to bring you important updates.

In today's research digest, we cover

adding pro-kinetics to proton pump inhibitor therapy for those with reflux, adding glutamine

to a low FODMAP diet, intestinal permeability, and graves disease patients, this, and much, much more.

Let's begin with our featured study.

This is a meta-analysis of 16 studies, 1,500 participants with reflux or GERD, 727, so about half received PPI therapy only, whereas another half

received not only PPI therapy, but also an additional prokinetic.

And they found that the PPI and prokinetic group had a greater improvement in GERD symptoms,

regardless of prokinetic type or reflux severity.

There was no difference, however, in quality of life or adverse effects between the two groups.

Again, the study showed that PPI plus prokinetic therapy is superior to PPI use alone in those with GERD.

However, a few notes here.

Dr. Rucho and I wanted to add that him and the rest of the clinical team have mixed emotions about regular use of prokinetics.

When we checked the study, this hesitancy was reinforced by the following quote. The authors say, quote,

in Asia, the most commonly used prokinetics are mosopride, etopride, and domperidone. However,

another prokinetic Asian cisopride has been withdrawn from the market owing to its association

with fetal heart arrhythmia. All right. So there is some potential drawbacks of regular use of

prokinetics, especially long term. And it goes back to our clinical model that we use at the clinic

to aim of treating the most upstream

...