Effects Of Herbal Medicine In Gastroesophageal Reflux Disease Symptoms: A Systematic Review And Meta-Analysis

Background: Pyrosis and regurgitation are the cardinal symptoms of gastroesophageal reflux disease. Several herbs have been used for treating gastrointestinal disorders worldwide. This systematic review was conducted to investigate the effects of medicinal herbs on gastroesophageal reflux disease and adverse events. Methods: MEDLINE (via PubMed; The United States National Library of Medicine, USA), Scopus, ScienceDirect, Cochrane Central Register of Controlled Trials, Web of Science, Magiran, and Scientific Information Database were systematically searched for human studies, without a time frame, using medical subject heading terms such as "gastroesophageal reflux disease", "reflux", "esophagitis" and "herbs". Manual searches completed the electronic searches. Results: Thirteen randomized controlled trials were identified, including 1,164 participants from 1,509 publications. In comparing herbal medicine to placebo, there were no significant differences in terms of heartburn (P = 0.23 and 0.48), epigastric or abdominal pain (P = 0.35), reflux syndrome (P = 0.12), and effective rate (P = 0.60), but there was a significant difference in terms of acid regurgitation (P = 0.01). In comparing herbal medicine to drugs, there was a significant difference in terms of effective rate (P = 0.001), and there was one trial that reported a significant difference in terms of epigastric pain (P = 0.00001). Also, in comparing herbal medicine to drugs, there were no significant differences in terms of acid regurgitation (P = 0.39). Conclusion: This meta-analysis showed that herbal medicines are effective in treating gastroesophageal reflux disease. Further standardized researches with a large-scale, multicenter, and rigorous design are needed.