10/04/2025
There is a huge problem in modern medicine. This is the over-reliance on proton pump inhibitors (PPIs) for the management of gastro-oesophageal reflux (GORD). Such drugs were never intended for long-term use and the chronic suppression of gastric acid they induce is linked to increased risk of pneumonia, osteoporosis, micronutrient malabsorption, some cancers, gut bacterial overgrowth, oesophageal candidiasis and food allergy, to name a few. GORD can be a mild condition, so given these side effects, the risk of long-term treatment often outweighs any benefit. There is a clear need for clinically proven alternatives to PPIs, but to date there have been only a few clinical trials of herbal options. In this context, a recent trial of a deglycyrrhizinised licorice root extract (DGL) is a welcome addition.
This was a large, 28-day, double blind, parallel group, randomised, placebo-controlled trial (n = 200) with participants randomised in a 1:1 ratio to either the placebo or DGL group. Primary outcome measures studied were the changes in the Gastro-oesophageal Reflux Disease-Health-Related Quality of Life and the Gastro-oesophageal Reflux Disease Symptom Assessment Scale.
The DGL 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 GORD compared to the placebo group, especially 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).
The DGL used in the study was a flavonoid-rich licorice root extract standardised to glabridin (≥3.5% w/w) with glycyrrhizin (≤3.0% w/w). The dose was 75 mg twice a day after meals. I use substantially higher doses of this particular DGL in my clinical practice.
For more information see: https://pubmed.ncbi.nlm.nih.gov/39929150/
