The regulatory effect of proton pump inhibitors combined with triple therapy on gut microbiota, visceral hypersensitivity and gastrointestinal hormone secretion disorders in elderly patients with non erosive gastroesophageal reflux disease.

This study investigated the effects of Proton pump inhibitors (PPIs) combined with triple therapy on elderly non-erosive gastroesophageal reflux disease (NERD) patients. A total of 120 elderly patients diagnosed with NERD were divided into two groups: The study group received PPIs combined with triple therapy, while the control group received PPI monotherapy. Significant improvements were observed in the study group compared with the control group: gut microbiota diversity (Shannon Index: from 3.80±0.40 to 5.30±0.60), increased abundance of beneficial Lactobacillus and Bifidobacterium and reduced Enterococcus levels (All p<0.001). Visceral hypersensitivity scores showed increased pressure and pain thresholds (p<0.001) and reduced urgency and bloating (p<0.05). Gastrointestinal hormone such as motilin, ghrelin levels were increased (both p<0.001), and somatostatin was decreased (p=0.034). Systemic inflammatory markers such as IL-6, CRP, TNF-α, and IL-1β significantly declined, while anti-inflammatory IL-10 increased (All p<0.001). GERDQ scores improved more significantly in the study group (p < 0.001), and SF-36 quality of life domains reflected better physical and mental outcomes (p<0.001). These findings underscore the potential of combination therapy as a superior treatment strategy for elderly NERD patients, improving both clinical outcomes and quality of life. Further studies are warranted to explore long-term benefits and optimize treatment protocols.