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Effect on Acid Reflux Symptoms Occurring during Sleep of an Oral
Adhering Disc Containing only Food Ingredients
Peter Van Der Ven, Jeffrey Alan Burgess* and Michael D Karcher
Department of Oral Medicine, University of Washington, Seattle, USA
*Corresponding author: Burgess JA, Department of Oral Medicine, University of Washington, Seattle, USA, Tel: 2064502640; E-mail:
oral.care.research.assoc@gmail.com
Receiving date: August 10, 2017; Accepted date: August 30, 2017; Published date: August 31, 2017
Copyright: ©
use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
The aim of this double-blinded, randomized, controlled study was to determine if OraCoat XyliMelts, an over the
counter, dissolvable, adhering disc used to reduce excessive day time or night time dry mouth by increasing
salivation, would also reduce reflux and heartburn symptoms occurring during sleep among subjects suffering from
both GERD and xerostomia. Subjects submitted 14 days of baseline data by answering questions and were then
randomized into one of two groups: one receiving a dry mouth gel (control) and a second receiving a disc (product of
interest). Neither the identities of the two products nor the manufacturers of the products was revealed to subjects.
Answers to the same set of questions were then collected for an additional 14 days as the supplied products were
used. The accumulated data were evaluated for pre-post treatment changes within and between groups. Variables
included reported heartburn, reflux, reflux taste, hoarseness, dry mouth, and antacid use. The results showed a
significant decrease in the severity of the above symptoms of GERD with both disc and gel use, although
improvement was greatest for those using the discs. Comparison between the gel and disc groups for most
symptoms did not reveal significant differences. For heartburn, subjects using the discs perceived significantly less
pain than subjects using the gel. We conclude that the use of certain products intended to reduce dry mouth during
sleep, including OraCoat XyliMelts, may be an effective adjunctive remedy for reducing reflux and heartburn
symptoms in patients with GERD and xerostomia.
Keywords: Esophageal reux; Heartburn; Xerostomia; Mouth
dryness
Introduction
Background
Gastro-esophageal reux disease, commonly referred to as GERD, is
estimated to occur in ten to 30% of the population in developed
countries, with its frequency increasing [1]. Nocturnal GERD involves
reux of acid into the esophagus during sleep. e condition is
estimated to occur once a month in up to 43% of individuals and once
a week in 20% of the population [2,3]. GERD and its variants, is
associated with multiple symptoms including heartburn, sleep
disturbance, impaired salivation and swallowing, reduced esophageal
motility, and erosion of teeth [4-6]. e two ‘classic’ symptoms that are
typically associated with GERD are heartburn (epigastric pain) and
acid reux (an acidic taste at the back of the throat) [7,8]. As a natural
antidote to GERD, salivary ow serves to neutralize, dilute, and wash
down acid that escapes the stomach [9,10].
Hence, we hypothesized that stimulation of salivation during sleep
by a slowly dissolving avored disc that adheres to the oral mucosa
could improve reux and heartburn symptoms associated with GERD.
ere is no denitive test to diagnose GERD. Upper endoscopy and
pH (acid) monitoring have demonstrated low predictive values and are
not considered to be stand-alone criteria for identifying GERD [11].
Consequently, in selecting subjects for this on-line study, we relied on
Guidelines for diagnosing GERD published by the American College
of Gastroenterology and the American Gastroenterological Association
[12,13]. ese guidelines state that “a presumptive diagnosis of GERD
can be established” in the clinical setting “by the typical symptoms of
heartburn and acid regurgitation” and response to empiric trials of
proton pump inhibitors (PPIs).
A signicant problem associated with GERD is sleep disturbance.
e research supporting the connection between GERD and sleep
disturbance includes epidemiologic as well as clinical studies [14,15].
GERD-associated sleep disturbance may contribute to greater health
care utilization, work loss, and decreased quality of life [16-21]. An
epidemiological study by Mody et al. using data from the US National
Health and Wellness Survey, notes that 19% of their over 60,000
surveyed respondents experienced heartburn at least two times a
month [22].
Of those with night-time GERD, 68% also reported sleep diculties,
with 49% indicating diculty getting to sleep and 58% indicating
diculty maintaining sleep. Of potential signicance, subjects
reporting night-time GERD had 1.5 times more overall sleep problems
compared to those reporting daytime GERD. In addition, sleep
diculty was reported to be associated with increased health care
utilization, impairment of daily activity, and loss of work productivity.
Similar results have been published elsewhere [23]. Evidence suggests
that reducing nocturnal GERD could provide a signicant
improvement in sleep, health care costs, and quality of life [24].
Other problems associated with nighttime GERD include oral
disease, epigastric pain, and hoarseness. Oral problems arising as a
direct result of GERD include tooth erosion and halitosis [5,25-27].
Tooth erosion is thought to result from the acidity of the gastric
Journal of Gastrointestinal &
Digestive System der Ven et al., J Gastrointest Dig Syst 2017, 7:4
DOI: 10.4172/2161-069X.1000524
Research Article OMICS International
J Gastrointest Dig Syst, an open access journal
ISSN:2161-069X
Volume 7 • Issue 4 • 1000524
2017 der Ven PV,, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted
contents that reach the mouth during repeated GERD episodes,
especially if they are inadequately buered by saliva [28,29].
Saliva, or a lack thereof, may also have an eect on the esophageal
mucosa exposed to reuxed acid, with this resulting in subsequent
thoracic symptoms including chest pain (heartburn) and voice changes
(hoarseness) [30]. A reduction in GERD could be expected to reduce
the risk of acidic taste, dental pathology, bad breath, chest pain, and
morning hoarseness.
Saliva is thought to play an important role in protecting the
esophageal lining, by diluting, washing down, and buering stomach
acid that enters the esophagus through reux [31-35]. Salivary ow has
been shown to fall signicantly during the night, according to an
individual’s circadian rhythm [36]. is is signicant because a
number of studies report that stimulated night time production of
saliva and its associated constituents can mitigate the symptoms of
heartburn and reux [32,37,38]. It has been proposed that increased
salivation resulting from esophageal acidication may be mediated
through an 'esophago-salivary' reex [39]. Reex salivation with
associated increased bicarbonate content appears to be greatest when
acid accumulates in the upper region of the esophagus [40].
e eect of acid infusion into the lower part of the esophagus does
not appear to have the same eect on salivary ow. It has been
reported that a signicant increase in heartburn occurs when acid
reaches the upper area of the esophagus [32,41]. Hence, in patients
with reux where the acid does not reach the upper area of the
esophagus, a reexive increase in saliva production may not be
initiated. us, there may be benet from stimulating the release of
additional saliva whose buering capacity could help protect the lower
esophageal lining from reuxed acid.
Current Medication Management of GERD
GERD is managed by various medications including drugs that
inhibit acid secretion, such as proton pump inhibitors (PPI’s) and
histamine receptor antagonists (H2 blockers), and prokinetic drugs
which increase tone in the lower esophageal sphincter [42,43]. Other
remedies include OTC alkaline agents such as calcium carbonate,
which simply neutralize acid. While the above drugs may help some
patients, they may not be helpful in all cases. For example, it is
reported that one-third of patients taking the PPI drugs do not
respond to these drugs and side eects can be problematic [44].
PPI use has also been associated with an increased risk of bone
fracture and Vitamin B12 deciency [45]. PPI’s44 inhibit the liver P450
enzyme system and may interact with other drugs [46]. Further, the
literature suggests that women planning on becoming pregnant or who
are pregnant should consult their physician prior to taking PPI’s, and
patients with kidney or liver problems or certain lung diseases such as
COPD, diabetes, or a history of porphyria should also be cautious with
the use of these drugs [47,48].
Prokinetic medications are only recommended for short term use
and their potential side eect such as depression and severe muscle
twitching, dizziness or lightheadedness, and potentially fatal heart
arrhythmias limit their general usefulness [49]. Antacids are eective
in managing acute GERD but are not considered reasonable for long
term use due to potential side eects [50].
Another problem with antacid use is that for GERD occurring at
night, it is not until sleep is disturbed that this class of medication is
taken, which reduces the benet in terms of sleep quality. Given the
facts that many people do not gain relief from PPIs, that histamine-2
receptor antagonists are associated with multiple side eects and
interactions with other drugs, and that the benet of antacid use is
limited by associated sleep disturbance and side eects can be an issue
with chronic use, additional approaches to the treatment of GERD
occurring during sleep need to be considered [15].
Study Rationale
e aim of this study was to determine if an orally dissolvable,
adhering disc, previously shown to reduce excessive day time or night
time dry mouth, would also reduce reux and heartburn occurring
during sleep. e discs are made from food ingredients and stimulate
saliva via slowly released avor when used as directed. Ho et al. report
that among people with xerostomia, their use more than doubled saliva
production when applied during the day [51].
Reux symptoms are sometimes more prominent at night because
acid can more readily enter the esophagus while patients are lying
down. Anecdotal reports and research show that salivary stimulants
can reduce the sensation of dry mouth. Research also suggests that
salivation can ameliorate reux and heartburn [24,31,32]. We
hypothesized that the stimulation of salivation by a slowly dissolving
intraoral disc could signicantly reduce nocturnal reux and
heartburn symptoms associated with GERD in subjects who self-report
xerostomia.
Subjects and Methods
Study design
is study was approved by the Western Institutional Review Board
on September 16, 2014 (WIRB; 1019 39th Ave S, Ste 120, Puyallup, WA
98374). It was designed as a randomized, double-blinded, controlled
trial involving two over the counter products currently on the market
for use in the management of dry mouth symptoms. e product of
interest was cleared by the FDA for investigation in the context of
GERD on September 4, 2014 (Investigational New Drug Application
number 123574 US FDA). Study information and results can be found
on ClinicalTrials.gov (project identier NCT02274636)
Both the participants and the research coordinator conducting the
study were blinded as to which of the two products was the one of
interest and delivery was independently randomized. e product of
interest, OraCoat XyliMelts, was produced by OraHealth Corporation
in Bellevue, Washington.
e ingredients are all-natural and commonly used in foods: xylitol
for sweetness, mild mint for additional avor, cellulose gum to slow
dissolution and lubricate the mouth, an acacia gum adhesive layer, and
a small amount of calcium carbonate to neutralize the acidity of acacia
gum and render the product slightly basic. When a single disc is
dissolved in 5 parts water, the resulting pH is 8.1 [52]. When used
during the day by subjects with dry mouth having a mean salivary pH
of 7.25, the use of two discs did not make saliva more basic [51].
Product users also report that discs slowly dissolve over six hours
during sleep and that the avor can still be sensed upon awakening
aer 8 hours of sleep [51,53]. e product used as a control was a water
based gel containing cellulose hydrocolloid gums with sorbitol and
xylitol sweeteners marketed by GlaxoSmithKline as a remedy for dry
mouth. As it is a soluble gel introduced prior to sleep, it was presumed
Citation: Burgess JA, Der Ven PV, Karcher MK (2017) Effect on Acid Reflux Symptoms Occurring during Sleep of an Oral Adhering Disc
Containing only Food Ingredients. J Gastrointest Dig Syst 7: 524. doi:10.4172/2161-069X.1000524
Page 2 of 7
J Gastrointest Dig Syst, an open access journal
ISSN:2161-069X
Volume 7 • Issue 4 • 1000524
to be eliminated from the oral cavity fairly quickly via salivary
stimulation.
Study population/subjects
Subjects were drawn from 372 individuals living in the United States
who responded to an ad soliciting paid volunteers for an internet
administered study involving substances recognized as safe for possible
management of reux symptoms. When individuals expressed interest
in the study, a 21 item questionnaire was sent to them via email. For
inclusion in the study, subjects had to have internet email access and be
computer literate, be 18 years of age or older, have had a medical
evaluation in the prior year, and have self-reported frequent symptoms
of reux or heartburn and dry mouth while sleeping.
Study exclusion criteria included a history of thoracic, esophageal or
gastric surgery, current or past coronary artery disease, gallbladder
disease, gastric or esophageal cancer, peptic ulcer disease, esophagitis,
and eosinophilic, infectious, or esophageal motility disorders. Subjects
were also excluded if another member of their household was already
participating in the study. It was not necessary to have received a
medical diagnosis of reux, but 91% of nal subjects reported this
diagnosis. Subjects satisfying the inclusion criteria and qualifying for
the study based on medical criteria were sent a comprehensive, WIRB
approved consent form detailing the study intent, design, procedures,
risks and discomforts, benets, alternatives, condentiality, legal
rights, and other information.
Variables of interest
Study subjects were emailed a questionnaire every day during an
initial two week baseline collection period and then a two week
product intervention trial, for a total of four weeks participation.
Questionnaire variables (listed below) were chosen because previous
research suggests that reux, characterized by a perception of a sour
taste at the back of the mouth, is also associated with symptoms of
heartburn, morning hoarseness, use of water during the night, and
antacid use [8,54].
Procedures
Phase 1: Baseline
Upon receiving written consent via email response, subjects were
entered into the 14 day baseline data collection phase of the study
(Phase 1). During this period, they were instructed to continue with
their normal daily activities including their usual diet and the use of
ongoing OTC and/or prescribed medication for reux, heartburn, and
any other non-excluded medical conditions. Each subject was asked to
answer the same nine questions delivered by email each morning by
the research coordinator, relating to what occurred during their prior
night’s sleep.
e specic questions were:
• Did you taste reuxed stomach acid during your sleep last night
(yes/no);
• How severe was the reux (mild, moderate, severe, very severe);
• Did you have heartburn when you slept (yes/no);
• How severe was the heartburn (mild, moderate, severe, very
severe);
• Did you keep water by your bedside because of dry mouth
occurring during sleep (yes/no);
•Did you have uncomfortable dry mouth when you slept or upon
awakening (yes/no);
• Did you experience hoarseness of your voice in the morning (yes/
no);
• Did you need to take antacids during sleep (yes/no); and
• If so, how many did you take (number).
Subjects were asked not to view their prior email responses when
replying in the morning and to maintain the same email thread for
subsequent review, should it be necessary. When a subject replied with
the exact same answers each day without variation during the baseline
data-collection period he/she was disqualied from the study as this
was considered to be statistically improbable.
Phase 2: Product trials
Upon completion of Phase 1, each subject’s data were quantied to
see if he/she qualied for the second product phase of the study. To be
accepted into Phase 2, subjects had to have reported reux taste on
eight of the fourteen mornings following their night’s sleep during
baseline assessment and dry mouth on seven of the same mornings.
ose qualifying were then randomized into one of two groups:
treatment or control. Each subject then received by mail either the
adhering discs disguised in unmarked packaging (treatment), or the
sweetened water based gel in an unmarked white tube (control), with
printed instructions copied from the manufacturer’s instructions for
their method of use at bedtime.
e dispensed product was then used by each subject every night
for two weeks. During this second phase of the study, subjects
answered the same nine questions as in Phase one delivered to them by
email each morning. As in Phase one, subjects were asked not to view
their prior email responses when replying.
In both study arms, subjects were allowed to miss one night’s
responses but were disqualied if they failed to respond more than
once. Some questions posed by subjects during the study relating to
how the questionnaire should be completed indicated that there were
instances of confusion regarding interpretation and intent. When
subjects asked for clarication regarding completion of the
questionnaire, consistent advice was provided by the research
coordinator.
Statistics
As noted, variables of interest included reux taste, reux severity,
heartburn sensation, heartburn severity, morning voice hoarseness,
and antacid use each night. Baseline data for the above variables was
collected from a total of 119 subjects who qualied for and consented
to be in the study.
Based on the above qualifying criteria 53 subjects were selected to
enter the two week intervention phase of the study, randomized to
receive the disc or the gel. Comparisons were made within and
between groups for all outcome variables. e severity data take the
form of two clinical phases (baseline and treatment), each representing
14 nights of ordinal categorical data (no heartburn, mild heartburn,
moderate heartburn, severe heartburn, and very severe heartburn).
e ordinal data suggest using a Mann-Whitney U test to compare
the results from the treatment phase to the baseline phase for disc and
gel groups, the results from the baseline phase of the disc group to the
baseline phase of the gel group, and the treatment phase of the disc
group to the treatment phase of the gel group [55]. e U test
Citation: Burgess JA, Der Ven PV, Karcher MK (2017) Effect on Acid Reflux Symptoms Occurring during Sleep of an Oral Adhering Disc
Containing only Food Ingredients. J Gastrointest Dig Syst 7: 524. doi:10.4172/2161-069X.1000524
Page 3 of 7
J Gastrointest Dig Syst, an open access journal
ISSN:2161-069X
Volume 7 • Issue 4 • 1000524
compares two groups of ordinal data by tabulating the pairwise
comparisons (greater than, equal, or less than) between the data in
each group and then comparing that tabulation to the known null
distribution under the null hypothesis that a random member of either
group is equally likely to be greater than a random member of the
other group.
As with T-tests, U test alternative hypotheses can be one-sided or
two-sided, depending on which outcomes are clinically relevant. e
reux taste and hoarseness data take the form of two clinical phases
(baseline and treatment), each representing 14 nights of yes/no data
stating whether each of the 26 subjects using the disc experienced the
taste of acid during the night. e yes/no data suggest use of logistic
regression with a random eect of subject. e nightly antacid use data
take the form of two clinical phases (baseline and treatment), each
representing 14 nights with computation of the mean number of
antacids used. is suggests the use of a matched-pair T-test.
Results
ree hundred seventy-one individuals responded to the solicitation
for participation in the study. Baseline data for the above variables was
collected from a total of 119 subjects who qualied for and consented
to be in the study. Based on the above described inclusion criteria post
baseline, 53 subjects were selected to enter the two week intervention
phase of the study, with 26 randomized to receive the disc and 27 to
receive the gel. Forty-two qualifying subjects did not complete the rst
phase of the study.
Eight subjects did not qualify for the second phase of the study,
while sixteen subjects were terminated from the study either because
they did not comply with daily reporting or because someone in the
household had already been in the study. Subjects in the two nal
intervention groups were not signicantly dierent when compared on
the basis of gender, age, or prior medical diagnosis of reux. Mean age
for the disc group was 46.1 (SD 12.1) and for the gel group was 41.3
(SD 13.4).
Heartburn
Subjects using the discs demonstrated a signicant reduction in
reported pain of heartburn when compared with baseline (one sided
U-test p-value <0.001). Subjects using the gel also experienced a
signicant reduction in pain when compared to baseline (U-test p-
intervention demonstrates signicantly greater improvement in
heartburn pain than gel intervention (U-test p-value <0.01) (Figure 1).
Reux severity
Subjects using the disc intervention reported a signicant reduction
in reux severity when compared with baseline (one sided U-test p-
value <0.001) (Figure 2).
Subjects using the gel also experienced a signicant reduction in
reux severity when compared to baseline values (U-test p-value
<0.001). When the performance between the disc and gel treatments is
compared, a statistically signicant dierence is not observed (U-test
p>0.13).
Figure 1: Comparison of the Disc and Gel under the conditions No
Treatment and Treatment for Heartburn. e Y axis is the number
of nights reported; the X axis is the reported severity level.
Figure 2: Comparison of subjects for severity of reux taste; the Y
axis is the mean number of nights with the reported severity level
without disc treatment and with disc treatment.
Using logistic regression with a random eect of subject, the disc
treatment had a statistically signicant (p <0.001) eect on taste of
acid, with an 81% reduction in the odds of reporting taste of acid.
For the gel treatment, we also observed a statistically signicant (p
<0.001) eect on acid taste, with an 82% reduction in the odds of
reporting taste of acid. When we test for a dierence between the two
treatments, the dierence is not statistically signicant (p=0.71)
(Figure 3).
Hoarseness
Using logistic regression with a random eect of subject, the disc
treatment had a statistically signicant (p<0.001) eect on reduced
hoarseness, with an 87% reduction in the odds of reporting hoarseness.
Citation: Burgess JA, Der Ven PV, Karcher MK (2017) Effect on Acid Reflux Symptoms Occurring during Sleep of an Oral Adhering Disc
Containing only Food Ingredients. J Gastrointest Dig Syst 7: 524. doi:10.4172/2161-069X.1000524
Page 4 of 7
J Gastrointest Dig Syst, an open access journal
ISSN:2161-069X
Volume 7 • Issue 4 • 1000524
value <0.001). When these two remedies are compared via U-test, disc
For the gel treatment, there was a statistically signicant (p <0.001)
eect with a 92% reduction in the odds of reporting hoarseness. e
dierence between the two treatments was not statistically signicant
(p=0.41) (Figure 3).
Antacid use
Using a matched-pairs T-test, for the disc treatment, a mean of 60%
fewer antacids were used compared to baseline (average 11 fewer used
in 14 days, with standard deviation 9.8), with a p-value <0.001.
For the gel treatment, an average of 45% fewer antacids were used
(average 11.5 fewer used in 14 days, with standard deviation 17.9),
with p-value <0.001. A T-test comparing the two treatments did not
show a signicant dierence (p=0.89) (Figure 3).
Figure 3: Comparison of antacid usage, nights with the taste of acid,
and mornings with hoarseness in subjects during 14 nights without
treatment and during 14 nights of disc use. Gel data is not presented
here as the results were statistically indistinguishable.
Discussion
e data indicate that nightly use of both discs and gel signicantly
reduces symptoms associated with GERD, including morning
hoarseness, reux acid taste, night time heartburn, and perceived
reux. Subjects who used the discs and gel for two weeks also
demonstrated a signicant reduction in antacid use during the night in
comparison to two weeks of baseline use. e discs were found to be
generally more eective in reducing symptoms than the gel, although
most of the dierences were not statistically signicant. e exception
was heartburn, where improvement was found to be signicantly
better for subjects using the discs than the gel. Signicant side eects
were not reported in either group during product use.
Subjects in the ‘control’ gel group were asked to use what was
assumed would be an ineective remedy. It was thought that the
applied gel would wash out or be swallowed relatively quickly during
the initial hours of sleep, thus providing only a narrow window of
possible eectiveness. e unexpected result demonstrating signicant
reduction in symptoms for both disc and gel users, however, suggests
that both of these products may have the eect of increasing salivation
during sleep. Or alternatively, one or more constituents of the disc or
gel, when swallowed, may have helped to protect the esophageal lining
from acid irritation. Hence, rather than being an inert control, the gel,
like the disc, appeared to function as an active agent.
As with any type of questionnaire methodology, reliance on subject
memory of events can be problematic and the reliability of daily
responses, in the absence of corroboration by direct measurement may
be questioned. However, studies assessing questionnaire methodology
suggest that memory issues may be lessened by regularly providing
questions that are repeated in the exact same order and wording which
was the approach used in this study [56]. Further, the specic
questions used to assess the presence of symptoms were based on other
previously validated self-reported questionnaires assessing potential
GERD [57-60].
Subjects accepted into the study were not asked to discontinue any
previously prescribed medication for reux or heartburn during their
participation. ey were instructed that the disc or the gel were to be
taken in conjunction with any other prescribed treatment. Our study
protocol did not include a detailing by each subject of additional
prescribed treatments (including the use of medication) during gel or
disc use, hence it remains unknown if these additional prescribed
interventions may have confounded or altered the ndings. However,
the use of any additional prescribed treatments by any subject was the
same during the baseline and treatment phases, and the tested
treatment showed a signicant eect beyond any eect of the
additional prescribed treatments.
Conclusions
is study suggests that two available OTC products used to
manage dry mouth during sleep may provide an eective adjunctive
remedy for reducing reux and heartburn symptoms in patients with
concomitant xerostomia. e discs and the gel were well tolerated and
not associated with adverse reactions during use. Further, the data
appear to support the hypothesis that an increase in salivation during
sleep may be the reason for symptom reduction. However, more
research is needed to conrm the mechanisms responsible for the
therapeutic eects identied in the study.
e ndings of this study are novel and potentially medically
relevant for physicians treating GERD. And they are encouraging with
respect to future research. Individuals who have dry mouth and
experience symptoms of GERD during sleep may nd benet in using
an OTC dry mouth product such as OraCoat XyliMelts.
Acknowledgements
e authors wish to thank OraHealth Corporation for providing the
OraCoat XyliMelts discs and for coordinating the blinded distribution
of the gel and disc products to subjects.
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Citation: Burgess JA, Der Ven PV, Karcher MK (2017) Effect on Acid Reflux Symptoms Occurring during Sleep of an Oral Adhering Disc
Containing only Food Ingredients. J Gastrointest Dig Syst 7: 524. doi:10.4172/2161-069X.1000524
Page 5 of 7
J Gastrointest Dig Syst, an open access journal
ISSN:2161-069X
Volume 7 • Issue 4 • 1000524
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Citation: Burgess JA, Der Ven PV, Karcher MK (2017) Effect on Acid Reflux Symptoms Occurring during Sleep of an Oral Adhering Disc
Containing only Food Ingredients. J Gastrointest Dig Syst 7: 524. doi:10.4172/2161-069X.1000524
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ISSN:2161-069X
Volume 7 • Issue 4 • 1000524
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Citation: Burgess JA, Der Ven PV, Karcher MK (2017) Effect on Acid Reflux Symptoms Occurring during Sleep of an Oral Adhering Disc
Containing only Food Ingredients. J Gastrointest Dig Syst 7: 524. doi:10.4172/2161-069X.1000524
Page 7 of 7
J Gastrointest Dig Syst, an open access journal
ISSN:2161-069X
Volume 7 • Issue 4 • 1000524
